Until recently, physicians were required by rules of the State Medical Board of Ohio to notify their patients upon termination of services or retirement from practice. As of March 22, 2013, Ohio law requires healthcare entities that employ physicians to provide direct patient care services to notify patients of a physician's employment termination. All patients who received physician services from the physician in the two-year period immediately preceding the date of the employment termination must be notified by the employer. Alternatively, the employer may (1) give the physician a list of the patients treated by the physician during the two-year period, as well as those patients' contact information, and (2) require the physician to send the notice. The notice is required regardless of whether the physician is terminated for or without cause and regardless of which party elects to terminate the employment. The list of covered healthcare entities includes hospitals, professional corporations and associations, nonprofit corporations, limited liability companies, partnerships and health insuring corporations.

Content and Timeframe for Providing Notice

The new law requires the State Medical Board to promulgate regulations implementing the notice requirement. Under the statute, the employer healthcare entity (or physician, if required by the employer) must provide the notice no later than "the date of termination or thirty days after the health care entity has actual knowledge of termination or resignation of the physician, whichever is later." Additionally, the notice must (1) inform the patient that his or her physician will no longer be practicing medicine as an employee of the healthcare entity; (2) provide the patient with the physician's name and contact information (if known by the healthcare entity), unless the healthcare entity has a good faith concern that the physician's conduct or provision of medical care would jeopardize the health and safety of patients; (3) specify the date on which the physician's employment ceased or will cease; (4) provide contact information for an alternative physician or group practice that can provide care to the patient; and (5) provide contact information that enables the patient to obtain information regarding his or her medical records. As of March 20, 2013, the new regulation has not yet been proposed but is likely to replace the current regulation at Rule 4731-27-01. The State Medical Board has invited the public to provide comments in connection with the proposed rulemaking.

Exceptions to the Notice Requirement

The statute contains certain exceptions to the notice requirement. For example, notice will not be required if the physician provided services to a patient on an "episodic basis" (e.g., in an emergency department or at an urgent care center). Similarly, employers of residents, interns and fellows who work in hospitals, health systems and federally qualified health centers as part of their medical education and training also need not provide notice to patients who have received medical services from these individuals.

In Practice

As with most physician separation issues, valid and enforceable employment contracts offer the best means for addressing obligations arising after the end of the employment relationship. Notification to patients in accordance with the new law should be clearly addressed in the employment contract, in addition to provisions discussing ownership of and access to medical records and patient lists and payment for malpractice insurance tail coverage following the termination of employment.