| Maintaining medical records is one of the most | | | | even longer. |
| important functions of a modern medical practice. | | | | Failure to maintain adequate medical records opens |
| Properly maintained records ensure smooth | | | | the door to a variety of consequences including |
| operations of the practice and significantly decrease | | | | refusal of an insurance carrier to defend malpractice |
| malpractice liability or probability of a misconduct | | | | claims, professional misconduct investigation and |
| accusation. This article discusses various issues related | | | | discipline, and criminal prosecution. A practitioner who |
| to proper medical record maintenance by New York | | | | has failed to maintain medical records properly and |
| healthcare practitioners and potential consequences | | | | who submits insurance claims may be charged with |
| of failure to do so. | | | | insurance fraud and other crimes and violations. |
| New York Education Law 6530(32) requires that all | | | | Insurance fraud may occur in many ways, but it is |
| New York practicing physicians and other healthcare | | | | mostly defined by submitting false claims, billing for |
| professionals maintain detailed records for each and | | | | services not performed or for performing |
| single patient. Maintaining proper medical records is a | | | | unnecessary treatment. Poorly maintained medical |
| professional responsibility of a New York doctor or | | | | record that does not account for the evaluation and |
| another practitioner. Very basically, each patient's | | | | treatment of the patient or absent record is the red |
| record must accurately reflect the evaluation and | | | | flag that would suggest some wrongdoing and trigger |
| treatment of the patient. There are two types of | | | | further investigation into the medical practice. |
| information that a medical record may contain. First, it | | | | Obviously, insurance fraud is a criminal act as well as |
| is the actual patient information. Second, it is | | | | professional misconduct. |
| additional information that could not be released with | | | | Under New York law, any New York health care |
| the rest of the medical record. That includes some | | | | professional found guilty of violating the medical |
| types of the physician's personal notes and | | | | record maintenance and disclosure rules may be fined |
| observations, information confidentially disclosed to | | | | up to $2,000 per each violation. If such violation is |
| the physician on condition that it would not be | | | | "willful", the practitioner may be found guilty of a |
| disclosed to anyone including the patient, information | | | | misdemeanor, which is a separate professional |
| that relates to prior treatments by another | | | | misconduct in its own right. There are numerous |
| practitioner if the patient is able to request this | | | | instances of professional discipline taken against New |
| information from the other physician, and certain | | | | York healthcare practitioners' licenses for "failure to |
| information subject to NY Mental Hygiene Law that | | | | maintain accurate medical records" and fraudulent |
| relates to some types of mental health treatments. | | | | activities associated with it. |
| Maintenance and disclosure of New York Psychiatric | | | | One way to prevent medical record related problems |
| medical records is separately controlled by the New | | | | in New York is to consult an experienced New York |
| York Mental Health Law section 33. New York | | | | medical or professional license defense or health law |
| Medicaid providers and hospitals are additionally | | | | attorney or visit one of the seminars given by |
| subject to specific requirements of medical record | | | | insurance carriers. Any medical practice should |
| keeping which are quite extensive. | | | | implement permanent record keeping and release |
| New York demands that medical records be | | | | procedures. |
| maintained for at least six years and in some cases | | | | |