NC Attorney General reprimands HCA/Mission Health for providing inadequate cancer services
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ASHEVILLE – The office of North Carolina Attorney General Josh Stein sent a letter to the president of HCA Healthcare's North Carolina division, Greg Lowe, sounding the alarm on HCA’s oncology services in Western North Carolina.
HCA, a Nashville-based for-profit company, bought Asheville's Mission Health in 2019. Stein, who approved the 2019 sale, is also a candidate for governor.
The Sept. 29 letter, sent by Assistant General Counsel Llogan Walters, questions whether HCA is complying with the terms of the $1.5 billion agreement to buy the former nonprofit system by failing to provide adequate oncology services in the region.
“The people of western North Carolina deserve access to high quality cancer care in their own community, not several hours away from their families and support systems,” Walters wrote. “That is why the Attorney General conditioned his approval of HCA’s acquisition of Mission Health System on HCA’s commitment to continue providing oncology services in the area.”
The letter points at the decision made by Messino Cancer Center, a Western North Carolina-based medical oncology provider, to stop providing inpatient complex hematology treatment at Mission Hospital for adults with leukemia or lymphoma.
Martin Palmeri, who leads Messino’s cancer treatment at Mission entities clarified to the Citizen Times that this stoppage only included central nervous system lymphoma. Medical oncologists are primary care physicians for cancer patients.
"Regarding our feelings on hematologic malignancies at Mission and providing of care for acute leukemias and primary CNS lymphomas, I would echo those concerns and they were accurately reflected in the letter there," Palmeri told the Citizen Times Sept. 29.
Stein Sept 29 Letter by Mitchell Black on Scribd
Physicians at the center made the decision to stop providing the service because “HCA failed to provide adequate staffing and resources to support acute hematology chemotherapy treatment,” the letter read. “As a result, western North Carolinians with one of the most severe forms of cancer must now travel to Charlotte, the Research Triangle Park area, or out of state to receive lifesaving treatment.”
The Citizen Times first reported Sept. 21 that GenesisCare Surgical Specialists, a group of specialized surgical oncologists who physicians say provide the plurality of specific cancer surgeries in the region, were fired following a bankruptcy filing from its private equity backed management company. Stein’s office wrote that the “loss of GenesisCare’s oncologists leaves Mission Hospital’s oncology practice further understaffed.”
While the physicians set up a new practice, some patients who need specialized cancer surgeries will need to travel long distances to get the procedures they need, such as Duke University Medical Center, about three-and-a-half hours away in Durham.
“Forcing the most acute cancer patients to travel hundreds of miles to receive care is plainly inconsistent with that commitment,” the letter read, referring to HCA’s commitment to provide cancer care in the region.
"As evidenced by the recent decision by GenesisCare to file for bankruptcy, a development noted in Attorney General Stein’s letter, there are broad and significant challenges that area oncology providers face in order to care for patients in western North Carolina," HCA spokesperson Katie Czerwinski said in a Sept. 29 statement. "Ignoring those challenges and attempting to vilify Mission Health is unproductive. At Mission Health, we are proud that, despite those challenges, we are meeting our commitment to provide oncology care to the community while working diligently to add additional oncologists to our team."
The Sept. 29 letter is the latest in a series of correspondences between HCA and the attorney general’s office regarding the company’s local cancer care services dating back to May.
Walters reprimanded Lowe in a June 20 letter for employing a single medical oncologist at Mission Hospital, writing “it is inconceivable that HCA could provide the hundreds of thousands of North Carolinians who reside within this expansive geographic area with the quality of care that they need and deserve using a single oncologist.”
More: 6 Asheville cancer surgeons fired amid corporate private equity-backed bankruptcy
More: HCA executive responds to attorney general over claim of Mission cancer care understaffing
More: NC Attorney General issues warning to HCA for employing only 1 general cancer doctor
Lowe responded July 19, pointing to the number of oncology physicians on Mission’s “medical staff,” a technical term for physicians who have privileges to practice at the hospital. These are not necessarily doctors employed by Mission Hospital. All the doctors at Messino Cancer Center, for example, are members of Mission’s medical staff, according to Palmeri.
In the Sept. 29 letter, Walters asked Lowe to answer six questions regarding hematology treatments and their plans to “ameliorate any negative effects on oncology services” stemming from the GenesisCare firings. Walters requested that Lowe provide responses at his “earlier convenience.”
This story was updated to include HCA's statement and a quote from Martin Palmeri.
Mitchell Black covers Buncombe County and health care for the Citizen Times. Email him at mblack@citizentimes.com or follow him on Twitter @MitchABlack. Please help support local journalism with a subscription to the Citizen Times.
This article originally appeared on Asheville Citizen Times: NC AG reprimands HCA Mission again for inadequate cancer services
