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Message on Patient Answering Machine OK? / OBS Clarification

February 11, 2014
Question:

Jennifer,

Can our practice leave a message for a patient on their home answering machine even if we do not have written permission from the patient?

Thanks, G

Answer:

Yes, the practice may leave a message on a patient's answering machine, even if it is known or  unknown whether it is shared. The Office for Civil Rights has opined on this scenario and explicitly approved.  Click here to view.   Presumably the patient's phone number was provided by the patient; all patient contact information should be obtained in a Consent to contact the patient so you have explicit written permission to communicate with the patient at that number (or email).  I recommend reviewing our available consent forms for anyone who does not have on file. 

Remember - stick to the minimum necessary rule - only disclose the minimum necessary information on the patient's machine. 

Clarification on OBS space renting - Must be accredited!

Question:

Jennifer

I read your answer re OBS and renting space and have a problem with your answer -

From my understanding if two or even three physicians are in solo practice and they rent space together and they are both part of the OBS certification through AAAASF or the other agencies and follow all of the rules, then they can practice out of the same OBS.

anyone who operates in my AAAASF certified OBS center is credentialed , and follows the rules -- even though we are not partners or part of a group practice  -- I found your answer confusing -- even the DOH web site is not very clear. But the certifying agencies require all operating physicians to follow the rules - and the DOH has allowed the three certifying agencies to make the basic rules. Obviously any MD operating needs to follow the reporting requirements.

Dr. R

Answer:
Dr. R, Thank you for requesting the clarification.  I agree any practice that is accredited by an authorized accrediting body at the facility location may render services.  My answer did not flesh out or make specific reference to those diligent practices taking the time (and incurring the expense) to accredit a licensee or subtenant appropriately and that complies with the DOH requirements - 
 

Physicians or non-physician licensed health care practitioners may not perform OBS unless they are part of the practice as noted above or affiliated with the practice as employees of the OBS practice or working under a contractual arrangement with the OBS practice to perform procedural and/or sedation/anesthesia services, as applicable.

The contractual agreement must spell out the terms of the affiliation between the accredited OBS practice and the affiliated physician or non-physician health care provider(s) and at a minimum require the following:

From last week -


Question:

Jennifer,

I am aware in NY I need to perform certain services at a hospital, article 28 or OBS facility that require anesthesia.  A friend owns an OBS and offered to let me rent.  Is that kosher?

Thanks, Dr. L

Answer:

Nope.  This exact question is directly addressed by the department of health on its website  - http://www.health.ny.gov/professionals/office-based_surgery/obs_faq.htm - which is worth reviewing if you own, operate or are considering owning or operating an OBS, because the FAQs have been significantly revamped.  The full answer to today's question is below, copied from the DOH website -

33. Are physicians who are not part of or affiliated with an accredited OBS practice permitted to use the physical office space of the accredited OBS practice to perform procedures or provide anesthesia services?

No. Only those practitioners who are part of the practice, as defined below, may perform procedures or provide anesthesia services in an accredited OBS office.

State Education Law prohibiting the corporate practice of the professions in NYS only allows private physician practices to be legally structured as one of the following: a sole practitioner; professional corporation (all of the shareholders, officers and directors must be physicians); professional limited liability company (all of the members and managers must be physicians); or university faculty practice corporation (all of the officers and directors must be physicians); general partnership (all of the partners must be physicians); or registered limited liability partnership (all of the partners must be physicians).

Physicians or non-physician licensed health care practitioners may not perform OBS unless they are part of the practice as noted above or affiliated with the practice as employees of the OBS practice or working under a contractual arrangement with the OBS practice to perform procedural and/or sedation/anesthesia services, as applicable.

The contractual agreement must spell out the terms of the affiliation between the accredited OBS practice and the affiliated physician or non-physician health care provider(s) and at a minimum require the following:

The accrediting agency of the OBS practice must be made aware of all OBS practice affiliations and credentialed/privileged practitioners.

Physicians/licensed practitioners who are not part of or affiliated with an accredited OBS practice may not perform procedures or provide anesthesia services in an accredited setting on their own behalf simply because they have entered into arrangements such as real estate leases that allow them to use space in an accredited OBS setting.

10 NYCRR § 600.8 provides detail regarding when a private practice must become licensed as an Article 28 health care facility. If a practice is "sharing" their accredited space with a physician or other licensed practitioner, then the practice should be careful to ensure that it is not subject to enforcement action as a scofflaw Article 28 facility.


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