Unhealthy Proposal

Two New Mexico doctors have filed a lawsuit against Lovelace Health Systems, charging that the company fired them because they wouldn’t go along with a plan to provide substandard care to state inmates.

Dr. Bradly Jay Keller and Dr. Jolynn Muraida say Lovelace Health System axed them because they refused to provide “telepsychiatry” services to inmates. The telepsychiatry was part of a proposed contract between Lovelace and Wexford Health Sources. Wexford, a private Pennsylvania company, has handled health care for New Mexico state inmates since 2004.

According to the lawsuit, the contract with Wexford would have required the doctors to treat inmates by "seeing them remotely for about five minutes each via a television screen, assessing and evaluating them, and prescribing medication for them."

Lovelace's outpatient behavioral health department, of which Keller was medical director, collectively agreed that the contract called for providing "substandard treatment to patients," the lawsuit says.

According to the lawsuit, the State of New Mexico would have been billed for the telepsychiatry services.

The lawsuit also alleges that the contract was initially proposed because one of Wexford's directors is "a friend" of David Vandewater, president and CEO of Ardent Health Services. Ardent is Lovelace's parent company and based in Nashville, Tenn.

Once the doctors were confronted with the proposed contract last fall, Muraida, herself a former medical director of Lovelace's outpatient behavioral health department, called Ardent's ethics line to complain. Shortly after Muraida and others voiced opposition, the entire department-consisting of approximately 70 employees-was targeted for closure. Vandewater informed Muraida that the department was being closed because of its refusal to participate, the lawsuit says.

Carol Dominguez Shay, attorney for the plaintiffs, sent SFR an Aug. 21 e-mail on the matter:

"We think that the factual allegations in the Complaint about the proposed Wexford contract state the essentials about what the doctors were asked to do-i.e., provide substandard psychiatric care to New Mexicans," Dominguez Shay writes. "As the Wexford contract was proposed to them, the doctors were asked to see inmates with psychiatric problems for about five minutes each. From even a layperson's perspective, this is inadequate on its face and would be merely a façade of treatment." Dominguez Shay says her clients do not wish to comment on the lawsuit.

Susan Wilson, director of public relations for Lovelace, says the company is aware of the lawsuit but cannot comment because of the pending litigation. Wilson confirms that Lovelace decided to “discontinue” its outpatient behavioral department at the end of 2005. She says the decision was made because of changes in how the state provides care to Medicaid recipients, financial difficulties and “some conflicts within the department.”

Calls to Ardent Health Services were not returned.

Via e-mail, Wexford Vice President Elaine Gedman said Wexford had no comment "as we are not a party to the suit and we do not know the detail of the case."

Wexford is not a defendant in the case. But the company has come under fire from former employees for its health care practices.

On Aug. 9, SFR reported that six ex-employees allege that Wexford shirks basic health care for inmates in order to save money [Cover story, Aug. 9: Hard Cell? ].

According to the story, the former Wexford workers also claim that the New Mexico Corrections Department does not sufficiently monitor its multi-million dollar contract with the company. Both Wexford and NMCD deny the charges.

One of the primary allegations levied by the six ex-Wexford employees is that Wexford does not adequately staff the nine New Mexico correctional facilities where it operates. Both a US Justice Department investigation of Wexford's operations in Wyoming during the late 1990s and a 2004 Florida legislative assessment of the company's contract in that state cited staffing as a paramount concern.

Psychiatry services has been a particular problem for Wexford in New Mexico. Last fall, a $35,000 agreement was reached between NMCD and Wexford related to the state's concerns that the company didn't provide enough work hours for full time employees, especially psychiatrists.

According to NMCD spokeswoman Tia Bland, the State Corrections Department has no knowledge of the lawsuit against Lovelace nor of any relationship between Lovelace and Wexford.

"Overall, Wexford is currently doing a satisfactory job meeting staffing and other contract requirements for inmate psychiatric services," Bland wrote to SFR in an Aug. 21 e-mail. "The Corrections Department has a contract monitoring team to ensure accountability."

The lawsuit originally was filed in the Second Judicial District Court in Bernalillo County on June 21. Attorney Dominguez Shay says she expects to hear back from the defendants some time in September.

“The fact that the Lovelace Behavioral Health Department as a whole rejected the proposal is a testament to the professionalism and decency of the providers,” Dominguez Shay writes in her e-mail to SFR. “Because the Department refused to participate in this sham, it was shut down and all of the providers were terminated.”

Santa Fe Reporter