LMH, doctors group close to completing deal for emergency room services
photo by: Ashley Golledge/Journal-World File Photo
LMH Health and the longtime Lawrence-based company that has run the day-to-day operations of the hospital’s emergency department are close to finalizing a contract extension.
Members of the board of trustees for LMH Health were told at a Wednesday meeting that the hospital’s negotiations with Lawrence Emergency Medicine Associates are in their final stages, and a new contract should be signed before Nov. 1.
Earlier this year, LMH Health executives had recommended ending the hospital’s more than 25-year relationship with LEMA. Executives were recommending LMH Health sign a deal with Envision Physician Services, a hedge fund-owned company that has some of its practices questioned on the national level.
After members of the public and hospital’s medical community spoke out against the deal, the LMH board reversed course and directed negotiations begin again with LEMA.
“We can see the tape at the end of the race,” Russ Johnson, president and CEO of LMH Health, told board members. “We maybe haven’t put our chest through it, but we are getting close.”
Board members were told that attorneys for both organizations were reviewing the final documents of the agreement.
Dr. Scott Robinson, founder and president of LEMA, wasn’t immediately available to comment on the negotiations.
Last month, board members were told that one item of negotiations involved the controversial practice of balance billing and whether the contract would prohibit the practice. That refers to a situation where a patient, for instance, goes to LMH’s emergency department and receives one bill from the hospital itself for the services the hospital provided, such as the drugs, supplies and the care provided by nurses, who are employees of the hospital. The patient also will receive a bill for the services provided by the actual doctors or other advance caregivers who are employees of LEMA.
Currently, patients to LMH’s emergency department don’t receive separate bills for those types of services. LMH does all the billing and then pays the LEMA doctors. Under the proposed agreement, LEMA would be responsible for doing its own billing for its own services.
That creates a situation where some insurance companies may consider the LMH hospital in-network, but consider the emergency room doctors employed by LEMA as out-of-network. In those instances, LEMA could “balance bill” the patients in an effort to recover a large part of the money it would have expected to receive had the bill been covered by the patient’s insurance provider.
LMH had taken a hard line against that practice and wanted the contract to prohibit such practices. Robinson previously said he also is opposed to the practice of balance billing but said he want the hospital to agree to make up for shortfalls in payments, if the LEMA is unable to negotiate in-network contracts with certain insurance providers.
In the update to the board, it wasn’t disclosed how that issue was resolved. The Journal-World has asked for more details about that matter, but didn’t immediately receive a response. However, Johnson indicated in his comments to the board that it wasn’t an issue that was expected to delay completion of the deal.
In a separate but related contract, the LMH Health is close to signing an agreement that will create a new contract for hospitalists, which are a type of doctor that does general medical calls for patients that have been admitted to the hospital for overnight stays. Currently, LEMA employs those physicians, but under a new contract those doctors will become employees of LMH.
That contract is expected to be finalized by Oct. 1.
In other news from Wednesday’s meeting:
• Board members were told that the new LMH West facility that opened this week had 400 patients in its first day, 500 patients on its second day, and expects to be at 1,000 patients per day in the near future. The new facility, located near the Sixth Street interchange on the South Lawrence Trafficway, includes a women’s health care center, an orthopedic therapy practice, an outpatient surgery center and several other medical practices.
• Bob Moody was elected to serve as the chair of the LMH Health board of trustees for the next year. Moody, a former Lawrence mayor, takes over for Lawrence banker Cindy Yulich, who finished her second four-year term on the city-appointed board at Wednesday’s meeting.