Hospital Replaces Anesthesiology Group After Health Insurance Contract Dispute
El Camino Hospital in Mountain View on Monday replaced Northern California Anesthesia Associates, a 19-member physician group, with a new group of anesthesiologists because of a disagreement with NCAA over health insurance contracts, the San Jose Mercury News reports. El Camino officials say NCAA physicians initiated the disagreement by saying they would refuse to provide anesthesia for elective surgeries.
However, the physician group says hospital officials tried to require it to sign the same health insurance contracts as the hospital. NCAA says the contracts' reimbursement rates do not cover the cost of care. As a result, the physician group has set its own rates and billed patients for the amount not covered by their health insurance.
Hospital spokesperson Judy Twitchell said that El Camino has received "numerous complaints" from patients regarding the doctors' billing practices. The anesthesiologists say they have received only one patient complaint.
El Camino officials gave the doctors until Friday to provide services at the contract rates, but they refused to do so, according to the Mercury News. NCAA doctors said they would perform only emergency anesthesiology after Friday's deadline.
NCAA spokesperson Noah Griffin said the doctors expected to work alongside a new group of anesthesiologists while negotiations continued, adding that the physician group had not anticipated being escorted from the hospital by security and local police officers.
Dr. Paul Goehner, an NCAA anesthesiologist, said the doctors feel that El Camino CEO Lee Domanico acted inappropriately when he asked to see the anesthesiologists' billing records and tried to become involved in patient care issues and the doctors' financial performance.
El Camino board member Wes Alles said the hospital wanted a greater role in how the doctors bill patients and generally operate, according to the Mercury News (Koury/Walker, San Jose Mercury News, 11/23).
Twitchell said, "It's about business principles and how we want to operate the hospital." She added that the hospital believed NCAA physicians' rates were higher than rates of other anesthesiology groups in the area (Feder Ostrov/Carroll, San Jose Mercury News, 11/22).
Eight anesthesiologists from Washington Hospital Healthcare System in Fremont on Monday replaced NCAA physicians, after the Washington Hospital physicians "abruptly left" their previous positions, the Mercury News reports.
Nancy Farber, CEO of Washington Healthcare, said, "We were very disappointed with Fremont Anesthesia Consultants for moving forward in this manner, abandoning without notice those patients who were scheduled for surgery and in need of their services."
Some El Camino surgeons postponed or moved operations to other facilities so they would not have to work with a group of anesthesiologists that was unfamiliar with their casework. However, El Camino officials said 13 of the 17 procedures scheduled for Monday were performed as planned (San Jose Mercury News, 11/23).