As most physician practices move towards implementing EHR systems and technologies, medical offices are often prompted to decide whether or not to dispose of old medical records for inactive patients. The question of how long a physician must maintain patient medical records depends on a variety of business and legal factors, as outlined below. For physicians, “when in doubt, throw it out” may not apply. Factors to consider for your practice include:
- Type of practice—A physician must consider the type of their practice as it relates to record retention. In general, the frequency of patient contact may dictate how long to maintain records. For example, specialists who see patients on a less frequent basis, or on a more highly-specialized basis, should maintain records longer than others. If you practice in a specialty where records (although aged) may be relevant to a future course of treatment or diagnosis, err on the side of retention.
- HIPAA– The Health Insurance Portability and Accountability Act’s (HIPAA) administrative simplification rules require covered entities (including those who bill Medicare), to retain records for a period of six years. This period is for six years from the date the record was created, or when it was last in effect, whichever is later. If your practice is a covered entity, this is the minimum length for record retention, even though your state law or third party contracts may require less.
- Insurance and Third Party Payor Agreements—Insurance contracts with third-party payors (including Medicare) may set their own contractual requirements for record retention that differ from state law, or even the applicable statute of limitations. In this case, while state law may mandate one specified timeframe, the insurance contracts may demand a different timeframe. In order to maintain insurance eligibility and to comply with the contract, these timeframes must be complied with.
- Statute of Limitations—The statute of limitation, or the “expiration date” by which a patient must institute a lawsuit (medical malpractice being the most common), will dictate the length of record retention, depending on the type of patient. Practices working with infants or children, such as pediatricians, must maintain their records significantly longer than other specialties. For children, the statute of limitations may be tolled, or “paused,” until the patient reaches adulthood.
- Statutory Requirements—State laws may differ on the required retention period. Thus, if you work in a practice that frequently sees patients residing in various states, compliance with the state law having the longest retention requirement is advised.
- Custodial Agreements—Other contractual arrangements, such as Custodial Agreements, are often used by physicians selling their practice, to transfer to the acquiring healthcare network assuming the responsibility of record maintenance. In this case, the contract may add to the duties of the physician or health network and may mandate yet another retention period.
When in doubt, do not throw out. Err on the side of caution and retain medical records for the longest period based on the factors above. They will be essential in the event of a future dispute or litigation.