Author: P Hasselbacher

UofL and KentuckyOne Agree to Extend Their Academic Affiliation Agreement Another Four Months.

Barely within the statutory requirement for a response to an open records request, I received two critical pieces of the new contractual agreements between the University of Louisville and KentuckyOne Health that extend the current terms of their Academic Affiliation Agreement (AAA) and Master Support and Services Agreement (MSSA). These documents define the conditions and financial arrangements between the institutions for another four months with an option for automatic renewals. The extensions give some breathing room to the organizations currently working behind the scenes to determine the future of KentuckyOne’s operations in Louisville and simultaneously protect the ability of UofL to place students and trainees at Jewish Hospital and Fraser Rehabilitation Institute while simultaneously allowing Jewish Hospital (and Sts. Mary & Elizabeth) to maintain their status as a teaching hospital for Medicare purposes.

The AAA extends the financial obligations of KentuckyOne to the University until April 30, 2019 at the existing prorated monthly amount of $1.98 million for a total of an additional $7.92 million. This is a blessing for financially strapped UofL. The attachments to the agreements that I requested were not provided leaving me to assume that the intended ultimate beneficiaries of the continuing financial support remain unchanged. (Previous versions of Attachment-C contain a lot of personnel details so I will not to post a copy here.)

The two agreements referenced above are interlocking and these second amendments reinforce their connection.  Specifically, item 3 of the AAA notes that its Exhibit C is amended by adding the “Second Amendment to Master Support and Services Agreement.”  Linking the documents together makes sense, but I am not exactly sure what that looks like in final print, and I do not understand the reasons for changes in term-lengths of the Agreements.  The major clause in the new MSSA allows the agreements to automatically renew for periods of 10 months (up from the previous 6 months of potential auto-renewal) further deferring any last-minute anxiety for the concerned!  (There are several versions of earlier AAAs in circulation. The new language appears to amend Section 8.1 of the previous first amendment to the AAA by deleting and replacing its second sentence. In the original version of the AAA available to me, Section 8.1 contains only a single sentence! Any confusion is probably only mine and I will clarify later for this record if I can.)

Final Comment.
The extension of the agreements was, as I argue previously, critically important for the integrity of the two institutions. Obligations to students, trainees, and patients alone are manifestly inviolable. I commend KentuckyOne for shouldering its responsibility which will certainly present challenges. Its parent organization, Catholic Health Initiatives (CHI), has been under financial stress for some time and which I suspect has complicated its intended merger with Dignity Health anticipated at the end of this month. The long-sought goal of CHI to sell QualChoise, its poorly performing health insurance division, was recently announced and which may give the corporation some temporary room to maneuver financially.

As desirable as the extensions to the current Agreements are, the can is only being kicked further down the road. I have no information or prediction of what is yet to come. It is not clear that Blue Mountain Capital is currently the only party negotiating with KentuckyOne to buy its Louisville hospitals, or to what extent UofL will succeed in finding the money or a partner to take over (and at what non-financial cost).  We are still wandering in the dark woods without even a trail of breadcrumbs to follow. Not all fairytales end well for their protagonists.

Peter Hasselbacher, MD
Emeritus Professor of Medicine
President, KHPI
January 8, 2019

What Will Louisville’s Medical Landscape Look Like in 2019?

Isn’t it about time that the curtain is raised a little?

As we enter the new year, many anxious folks in Louisville are waiting to learn about the status of a proposed sale of KentuckyOne Health’s Louisville assets, and what that will mean to the University of Louisville and its Health Sciences Center. The University and KentuckyOne had an existing, multiply-extended, Academic Affiliation Agreement that would have expired December 31, 2018. This critically important document and related agreements defined the financial, administrative, educational, and clinical relationships between Jewish Hospital and the University. A valid Affiliation Agreement is essential for Jewish Hospital for Jewish and Sts. Mary & Elizabeth Hospitals to claim the financial bonuses and other advantages of a Medicare teaching hospital. An Academic Affiliation Agreement is equally important for the accreditation of the Medical School if it wishes to continue to train students and residents in Jewish Hospital or document that it has adequate clinical teaching facilities for its family practice and all its specialty programs. These are no small details. Continue reading “What Will Louisville’s Medical Landscape Look Like in 2019?”

University of Kentucky Dental Professor Forced Off Faculty for Criticizing Gov. Bevin’s Medicaid Cuts Gets $620,000 in Court Settlement.

Yes.  But, behind them I suspect is the Emperor.
                                            Paul Atreides, in “Dune.”

More than a year ago I wrote about the capture of the academic process by the Kentucky Governor’s Office where some unnamed individual with clout became “pissed-off” when Dental Professor Dr. Raynor Mullins exercised both his faculty and first-amendment rights to suggest that cutting back on dental and vision services to Medicaid beneficiaries was a bad idea. Everyone involved seemed to know who in Frankfort held the power to intimidate the leadership of our “Flagship University,” but the Governor’s office denied any involvement in the matter.  (We have encountered that scenario before, right here in River City!)  The University rolled over and dismissed Dr. Mullins.

In response, and to both hold the University accountable and presumably to shine a bright light on what actually appended, Dr. Mullins filed a lawsuit against the persons of the Vice President for Administrative and External Affairs and the Dean of the University of Kentucky College of Dentistry.  In my earlier commentary, I opined that perhaps under oath that the truthfulness of the allegations would come out– or not!  It is not clear to me that any such disclosure happened. The University requested of Federal Judge Robert Wier a summary judgement (dismissal) of the case against it which was denied.  As I understand it, before the case was to go to a jury trial, a private settlement was reached without any admission of guilt.  I do not know how much pre-trial discovery was done. Today’s reports in the Lexington Herald and Courier-Journal do not refer to any information from depositions taken under oath.  Often such settlements include clauses of confidentiality that hide embarrassing findings from public view. Is it conceivable that court records might be sealed?  Is it possible that we may never know to whom the UK officials caved?

What is just as disturbing as not ever knowing the identity of the bully is the claim that communication within the University and with the Governor’s office in this matter was conducted using personal e-mails.  The use of personal electronic devises and emails to skirt open-meeting and open-record laws is an emerging threat to the ability of the public to hold its government accountable.

The University of Kentucky does not come off looking good in this matter.  It seemingly admits no guilt at all, but some UK entity now has a 6-figure settlement to pay with legal fees to boot. Dr. Mullins is taken back in to the faculty. Transparency disappears. No one is held accountable. Dr. Mullins may not have achieved all his goals, but in my view, he stood up to the state agency that is the University of Kentucky and won!

Peter Hasselbacher, MD
Emeritus Professor of Medicine,
University of Louisville
Dec 10, 2018

[If anyone has public court documents or other information that might shed light on this sad affair– or for that matter correct any misunderstanding of mine– I hope they will communicate with me confidentially or with the email link found in the side-bar of this website.]

Here is a copy of Judge Wier’s opinion of 9-28-18

Another St. Joseph- London Cardiologist Is Sentenced to Prison.

Could this have been averted early on before this unfortunate result?

Last week, following his conviction last April for medical billing-fraud related to medically unnecessary placement of cardiac pacemakers, Dr. Anis Chalhoub was sentenced to 42 months in prison; required to pay $257,515 restitution to Medicare, Medicaid, and private insurers; and fined an additional $50,000.  Dr. Chaloub’s attorneys had requested a shorter time in prison and perhaps it is possible they will appeal the sentence.

According to the press release from the U.S. Attorney’s Office, an additional term in the sentence was that following release from prison he will remain on probation for a three-year period during which the “court has prohibited him from practicing cardiology during that time.”  I am puzzled about whether a federal court has superior jurisdiction over Kentucky’s Medical Licensure Board for such a restriction on licensure.  If I were the Kentucky Board, I would be embarrassed or angry, or both.  Out of curiosity, I looked today at the Kentucky Board’s website which informs me and potential patients that Dr. Chalhoub still has an active Kentucky medical license with “no actions” or restrictions mentioned. (I confirmed this with a call to the Board.)  Although several physician-referral & rating websites have him affiliated with hospitals in Lousiville and Indiana, I do not know if he is still practicing medicine. Continue reading “Another St. Joseph- London Cardiologist Is Sentenced to Prison.”