Late last year, the emergency department (ED) physician practice management company NES Health ceased operations, leaving hundreds of physicians and advanced practitioners at 35 hospitals nationwide scrambling.¹ This “difficult decision to wind down and cease operations” left these health care professionals uncertain if they will ever get paid for up to 2.5 months of work already performed, wondering who they would be working for next, and whether they would still have essential malpractice liability “tail” coverage.

In 2023 there were bankruptcies of two private equity-based ED companies, Envision Healthcare, which has since emerged from bankruptcy protection and continues to operate, and American Physician Partners, which closed that same year. In this new case, NES Health, based in Tiburon, Calif., was founded and owned by radiation oncologist Allan Rappaport, MD, JD. A September 2, 2024, blog post at the Emergency Medicine Workforce Newsletter listed NES Health as the country’s 14th largest emergency department employer.²

The Timing

In September 2024, NES Health informed its contract physicians by email that their regular monthly payment would be delayed. Another delay in October was attributed to a transition to a new billing company. Then, in a November 22 email shared with ACEP Now, NES Health announced its intention to cease operations.

At press time, the NES Health website noted that the company “has experienced significant financial difficulties,” leaving it with no funding or available cash to pay venders or contractors, or the premiums for its physicians’ medical malpractice coverage.¹ ACEP Now was unable to reach anyone at NES Health for comment.

A December 13 “Dear Colleague” letter from ACEP President Alison Haddock, MD, FACEP, emphasized the College’s commitment to help physicians affected by the NES closure to “find a way forward that works for them.” She stated that “the expectation that emergency physicians would continue to treat patients absent contracted benefits and protections is unreasonable.”³

ACEP has supported its members in a variety of ways, including a November Town Hall webinar discussion for affected physicians to share legal strategies for navigating the disruption.³ ACEP also offered a hardship membership program for clinicians to join the College for free and thereby access resources, including tips for contract signing and a job board, among other tools and resources.⁴

But bigger questions remain: What legal recourse is there for doctors to pursue? How can the specialty prevent this from happening to other physicians at other hospitals?