A physician group and physician have filed a lawsuit alleging that West Orange, N.J.-based RWJBarnabas Health enacted anti-competitive policies that effectively bar independent physicians from treating their own patients at RWJB hospitals, according to court documents obtained by Becker’s.
East Orange, N.J.-based Salerno Medical Associates and internist Alexander Salerno, MD, claim that RWJB’s intensive care, observation and call policies convert emergency departments and ICUs into “closed units,” monopolizing patient care under hospital-employed physicians.
Here’s a breakdown of the policies the lawsuit claims are creating the “closed units:”
- ICU policy: Only hospital-employed intensivists may treat patients in ICUs, excluding community physicians from their own patients’ ICU care.
- Observation policy: Patients admitted through emergency departments face a mandatory 48-hour observation period during which only RWJB hospitalists may provide care.
- Call policy: Independent internists with admitting privileges are barred from call coverage, which is now reserved for employed hospitalists.
The complaint says these policies transfer patient control and billing from independent physicians to RWJB-employed physicians, cutting off revenue, undermining long-standing patient relationships and steering all referrals and follow-ups to RWJB’s medical group.
It further claims the policies amount to an “illegal tying arrangement” under antitrust law and describe a self-referral network that allegedly violates the Stark law and New Jersey’s Antitrust Act by requiring hospital-employed physicians to refer patients only within the RWJB system.
“At RWJBarnabas Health, patient safety is our No. 1 priority. Our long-standing process of utilizing on-site hospitalists and interventionalists to provide 24/7 care to hospitalized patients not only increases patient safety, but it also enhances continuity of care and provides the most timely and responsible medical care,” an RWJBarnabas Health spokesperson told Becker’s. “This practice in no way prevents patients from continuing to be cared for by their primary care physicians or other medical specialists. We are confident this matter will be resolved in accordance with the law, and we are fully prepared to defend our actions in court. We remain focused on the provision of excellent care to our patients to ensure the greatest possible outcomes.”
