By Stephen C. Fitzer
BCMS CEO/Executive Director
For some physicians it means, "Hooray! I finally have more time for myself." For others, it means, "Oh, no! I was hoping this day would never come." Most physicians feel a little of both, but for every retiring physician it means there are a lot of things to take care of. It's kind of like the old phrase, "they get ya comin' in, and they get ya goin' out."
In past articles, I've discussed preparing for retirement by transitioning a practice to someone else. However, for sole practitioners who don't have another doctor to take over their practice, retirement takes planning, time and expense. Questions needs to be answered, like, "Who's going to take over my medical records? What about all the equipment, drugs and inventory I have in my office? What are the rules about notifying patients? What do I need to tell the Texas Medical Board, insurance companies, Medicare and Medicaid and the DEA? How about wrapping up my personal and corporate tax obligations with
Uncle Sam?
The "Oh, no" reaction starts to come into focus.
Well, there is a lot to talk about on this subject, so please look at the graphics added to this article to help you with the laundry list of items that need to be addressed. Just about everyone you have done business with, every regulatory agency you have registered with and every payor you deal with needs to know about your plans. Employees need to be advised as well. It's time to sit down and start formalizing the list of "to-dos."
1. Notify the necessary
government agencies.
Government agencies need to know when you plan to stop practicing
medicine.
Any correspondence you send to them should be via certified mail, receipt requested. Plan in advance and research everything they want you to do. Unfortunately, you can't just decide to stop practicing medicine today and be out of practice tomorrow. Lead time is required. If you fail to notify the appropriate agencies, there may be civil and financial penalties.
1. Drug Enforcement Administration
10127 Morocco #200
San Antonio, TX 78216
(210) 525-2900
When retiring, notify the DEA in writing and enclose the DEA Controlled Substance Certificate and controlled substance order forms (cross out and write "void" on forms before sending). If changing address (like having things sent to your home instead of the office), send a letter to the DEA six weeks in advance notifying them of the change, along with old and new addresses.
2. Texas Department
of Public Safety
Triplicate Prescription Program
P.O. Box 4087
Austin, TX 78773
(512) 424-2189
If you plan to retire, send DPS a
letter stating your plans, along with the Controlled Substance Registration Certificate. Send triplicate prescription forms to the DPS and keep a copy of triplicate forms for two years.
3. Texas Department
of Public Safety
Controlled Substance Registration
P.O. Box 4087
Austin, TX 78773-0001
(512) 424-2188
Advise DPS of any changes in address, including your full name and DPS number on all correspondence.
4. Texas Medical Board
Registration Division
P.O. Box 2018
Austin, TX 78768-2018
(512) 305-7010
If you are planning to retire, notify the Texas Medical Board of your intentions. Also, check the TMB website for the latest rules on annual registration and for rules on medical records. Their web address is http://www.tmb.state.
2. Notify the BCMS
and TMA.
Send the BCMS membership department information about your intended retirement, including when and how to contact you in the future. Ask them about Life Membership in the Society.
1. Bexar County Medical Society Membership Department
6243 W. IH-10, Suite 600
San Antonio, TX 78201
(210) 301-4371
2. Texas Medical Association
Membership Department
401 W. 15th St.
Austin, TX 78701-1680
(800) 880-1300
3. Take care of final legal and business matters.
1. If you have practiced as a physician under a name other than your own (e.g., "Downtown Clinic"), you should have filed an assumed name certificate with the county clerk. You should contact the county clerk to deactivate this assumed name if you are closing the practice without a buyer but also if someone else is assuming the practice under that name.
2. If you have practiced as a physician in solo practice as a professional association, a lawyer must file "Articles of Dissolution" with the Texas Secretary of State's Office in Austin. In addition, a lawyer or accountant should contact the comptroller of public accounts to pay any annual franchise taxes that may be due.
3. If you and any other physicians have practiced as a professional association and the professional association will continue in existence after the physician's retirement or departure, shares of ownership must be transferred to another physician licensed in Texas. A lawyer should be consulted for this matter.
4. If you and any physicians have been practicing as a partnership (or have had an operating agreement like a partnership to share office space) and the partnership will continue after the physician's retirement or departure, then withdrawing from the partnership or otherwise transferring the partnership interest is necessary. The departing physician should consult a lawyer regarding this matter.
5. If you have operated X-ray and/
or mammography equipment in the office, you hold a license from the Texas Department of Health and must maintain a record of the transfer or disposal of such equipment. You must contact the TDH for information on how to record this transfer or disposal.
Texas Department of Health
Bureau of Radiation Control
1100 W. 49th St.
Austin, TX 78756-3189
(512) 834-6688
4. Notify Medicare
and Medicaid.
Send written notification of retirement or a change of practice address to Medicare and Medicaid. Include the effective date of the retirement or address change. Information may be sent to the following addresses:
MEDICARE:
Trailblazer Health Enterprises, LLC
Provider Services
8330 LBJ Freeway,
Executive Center III
Dallas, TX 75243
(469) 372-2609
MEDICAID:
National Heritage Insurance Co.
Attn: Provider Enrollment Dept.
12545 Riata Vista Circle
Austin, TX 78727-6404
(800) 925-9126 or
(512) 514-3000
CHAMPUS:
Contract Network Providers
(800) 406-2833 and option #5
Standard Medical Providers
(608) 243_ _ _ _ and the numbers that correspond with the beginning letter of physician's last name, as follows:
A-E: 7511
F-L: 7510
M-Q: 7508
R-Z: 7680
Mental Health Providers
(608) 243-7507
5. Notify your insurance carrier and make
necessary adjustments
to coverage.
Advise your professional liability insurance carrier of your change in status. If you have a "claims made" policy, consider purchasing additional insurance to cover claims that may be filed after the coverage lapses (this additional insurance is known as a "tail policy"). If you will be practicing part-time, insurance coverage may still be advisable. (See "TMA Insurance Information for Physicians Who Plan to Retire"). The Texas Medical Liability Trust maintains a liability insurance hotline to assist physicians in determining their insurance needs:
(800) 880-8658. Information on life, health, disability and office overhead coverage is also available to TMA members through the Texas Medical Association Insurance Trust, 401 W. 15th St., Austin, TX 78701-1680; (800) 880-8181.
Much of the information provided above came from a publication by the Texas Medical Association. TMA publishes a booklet entitled "Transitions, Legal Considerations in Closing or Selling a Medical Practice." This publication offers guidance from TMA's Office of General Counsel on the host of areas a physician must consider when making a practice change. It is available to TMA Members for $19
plus tax.
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NOTICE: The Office of the General Counsel of the Texas Medical Association provides this information with the express understanding that 1) no attorney-client relationship exists 2) neither TMA nor
its attorneys are engaged in providing legal advice and 3) that the information is of a general character. You should not rely on this information when dealing with personal legal matters; rather legal advice from retained legal counsel should be sought.
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There is much to ponder and even more to do when closing or transitioning out of a practice. TMA also has consultants available who can help you accomplish this. If you would like someone to do most of the work
for you, call Bridget McPhillips at
TMA (800-880-1300, or email her at
bridget.mcphillips@texmed.org).
