Policies and Procedures for Limited Services Clinics

(A) Each limited services clinic shall develop policies and procedures identifying the limited services the clinic will provide. No limited services clinic may serve as a patient’s primary care provider. No limited services clinic may provide treatment to a patient younger than 18 months old. (B) Each limited services clinic shall develop and utilize clinical practice guidelines for diagnosing and treating patients. Each limited services clinic shall utilize clinical practice guidelines for determining when patient needs are beyond the scope of the services it provides or beyond the scope of practice of its practitioners. (C) Each limited services clinic shall develop policies and procedures specifying its staffing pattern as required by 105 CMR 140.310 through 140.315. (D) Each limited services clinic shall develop policies and procedures for referring patients whose needs exceed the clinic’s services, including those circumstances in which a telephone referral may be appropriate; each limited services clinic shall develop policies and procedures for practitioner consultation on unclear cases. (E) Each limited services clinic shall maintain a roster of primary care practitioners, including community health centers, in the clinic’s geographic area who are currently accepting new patients, and who are willing to accept a referral from the limited services clinic to serve as a primary care provider. (1) The limited services clinic shall provide each patient who does not have a primary care provider with a referral from the list maintained pursuant to 105 CMR 140.1001(E). 140.1001: continued (2) If the purpose of the visit is for a childhood immunization other than the influenza vaccine, the limited services clinic shall counsel the parent or guardian on the importance of establishing and maintaining a relationship with a pediatric or family practice for ongoing medical and well-child care. (3) 105 CMR 140.1001(E)(2) shall not apply to a limited services clinic that is a satellite of, or is otherwise affiliated with, a health care facility licensed pursuant to M.G.L. c. 111, § 51, an accountable care organization or provider organization subject to M.G.L. c. 6D, or other licensed practitioners. (F) Each limited services clinic shall develop policies and procedures designed to identify and limit, if necessary, the number of repeat encounters with individual patients. (1) Each limited services clinic shall develop policies and procedures regarding the referral of such patients to primary care practitioners or other appropriate settings, including community health centers. (2) Each limited services clinic shall develop policies and procedures designed to limit repeat visits for routine childhood immunizations other than the influenza vaccine. (3) In the event the limited services clinic is a satellite of, or is otherwise affiliated with, a health care facility licensed pursuant to M.G.L. c. 111, § 51, an accountable care organization or provider organization subject to M.G.L. c. 6D, or other licensed practitioners, the limited services clinic may develop alternate mechanisms for assuring continuity of care within the system. (4) No limited services clinic may refer a patient to a named non-primary care provider unless the limited services clinic is a satellite of, or is otherwise affiliated with, a health care facility licensed under M.G.L. c. 111, § 51, an accountable care organization or provider organization subject to M.G.L. c. 6D, or other licensed practitioners, and the non-primary care provider practices in the facility or is affiliated with the accountable care organization or provider organization or is otherwise affiliated with the limited services clinic. (G) Each limited services clinic shall provide a copy of the medical record of each visit to the patient at the end of the visit or as soon as available and, with the patient’s consent, provide a facsimile or electronically transmitted copy of the medical record of the visit to the patient’s primary care provider, if any. Such copies or transmissions shall be provided at no charge to the patient. For pediatric immunizations the limited services clinic shall maintain documentation of the transmission. (H) If the limited services clinic is located within a retail location, the clinic shall have policies and procedures ensuring that clinic personnel do not promote the use of services provided by the host retail location. (I) Required Disclosures. (1) The limited services clinic shall prominently post or otherwise disclose a description of the services provided and shall provide a clear written statement informing the patient to seek care from his or her primary care provider or an emergency provider for other complaints or conditions. (2) The limited services clinic may not use false or misleading information in its advertising including, but not limited to, information related to its services, practitioners, or that it may act as a patient’s primary care provider. (3) If a limited services clinic is located within a retail location, the clinic shall prominently post a statement informing the patient he or she may obtain any prescription medications or other recommended supplies at any location and is not required to purchase such supplies from the host retail location. (4) Each limited services clinic providing immunizations shall follow Department guidelines to disclose whether it receives vaccines free of charge through the Massachusetts Immunization Program and notifying patients there may be a difference in cost between immunization services provided at a limited services clinic and a primary care provider’s office. 140.1001: continued (J) No limited services clinic may use any name implying that it may act as the patient’s primary care provider. If a limited services clinic is an affiliate or satellite of a licensed health care facility, the name of the limited services clinic shall be sufficiently different from the parent facility such that members of the public can readily understand that the services offered are more limited in scope from those offered by the parent. (K) Each limited services clinic shall make interpreter services available as appropriate to the population served. Such services may be provided by a telephone interpreting service. (L) If a limited services clinic is located within a retail location that sells tobacco products, the clinic shall prominently post information regarding tobacco usage, the content of which is determined by the Department’s Tobacco Control Program.