San Francisco Marin Medical Society Blog

Medical Board Requests for Patient Records



CMA has received several inquiries regarding physicians who recently received letters from the Medical Board of California (MBC) requesting medical records for patients who died in 2012 and 2013. The physicians were informed that the records were being requested based on investigation of prescribers connected to opioid-related deaths during this time period.

At the July 2017 meeting of the MBC Enforcement Committee, MBC staff reported that in 2015, pursuant to an interagency agreement with the California Department of Public Health (CDPH), it had received information on deaths in 2012 and 2013 related to opioid prescription drugs. Attached is an excerpt from the July 2017 Medical Board Enforcement Committee that provides more detail about the scope of this project.

California law requires the MBC to file an accusation within seven years after the act or omission alleged as the ground for disciplinary action occurred. The MBC cited the statute of limitations as the reason for requesting data back to 2012. The CDPH dataset received by the MBC in 2015, which is based on death certificate information, used a set of codes that CDPH used to identify the underlying cause of death and the contributing cause of death to identify opioid pharmaceutical-related deaths. The data identified 2,692 deaths that met the criteria.

Once the data file was received, the MBC used the Controlled Substance Utilization Review and Evaluation System (CURES) database to identify physicians who were prescribing to the individuals, as well as the attending physician and the physician who certified the death. Once the CURES information was obtained, the reports were sent to expert reviewers who reviewed the data to determine if there may be inappropriate prescribing. MBC stated that the reviews were completed and resulted in 522 cases that the MBC determined would require an investigation due to concerns that the physician may have inappropriately prescribed opioids. The MBC then sent out letters requesting authorization to review medical records to the next of kin identified on the death certificate to the last known address.

Beginning in December 2017, CMA began receiving inquiries from physicians who received letters from the MBC requesting 1) a written summary of care and treatment rendered to the named deceased patient; and 2) a copy of the physician's curriculum vitae. In addition, the letter attaches a declaration stating that the MBC is unable to locate the deceased patient's beneficiary or personal representative and requests that the physician provide certified copies of the deceased patient's medical records. The letter states that the physician must certify on an attached form that the records are a "true copy" and a complete set. The letter provides the physician a date by which to respond with the records, summary, and CV, but also includes a notice that pursuant to Business & Professions Code §2225.5, a "licensee that fails to provide the certified medical records within 15 business days is in violation of the Medical Practice Act and may result in a civil penalty of $1,000 per day for each day that the documents have not been produced."

At this time the MBC is constrained by staffing but intends to continue to obtain death certificate data for subsequent years. Based on the extent to which this project results in disciplinary action, the MBC intends to request additional funding in future years to expand staffing and review the death certificate data for years after 2013.

CMA has concerns with the Medical Board's activity in this area and we are monitoring the issue and reaching out to the Medical Board staff to obtain additional information on this issue.

ACTION REQUESTED: If you receive a letter requesting medical records pursuant to this issue, please contact CMA so we can track the extent to which these letters are impacting our members. Please note that the letters from the Medical Board contain personal health information and as such should not be circulated without redaction. Generally, it is enough for us to know the physician who has been contacted and we don't need to see the letter with the patient's information.

MEMBER RESOURCES: If you require additional information about how to respond to inquiries from the Medical Board, please see the CMA website: http://www.cmanet.org/resources/medical-board-assistance/
 


If you have any questions, please call CMA's member help center, (800) 786-4262 or e-mail legalinfo@cmanet.org.

Yvonne Choong
Vice President
Center of Health Policy
California Medical Association


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