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could also govern record availability upon practice closing. State statutes of limitations, and/or hospital policies
and procedures, can also impact record retention and availability.
Physicians should contact the Medical Board of the state in which they practice as part of their practice closure
strategy. If a physician decides to store medical records with a custodian, patients still have a right to request
access to a copy as per HIPAA, so long as the records are available as per state laws and other agency and
organizational regulations for retention. AHIMA also has a resource with more information on Retention and
Destruction of Health Information that may be useful for physicians to review. While HIPAA protects a patient’s
right to privacy and medical information for up to 50 years after the patient’s death, state laws on the duration
of time that clinicians must retain medical records vary from state to state.
One of the most common access challenges patients face is failure to realize that their physician’s practice
is closing or has closed. Physician practices should make every eort to inform patients of a practice closure
or when a physician ceases to practice medicine with ample time for the patient to obtain a copy of their
medical records.
Ensuring Continuity of Care & Medical Records Coordination
Plans for closing, selling, or retiring from practice and what to do with medical records should begin at practice
start-up. The American Academy of Family Physicians (AAFP) has a resource for physicians starting, selling, and
closing a practice. Its Closing Your Practice Checklist highlights the importance of having a proactive plan for
medical records retention. Physicians must plan for safe, HIPAA-compliant storage of both paper and electronic
medical records, as well as imaging and pathology samples, tissue blocks, and slides, if their oce should close.
State Medical Boards must be notied of anticipated closures. Physicians must conrm how long records need
to be stored as per state and other applicable laws and requirements.
Patients should be notied by a letter at least 60 days (or greater when required by applicable law) in advance
of an upcoming oce closure, where possible. The letter should specify the date of the anticipated closure,
the option to transfer records to another physician, the option to obtain a personal copy, and the contact
information of the appointed custodian overseeing medical records storage. The AMA also recommends that
all physicians who plan to close their practice provide their local post oce with a forwarding address in case a
patient needs to contact them in the future.
Closing practices should encourage patients to either transfer their records to another physician’s oce or to
pick up a copy with instructions on best practices for coordinating one’s care from this juncture. This can be
done via written correspondence and a copy of this letter should be placed in each patient’s chart. Patients who
are diagnosed with high-risk conditions, who are actively undergoing aggressive treatments, or who require
routine follow-ups should have their letters sent with a return receipt request to minimize any disruptions
in care or continuity of care. Every attempt should be made to notify the patient about the oce’s closure
or the physician’s departure from medical practice. Physicians should also consider contacting any specied
emergency contacts, patient advocates, personal representatives, legal guardians, or executors of the estate of
the forthcoming oce closure or cease of medical practice in an attempt to coordinate medical records and
continuity of care.
Physicians should include an Authorization for Use and Disclosure of Health Information letter (AMA Patient
Records Electronic Access Playbook, Appendix C, p. 92) with the notication letter for the patient’s convenience.
If the practice is a Part 2 provider under 42 CFR Part 2, it should also include an Authorization for Substance
Use Disorder Records (AMA Patient Records Electronic Access Playbook, Appendix C, p. 94). The patient may
complete these forms to authorize the transfer of records to another physician or to specify if a patient wishes to
pick up a copy of their records.
It is critically important to notify patients and their carepartners of the oce closure and emphasize the
importance of getting a copy of one’s records while the oce is still open. While the oce is still open, someone
will be available to answer any patient questions, concerns, and provide guidance for any uncertainties on the
next steps. Once the practice closes, patients are left with no point person for assistance. This should be avoided
at all costs.
Patient Access Challenges: Obtaining Medical Records from Closed Practices