Reasonable notice is a component of the process to correctly terminate your relationship with a patient. The goal is to provide your patient with enough time so that they can comfortably find a suitable replacement to take over their medical treatment. If the patient feels rushed or like you’ve turned your back on them, the risk of a patient abandonment lawsuit skyrockets. Patient Abandonment Lawsuits.
So, what is patient abandonment anyway? The definition of patient abandonment on USLegal.com is as follows:
“Withdrawal by a physician from a contractual relationship with a patient without proper notification while the patient still needs treatment.”
Why is Giving Notice Important? Patient Abandonment Lawsuits
Although patient abandonment lawsuits are complicated, similar cases typically contain four common elements. These four common elements can help determine whether a lawsuit is able to be filed. Note that reasonable notice is front and center. The elements include:
- Did you have a physician-patient relationship established? Your provider must have agreed to treat the patient, and the treatment must have been underway.
- Is the patient still in need of medical care? If so, you can’t just end your relationship.
- Did you provide the patient with reasonable notice? You are responsible to provide your patient with enough time and/or resources to find a suitable replacement to take over their treatment.
- Did the patient suffer an injury due to the change? For patient abandonment to be a viable lawsuit, the patient must have suffered an injury as a result of you ending the relationship.
Terminating a patient relationship is delicate. You are basically telling the patient you don’t want them anymore, which can evoke an emotional response (if not done correctly). Whenever emotions are involved, things can go downhill fast. Accordingly, it is essential that you provide your patients with enough time to find a replacement for your services. But how much time is enough?
Determining Reasonable Notice Standards Patient Abandonment Lawsuits
This is where things get complicated.
Unfortunately, there is no federal standard that defines “reasonable notice,” and state requirements vary wildly. Although a handful of states, like Oregon, don’t have reasonable notice requirements at all, most states do have mandates in place. However, this doesn’t mean they provide you with everything you need to protect your practice. For example, Virginia has guidelines, but they don’t actually define the term “reasonable notice” – leaving the determination of how much time to give to protect against a patient abandonment lawsuit up to you.
When you’re faced with making the decision of how much time is reasonable, remember the goal. You want to give your patients enough time to find another healthcare provider to meet their treatment needs – without feeling rushed. So, even if your state only requires 15-days, many legal experts recommend that you consider offering 30. If the patient does end up filing a patient abandonment lawsuit, it is much harder to prove when you’ve provided more time than is typically recommended.
Another place to look for a guidance on “reasonable notice” timelines are in your payer contracts. Although not all payer contracts will spell this out, it’s important that you double check. Failure to comply with payer rules can result in you being in breach of contract and dropped from the plan.
The bottom line is, that reasonable notice standards are maddeningly unclear and are often subject to court interpretation. But there are several things you can do to protect your practice from a patient abandonment lawsuit.
Know Your State Rules Patient Abandonment Lawsuits
Even though every state does not provide clear reasonable notice rules, it’s essential that you know what your state requirements are. Once you know your state’s reasonable notice standards, you should also implement a process to check them annually to identify any changes.
The challenge is that although most states do have laws related to reasonable notice, their terminology, definitions and timelines will most certainly differ. Here are several options that may help you find your state reasonable notice requirements:
- Contact Your State Medical Society: Your state medical society should have access to this information. If not, they can probably offer you a recommendation of where to find the reasonable notice requirements you are looking for. To find your state medical society, the American Medical Association has a free online searchable database.
- State Laws: Another option is to look at your state legislature for state-specific rules on reasonable notice. Some states make it very easy to find what you are looking for, and other states it is quite a chore. Here is a free online resource of state legislatures produced by the National Conference of State Legislatures (NCSL). However, this resource may not be helpful for every state. Here are several general tips to help you find your state’s related regulations by using NCSL’s online free resource:
- Go to the NCSL’s free online resource: State Legislative Websites Directory
- In the left column, select the radio button for the state you want to look up
- In the right column, select the radio button for “home page”
- Click Search
- Your search results may provide you with a variety of links. Choose State Legislature link
- Normally this will take you to a page that provides you with options to put in search terms (i.e. patient abandonment, reasonable notice, physician patient relationship, etc.).
If after trying both of the options above, you still can’t find your state’s reasonable notice rules, try contacting an attorney in your state. You may have to pay for the information, but at least you’ll be compliant.
Although reasonable notice is only one component of the patient termination process, it is important that it is managed correctly. For additional advice on how to protect your practice from a patient abandonment lawsuit during the patient termination process, check out this immediately available online training, Fire Your Patient Without a Costly Abandonment Lawsuit. This training is presented by healthcare attorney, Heidi Kocher, BS, MBA, JD, CHC. During this 60-minute session, you’ll receive practical advice on how to avoid being accused of abandonment when you end a patient relationship. The valuable tactics provided during this training will be immediately available once you reserve your access.
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