Common Issues to Member Physicians

Abandonment of Patients

"Abandonment" occurs when a physician discontinues caring for a patient that the physician has assumed responsibility for and has not been properly relieved of that responsibility.   As a concept in tort law, abandonment is subject to malpractice action, and it is also considered "unprofessional conduct" under the education law.  According to Section 6530(30) of the Education Law, a physician engages in "unprofessional conduct" by abandoning or neglecting a patient who is under and in need of immediate professional care "without making reasonable arrangements for the continuation of such care".  A physician who leaves the employment of a group practice, hospital, clinic or other health care facility "without reasonable notice and under circumstances which seriously impair the delivery of professional care to patients" would also be engaging in unprofessional conduct.

Obligation to Patient - Once entering into a physician-patient relationship, physicians are under an obligation to attend a case as long as the patient is in need of care, unless the physician gives reasonable notice to withdraw from the case or is dismissed by the patient.  This principle applies to both private office and hospital cases.

"Withdrawal" - "Withdrawal" is a means physicians can use to professionally and legally remove themselves from a case.  A physician who wishes to withdraw from a case must give reasonable notice of this decision so that a patient can obtain the services of another physician without suffering adverse medical consequences.  The physician is NOT obligated to give a reason for the withdrawal.

"Reasonable Notice" - This depends on the facts and circumstances of the particular case.  These include the condition of the patient, the size of the community, and the availability of other physicians within that community.  Greater caution should be taken, and more notice given, in cases where a patient is seriously ill or has a medical condition that would make it difficult for the patient to obtain medical treatment elsewhere.

For further information and legal advise contact:

MSSNY Office of General Council
516-488-6100 ext. 320 or 323.

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Disciplinary Issues

Physicians are required by law to report possible misconduct.  Failure to make such a report is in itself misconduct.  The investigation and prosecution of misconduct is the responsibility of the Office or Professional Medical Conduct of the Department of Health, and complaints are treated confidentially.  Final decisions in disciplinary matters are made by the Board of Regents.

To report misconduct or to launch and inquiry contact:

New York State Department of Health
Office of Professional Medical Conduct
433 River Street
Suite 303
Troy, NY  12180
1-800-663-6114

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Licensing Issues:

New York State Education Department
Office of the Professions - State Board for Medicine
Cultural Education Center
Room 3023
Albany, NY 12230
(518) 474-3841 or (518) 474-3841

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Physician's Health

MSSNY's Committee for Physicians Health provides nonjudgmental, nonpunitive intervention for physicians suffering from alcoholism, chemical dependence or mental illness. Its aim is to aid the physician and to protect the public.  MSSNY's premise is that compassionate intervention can save an individual's career and possibly his life. In addition, where appropriate and after successful participation and/or completion of the program, MSSNY may advocate for the physician to the Office of Professional Medical Conduct (OPMC), hospitals or others needing verification of rehabilitation. 

It is not required to report information discovered solely as a result of participation in this committee to the OPMC, and the confidentiality of CPH records is protected by federal and state law.  By law, CPH activities must be reported monthly to IPMS for statistical evaluations. However, physician identities are never revealed.  Reports must be made to OPMC if the physician is presenting an imminent danger to the public, if the physician refuses to seek proper treatment, or if the physician does not respond to treatment. 

For further information, contact MSSNY at the following address:

MSSNY's Committee for Physicians Health
99 Washington Avenue, Suite 1111
Albany, NY  12204
(518) 436-4723

 

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Professional Liability Insurance

Before selecting a policy, you should make sure you understand the future implications and costs associated with varying forms of liability insurance (e.g. "claims -made" vs "occurrence").  Several companies currently offer medical liability insurance in New York State.  The Medical Liability Mutual Insurance Company (MLMIC) is the physician-owned company that was formed by MSSNY in 1975.  It insures over 14,000 physicians.

For further information, please contact:

MLMIC
90 Merrick Avenue
East Meadow, NY  11554
(516) 794-7200
or visit their website at: www.mlmic.com

 

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Worker's Compensation

Except in emergencies, only physicians with authorization and assigned Worker's Compensation ratings may treat patients with work-related injuries or illnesses.  Any physician may sign disability claim forms.

Ratings and claim forms may be obtained from:

Nassau County Medical Society
Adrienne Morvillo
(516) 832-2300 Ext. 20

 

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Medicare

In order to treat Medicare patients, you must have a Medicare Provider identification number.  Effective December 1, 1997, the National Provider Identifier (NPI) has replaced the UPIN and PIN numbers.   The NPI is both a unique identifier and a billing number. 

For physicians treating Nassau County Medicare patients, the Medicare carrier is Empire Blue Cross and Blue Shield.  For any questions on Medicare contact the Provider Inquiry staff at (631) 244-5151 or visit their website at www.empiremedicare.com.

For physicians treating Medicare residents of Queens contact:

GHI Medicare
(212)-721-1218

 

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Medical Records

According to Section 6530 (32) of the Education Law, physicians in New York State, unless otherwise provided by law, must retain all patient records for at least six years from the last date of treatment.  Medical records relating to the treatment of minors should be retained for al least six years or until the minor reaches 19 years of age, whichever time period is longer.  Obstetric records for minors should be retained until the minor reaches 19 years of age.  Any intention violation of this section of the Education Law may constitute grounds for disciplinary proceedings. 

For further information contact:

MSSNY Office of General Council
(516) 488-6100 ext. 320 or 323

	Is a physician required by law to allow a patient access to his or her medical records?
	Yes. The Public Health Law Section 18 requires a physician to provide a "qualified person" an opportunity to inspect "Patient information" within 10 days of a written request.  In most cases the "qualified person" will only request from the physician a copy of medical records.

	What is meant by the term "qualified person"?
	"Qualified person," as defined in Section 18 means: · a properly identified "subject" (an individual about whom "patient information" is maintained or possessed by a physician);  · a committee for an incompetent person appointed under Article 78 of the Mental Hygiene law;  · a parent of an "infant" (defined by law as a person under 18 years of age), or guardian of a person under 18 appointed under Article 17 of the Surrogate's Court Procedure Act, or other legally appointed guardian, who may be entitled by law to request access to a clinical record; · or an attorney representing or acting on behalf of the subject or the subject's estate.

	What is meant by the term "patient information"?
	"Patient information" refers to any information concerning or relating to the examination or treatment of the patient maintained or possessed by a health care practitioner who has treated or is treating the subject. As a result of a 1990 amendment, "patient information" also encompasses "health assessments" done for insurance and employment purposes.

	Can the physician charge for the copying of medical records?
	Yes. According to the law as amended in 1991, the physician may impose a reasonable charge for all inspections and copies, not exceeding the costs incurred by the physician.  However, the reasonable charge for paper copies will not exceed 75 cents per page.  Under the law, a qualified person will not be denied access to patient information solely because of inability to pay.

	If a patient request in writing that copies of medical records be forwarded to his or her attorney, does the 75 cents per page limitation apply?
	Yes.  A 1992 amendment to Public Health Law Section 18 expressly provides that an attorney representing the subject or the subject's estate is entitled to receive a copy of the medical records at a charge not to exceed 75 cents per page. Before forwarding the records to the attorney, the physician should obtain a signed statement form the patient identifying the patient's attorney. If the patient is deceased, the statement must come for the executor or next of kin of the patient

	Under what circumstances can a physician either withhold certain information or deny access altogether?
	The physician may deny access to all or a part of the information and instead grant access to a prepared summary of the information if, after consideration of all the attendant facts and circumstances, the physician determines that:  · The information can reasonably be expected to cause substantial and identifiable harm to the subject or others; · the material requested comprises personal notes and observations; · the information requested would have detrimental effect on the physician's professional relationship with, or on the care or treatment of, a minor.  A practitioner denying accessibility must provide the qualified person with the reasons for the denial using a form obtained from the Health Department.   This summary is intended as general information only and is not intended as legal advice. Additional information about medical record accessibility can be obtained from the New York State Department of Health at 518-474-7354.