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Board opens monthly review after Metro Legal flags expired Meharry agreement
Summary
Metro Legal requested action on an expired Professional Services Agreement (PSA) between Nashville General Hospital and Meharry Medical College; the board authorized a letter and placed the matter on the standing agenda for monthly updates while negotiations continue on a new signed agreement.
At its Jan. 30 meeting the Hospital Authority board discussed a letter from Metro Legal flagging potential vulnerabilities stemming from an expired Professional Services Agreement (PSA) between Nashville General Hospital and Meharry Medical College.
The board was told the PSA has lapsed on paper but both parties have continued to perform under its terms. Dr. Joseph Webb, CEO of Nashville General Hospital, told the board “both parties continue to operate within the guidelines of the PSA” and that the hospital is working with Meharry on a new PSA and an affiliation agreement. Board members said meetings between hospital staff and Meharry began in April and are now scheduled for the second Wednesday of each month.
Legal questions raised in Metro Legal’s communication included references to the federal physician self‑referral law (Stark) and the federal Anti‑Kickback Statute. In public discussion Metro Legal’s counsel did not identify existing violations to the board; hospital leaders described the concerns as prophylactic — seeking updated written terms to avoid future arguments about compliance.
Board members debated whether an expired but practically enforced agreement creates an implied contract; Dr. Webb and other hospital officials said case law supports that continued performance can preserve contractual obligations. The hospital’s explanation noted the prior PSA had been extended multiple times and remained the operating framework until a new signed document is completed.
To respond to Metro Legal and provide ongoing oversight, the board voted to authorize the chair to send a letter that (1) affirmed the board’s concurrence on the need for a current PSA or affiliation agreement, (2) confirmed that meetings to negotiate a new agreement have occurred and are ongoing, and (3) placed the PSA negotiations as a standing agenda item with monthly updates from the CEO. The board also noted that board members may attend negotiation meetings by invitation.
Dr. Webb said drafting a single updated agreement that combines physician‑services terms with an affiliation agreement is underway. He told the board he was “not content” with an unsigned arrangement and said both sides intend to reach a signed agreement.
The board’s action was procedural; no enforcement action or litigation was announced at the meeting.
