Understanding the Basics of Contract Exclusivity
Exclusivity. Subject to the terms and conditions contained herein, the Corporation shall have the exclusive right to provide all professional radiological services required by patients and the Medical Staff of Hospital (“Professional Radiology Services”) and the exclusive right to use the Diagnostic Imaging facilities of Hospital to provide professional radiological services to inpatients, outpatients and emergency room patients of Hospital. During the initial and any renewal terms of this Agreement, **** agrees that it shall not contract with, grant privileges to, or permit any other physician or group of physicians, or any other entity to perform Professional Radiology Services at Hospital. The Professional Radiology Services that fall within the exclusivity granted to Corporation are enumerated in Exhibit A.
Notwithstanding the foregoing language in this Agreement, the following radiological services may continue to be performed by both Corporation physicians and other properly credentialed non-radiologist physicians who currently have and exercise privileges to perform such services as of the effective date of this Agreement, in specially designated services and areas outside of the radiology department but in ****: ___________________
EXHIBIT A
PROFESSIONAL SERVICES
Exclusive Professional Radiology Services shall mean the full range of those medical services and/or procedures, whether invasive or non-invasive, that involve the use of imaging equipment and/or any technique or modality related to imaging of the body, all related supervision, interpretations, consultations and imaging guided interventional services and/or procedures, and exclusive access to and use of Hospital's equipment, personnel, resources and facilities necessary to perform such medical services and/or procedures, including but not limited to those described below and all those which are or may typically and customarily performed by radiologists as listed in the Radiology (Including Nuclear Medicine and Diagnostic Ultrasound) and the Adjunctive Surgical Procedures Section, of the current edition of the American Medical Association Physician's Current Procedural Terminology ("CPT Codes"):
1. Diagnostic Radiology (Diagnostic Imaging), including Head and Neck; Chest; Spine and Pelvis; Upper Extremities; Lower Extremities; Abdomen; Gastrointestinal Tract; Urinary Tract; Gynecological and Obstetrical; Heart; Aorta and Arteries; Veins and Lymphatics; and Miscellaneous.
2. Diagnostic Ultrasound, including Head and Neck; Chest; Breast, Abdomen and Retroperitoneum; Spinal Canal; Pelvis; Genitalia; Extremities and Joints; Vascular Studies; Ultrasonic Guidance Procedures; and Miscellaneous.
3. Nuclear Medicine, including Diagnostic which includes Endocrine System, Hematopoietic, Reticuloendothelial and Lymphatic System, Gastrointestinal System, Musculoskeletal System, Cardiovascular System, Respiratory System, Nervous System, Genitourinary System and Miscellaneous Studies: Positron Emission Tomography and all therapeutic administration of radionuclides.
4. Interventional Radiology, including diagnosis and therapeutics involving the Aorta, Arteries, and Veins (angiography, angioplasty, arterial and venous stent placement, arthrectomy, stent grafts, thrombolysis, embolization, intraarterial chemotherapy, transcatheter therapy and related or other miscellaneous procedures), Gastrointestinal Tract, Genitourinary Tract, Head and Neck, Chest, Breast, Extremities, Joints, Spine, Abdomen, Gynecological and Pelvis. This includes all interventional diagnostic procedures, biopsies and therapeutics utilizing any form of Medical Imaging (including, but not limited to, CT, Ultrasound, X-ray, Fluoroscopy, Mammography, MRI).
5. Computerized Tomography (CT), including Head and Neck; Chest; Heart, Spine and Pelvis: Upper Extremities; Lower Extremities; Abdomen, Gastrointestinal Tract; Urinary Tract; Gynecological and Obstetrical; Heart; Aorta and Arteries; Veins and Lymphatics; and Miscellaneous.
6. Fluoroscopy, including Head and Neck; Chest; Spine and Pelvis: Upper Extremities; Lower Extremities; Abdomen, Gastrointestinal Tract; Urinary Tract; Gynecological and Obstetrical; Heart; Aorta and Arteries; Veins and Lymphatics; and Miscellaneous, including C-arm Fluoroscopy.
7. Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA) and Magnetic Resonance Spectroscopy, including Head and Neck; Chest; Heart, Spine and Pelvis: Upper Extremities; Lower Extremities; Abdomen, Gastrointestinal Tract; Urinary Tract; Gynecological and Obstetrical; Heart; Aorta and Arteries; Veins and Lymphatics; and Miscellaneous.
8. Any medical services and/or procedures which, due to technological advancement or progress in the state of the art, supplement or replace, in whole or part, any procedures set forth in Paragraphs 1, 2, 3, 4, 5, 6, or 7 of this Appendix A.
9. Any medical services and/or procedures, in addition to those enumerated in Paragraphs 1, 2, 3, 4, 5, 6, or 7 of this Appendix A, which are materially the same as those enumerated, in terms of outcome and result.
10. Any other medical services and/or procedures falling outside the scope of those enumerated in this Appendix which are or may be typically and customarily performed by radiologists or that the American College of Radiology recognizes as falling within the scope of the practice of radiology.
11. Any consultations or interpretations relating to or resulting from the performance of the procedures enumerated in Paragraphs 1, 2, 3, 4, 5, 6, or 7 of this Appendix A.
12. In the event of any questions as to whether a new medical service and/or procedure is to be properly considered Professional Radiology Services for which exclusivity is granted CORPORATION, the parties shall refer the matter to the Medical Staff Credential Committee which shall first determine if such service and/or procedure falls under those listed in the Radiology Section or Adjunctive Surgical Procedures Sections of the current CPT Codes. If it does fall under those listed, said service and/or procedure shall be considered part of Radiology Services. If it does not, the parties shall next consult with and be guided by the American College of Radiology (or a radiologic specialty society, e.g., SCVIR or ASNR) and its formal policies with regards to services/procedures performed by radiologists.
If these methods do not make a finding asto whether said new medical service and/or procedure is customarily performed by physicians specializing in radiology, the final determining factor will be a review of specialists performing said procedure at teaching hospitals in the region.
In determining who should provide or interpret new radiological technologies, modalities, or procedures under such circumstances, the Credential Committee shall also consider data with respect to the need for additional practitioner(s) with privileges to perform the given procedure, including, without limitation, (i) the volume necessary for the practitioner seeking such privileges to also remain proficient; (ii) whether there is sufficient volume to ensure the opportunity for both those already credentialed and the requesting practitioners to remain proficient; and (iii) whether the Hospital has adequate personnel, equipment and facilities to support additional procedures to be performed by the applicant. To the extent that physicians of Corporation are unable to maintain their proficiency to perfom any such procedures because of a diminution in the number of procedures they are able to perform based on additional Medical Staff members outside of Corporation who are credentialed to perform the procedures, Corporation physicians may elect to relinquish the privileges to perform such procedures and Corporation will not be required to provide such services on an on-site or on-call basis.
Before granting applicable privileges the Committee shall also review credentialing criteria issued by the American College of Radiology and other relevant radiologic specialty societies, if any, having credentialing criteria relating to such imaging procedures and ascertain the types of criteria applicable to medical specialists who are performing such procedures in other teaching hospitals in the State of Florida. In this connection, the Committee shall also consider criteria such as subspecialty board-certification, fellowship training, and prior substantial experience in performing the requested procedure(s). All practitioners desiring to perform such procedures shall be subject to the uniform, specific credentialing criteria established with respect to such procedures. Only those practitioners for whom the Committee determines (i) there is a need for additional practitioner(s) to perform the perform the requested procedure and (ii) if so, the practitioner(s) meet or exceed the established criteria, shall be considered for privileges with respect to such procedures under the Medical Staff credentialing process.
13. The foregoing services shall be exclusively performed in the Hospital by CORPORATION physicians, except to the extend, and only to the extent, that the following services are currently being performed outside of the radiology department by members of the Medical Staff who presently have and exercise privileges to perform such procedures as of the effective date of this Agreement the services may be performed by those currently privileged individuals on patients otherwise seen in the course of their practice.
a. cardiac catheterization,
b. echocardiography,
c. non-invasive vascular ultrasound.
Corporation’s physicians shall provide the exclusive supervision of the performance and interpretation of the procedures listed in _______.
All physicians who are permitted by the provisions of the foregoing to perform imaging procedures in the Department shall be required by the Hospital to agree and acknowledge in writing that they will abide by the scheduling and other administrative directives reasonably established by Department Medical Director or his designee and that Corporation and its Physicians have no responsibility over the actual performance of clinical procedures by such non-radiologists and that such non-radiologists agree to hold Corporation and its physicians harmless from and against all claims, suits, judgments and liabilities arising out of or in any way related to performance of the procedures by the non-radiologists. All provides performing the foregoing services, including Corporation Physicians, shall be required to bear call responsibility with regard to such procedures in direct proportion to the volume of such services that such providers typically perform. None of the exceptions to the exclusivity of Corporation set forth in this Exhibit A shall be construed in any manner to permit radiologists who are not affiliated with Corporation to obtain privileges to perform any Services in Hospital or any other facility where Corporation has the right to provide Professional Radiology Services in accordance with this Agreement, including without limitation all the facilities falling within the definition of Hospital in Section 1.11 of this Agreement.
Used with copyright permission. Written by Paul J. Voss from The Law Offices of Thomas Reed.
