The Board of Medical Examiners and Medical Licensure Commission recently made substantial changes to their joint guidelines for medical record management, beginning with changing them from guidelines to rules. The new rules provide for more specific regulation of the management of medical records by Alabama physicians, including establishing a new minimum time frame for retention and appropriate methods for destruction of records, providing expanded criteria for patient notification when closing or leaving a practice, and detailing the steps for disposition of medical records in a variety of practice departure scenarios.
The previous guidelines recommended physicians retain patient medical records for “such period as may be necessary to treat the patient, and for such additional time as may be required for medical legal purposes,” without establishing a minimum time frame. The new rules provide that physicians must retain patient medical records, with some exceptions, for a minimum of seven years from the physician’s last professional contact with the patient. For records of minors, including immunization records that have not been transmitted to ADPH’s Immunization Registry, the rules require retention for the longer period of seven years from the last professional conduct or two years after the minor reaches the age of majority. Mammograms and reports must be retained for ten years, but x-rays and other imaging may be destroyed after five years if separate written reports exist.
Although the previous guidelines did address retention of records, if not in a detailed manner, they did not address destruction of medical records at all. The new rules list appropriate methods for destruction of records and also require the maintenance of a destruction log.
Recommendations for transfer or disposal of medical records in the previous guidelines included the responsibility of physicians to provide “reasonable notice” to “active patients” when the physician retired or otherwise left a medical practice. However, the guidelines provided no definition or detail for either of those terms. The new rules define “active patients” as any patients treated by a physician at least once in the preceding 36 months. “Notification” is defined as a HIPAA-compliant electronic message or form letter sent U.S. mail to the active patient’s last known address. The “reasonable” qualifier for notification from the previous guidelines has been quantified in the new rules as “no less than 30 days” before a qualifying event like retirement or after the death of a physician.
While the previous guidelines provided the same basic guidance for notification and disposal of records – reasonable notice to active patients – regardless of whether the qualifying event was retirement, termination from employment or otherwise leaving a practice, the new rules provide specifically for notification and disposition of medical records in the following circumstances: (1) Physician death; (2)Physician retirement; (3) License suspension or revocation; (4) Departure from a group; and (5) Sale of a medical practice. The new rules also require physicians to make arrangements for patients to access their records when voluntarily unavailable.
Physician members with questions on the new Board of Medical Examiners and Medical Licensure Commission Joint Rules on Medical Records Management can contact the Association’s Legal Department at 334-954-2540. They can also find all of the requirements of the new rules here: https://www.albme.gov/resources/licensees/medical-records/
1Ala. Admin. Code 540-x-9-.10; Ala. Admin. Code 545-x-4-.08.