Court trustee to watch over Access Medical Group

A former manager of health clinics will observe the quality of medical care at a Lower Hudson Valley medical practice that filed for protection from creditors in U.S. Bankruptcy Court last month.

Joseph J. Tomaino, a member of the board of directors of the parent company of Westchester Medical Center in Valhalla, was named last week by court Trustee Diana G. Adams to serve as patient care ombudsman in the bankruptcy filing of Access Medical Group.

Access Medical Group is headquartered in White Plains and has offices in Westchester and Orange counties. The practice, with more than 80 employees, filed for bankruptcy shortly after an arbitrator awarded $3.6 million to a medical practice management company with whom Access' principal had feuded bitterly in court for the past three years.

As ombudsman, Tomaino will interview patients and doctors at Access to monitor the quality of patient care and will report to the bankruptcy court no later than every two months on his findings. If he finds that patient care is declining significantly, he will notify the court "immediately," according to bankruptcy court papers.

The role of patient care ombudsman was created as part of the 2005 federal bankruptcy reform bill, said Jack Williams, a professor at the Georgia State University College of Law and a resident scholar at the American Bankruptcy Institute.

In addition to doctors' practices, the ombudsman provision also applies to nursing homes, hospitals and other health care businesses that find themselves in bankruptcy court, Williams said.

"The drafters of this provision were pretty wise in developing a system that works across all those entities," Williams said.

Tomaino is a former chief nursing officer and a director at RSM McGladrey Inc., a Manhattan health care consultancy. He will receive $320 an hour plus expenses for his work. He could not be reached for comment this week.

He said in a court filing that he had no relationships that would conflict with his work overseeing Access.

The medical practice's president and majority owner, Dr. Jeffrey M. Ambinder, stated in a court filing that he hopes to reorganize Access as a smaller business. It employs 15 doctors in offices in White Plains, Yorktown, Carmel, Yonkers and New Windsor.

Access' roots date back to 1982 when it was founded as an oncology service by Ambinder and Dr. Marc Straus, court papers said. Access does specialty work in cancer care and diabetes management. It had 55,000 outpatient visits last year, and revenues of $11.6 million.

But the practice lost $1 million in the first seven months of this year, and $3.5 million over 2006 and 2007, Ambinder's affidavit stated. He blamed the business's financial problems on a range of issues, but chiefly on his legal battles with his former partner Straus.

Ambinder, Straus and other doctors formed MDx Medical Management, a business to manage their medical practice, in 1997, court papers said. Last month MDx obtained an arbitration ruling against Access for $3.6 million. MDx is Access' largest unsecured creditor.

In his affidavit, Ambinder said Access' financial problems also included an unprofitable expansion in Westchester and Orange counties, as well as rising prices for malpractice and other costs, and reduced reimbursements.

Ambinder said his new business plan involved consolidating some offices and shedding unprofitable markets. Ambinder could not be reached for comment. His attorney, Joseph M. Gitto of Nixon Peabody in Manhattan, declined comment.

Williams said nine of 10 medical practices in bankruptcy fail in their attempts to reorganize. Among the problems facing such reorganizations are cash flow difficulties resulting from lengthy waits for insurance reimbursements.

Doctors in such straits must have the "ability to negotiate with a panoply of interests, including secured and unsecured creditors," Williams said. "They all have a different view of how this should go down."