Employee Health Systems Medical Group Reaches Settlement with California Department of Managed Health Care

PASADENA, Calif. (PRWEB) December 02, 2021

Employee Health Systems Medical Group (EHS) reached a settlement with the Department of Managed Healthcare (DMHC).

Court documents allege in late 2017, EHS became embroiled in the SynerMed collapse when the DMHC took the unprecedented step of ordering nine medical groups, including EHS, to discontinue their service contracts over SynerMed's alleged misconduct. Further, the agency ordered health plans to terminate their agreements with EHS.

EHS continued to assert that the allegations against them were a case of collateral damage and sought to reverse the Cease and Desist Order. Under the settlement, the DMHC issued an order directed to the health plans withdrawing and vacating the December 26, 2017, Cease and Desist Order. The parties also agreed to a mutual release and a cash payment by DMHC to EHS. EHS indicated that the funds will be used to support the underserved in Downtown Los Angeles.

EHS' new Board of Directors issued a statement saying, "Setting the record straight with the DMHC became our primary focus over the last 3 years. Historically, EHS was amongst the largest and best-performing medical groups in California. We were determined to revive EHS' network and protect the interests of patients, physicians and our healthcare communities. This settlement enables us to reactivate our contracted relationships with the health plans and do just that."

Recognizing the disproportionate access to quality health care, EHS is taking on the challenge of preserving gains made in these traditionally neglected communities. The IPA is launching an aggressive outreach campaign to appeal to the more than 10,000 physicians in EHS' network and is already in active negotiations with several health plans.

EHS was a major provider of healthcare services to patients primarily through minority-owned medical practices. These populations traditionally rely upon smaller, independent practices to provide much-needed healthcare to their local communities in Northern California, the Central Valley, Inland Empire, Los Angeles and Orange counties. Data estimates show that nearly 90% of EHS members were on California's Medi-Cal program for lower income patients. In light of the recent attacks on Asian Americans, many EHS physicians touted the settlement as a victory for the network that services a large AAPI population.

The EHS Board adds, "With this matter behind us, we are pleased to continue building upon our 30-year foundation. Patients and healthcare providers alike realize the importance of maintaining the integrity and continuity of care to achieve optimal health outcomes."

About Employee Health Systems Medical Group

Founded in 1990, Employee Health Systems Medical Group is an integrated healthcare delivery system focusing on government-sponsored programs, including Medi-Cal/Medicaid, the State Children's Health Insurance Program (SCHIP), Medicare and Dual-Eligibles (Medi-Medi), organized labor and specialty IPAs. Our physician-centric accountable care model promotes growth and sustainability for individual physicians by providing access to a robust offering of products, services and management tools.

For more information on the DMHC's Order to Withdraw and Vacate, please follow this link: https://wpso.dmhc.ca.gov/enfactions/docs/3046/1621353863931.pdf (Enforcement Matter Number: 17-1703)

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