Doctor wins battle over exclusive contracts
State reverses lockout practice
A Los Angeles pediatrician has won a two-year battle allowing neonatologists in his practice to treat hospital patients despite a hospital policy that limited its neonatal intensive care staff to physicians in a competing practice that had an exclusive contract with the facility.
This situation reflects an increasingly common situation facing physicians where local hospitals let contracts guaranteeing certain practices the exclusive right to treat patients in a unit in exchange for them agreeing to manage that department.
In this case, however, a California court and regulators have clarified previous state policy to conclude exclusive contracts outside the hospital-based practices of pathology, radiology, and anesthesiology are illegal in local hospitals that accept state funds. Meanwhile, Burbank’s Providence Saint Joseph Medical Center, the hospital that originally refused to let neonatologists from the practice of Pejman Salimpour, MD, see patients, has reversed its position and opened the staffs of both its neonatal intensive care and cardiac surgery units to outside physicians.
Salimpour’s argument to the both California’s Medicaid agency and the U.S. Department of Health and Human Services’ regional office was simple: All patients have a legal right to choose their physicians. He backed this up by pointing to a California regulation requiring all California hospitals’ Medicaid contracts — except for pathology, radiology, and anesthesiology services — to maintain an open-staffing policy.
After organizing the physician and nursing community to lobby the legislature and the California Medical Assistance Commission (CMAC), the commission issued a statement clarifying that the open-staffing clause in the Medicaid contract applied to all patients, not just those in the state’s Medi-Cal assistance program.
Bottom line: Open-staffing provisions required by California’s Welfare and Institutions Code in state Medicaid contracts "provide plainly and simply that a contracting hospital cannot deny clinical privileges to one physician based upon the existence of a contract with others," CMAC said.
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