St. Louis Heart and Vascular’s Lawsuit Against SSM Health

The St. Louis Heart and Vascular lawsuit against SSM Health was a $50 million case filed in March 2021 after the hospital system revoked the cardiology group’s privileges in favor of an exclusive contract with a different provider. In January 2022, a St. Louis County judge dismissed the suit, ruling that SSM’s actions were authorized by its own hospital bylaws.¹

Why SSM Revoked SLHV’s Privileges

St. Louis Heart and Vascular (SLHV) physicians had held privileges at SSM Health hospitals for nearly 30 years when, in January 2021, SSM notified the practice by letter that it had entered into an exclusive agreement with another cardiology provider covering adult cardiovascular services at its eight St. Louis-area hospitals.²³ The result: more than a dozen SLHV cardiologists would lose their privileges across the SSM system, with clinical privileges set to expire on April 2, 2021.⁴

SSM told the court its decision followed recommendations from an expert panel convened in response to a state report citing “the limited experience of some SLHV cardiologists in treating a rare type of heart attack.” The system described the exclusive contract as intended to “improve care and business practices” and as “well within normal business practice.”⁴³

SLHV founder Dr. Harvey Serota said the practice had offered to stop taking emergency calls for the specific type of heart attack cited in the state report, and that SSM never responded.⁴ SLHV also pointed to language in SSM’s notification letter stating the decision was “not based on any competence or conduct failures.”⁵

What SLHV Claimed in the $50 Million Suit

SLHV filed suit in St. Louis County Circuit Court on March 19, 2021, seeking $50 million in damages, which the practice described as the lifetime economic loss to the group if the revocations stood.⁵³ The complaint asserted four claims:

Breach of contract
Restraint of trade
Interference with business relationships
Lack of due process

⁴

To keep its cardiologists in the hospitals while the case proceeded, SLHV sought a temporary restraining order blocking the April 2, 2021 expiration of privileges. On April 1, the court denied the TRO but granted expedited discovery.³

Dr. Serota called the loss of privileges “economically untenable” and “an existential threat to the practice,” noting that volume at SLHV’s $15 million catheterization lab across from SSM’s DePaul Hospital dropped sharply after the revocation.⁶⁴ SSM responded that the affected physicians could still see patients at other area hospitals and at SLHV’s own ambulatory surgery center.²

The restraint-of-trade count faced a steep legal bar. Antitrust challenges to exclusive hospital contracts require plaintiffs to show harm to competition itself, such as higher prices across a market, rather than harm to one competing group.⁶

How the Case Was Dismissed

In January 2022, St. Louis County Circuit Judge Nellie Ribaudo dismissed the lawsuit. The court found that SSM Health had “substantially complied with its bylaws” and that those bylaws “expressly authorize” termination of clinical privileges when the hospital enters an exclusive provider arrangement. The judge also ruled that the bylaws did not entitle the affected physicians to a hearing before their privileges ended under those circumstances.¹ A separate summary of the ruling characterized SSM’s actions as “perfectly legal.”⁷

The dismissal effectively ended the due process theory at the trial level: under SSM’s bylaws, an exclusive contract was a permitted basis for stripping privileges without the hearing SLHV had argued it was owed.

What Happened After the Ruling

SLHV said at the time of the dismissal that it planned to appeal.⁷ The available record does not confirm the outcome of any appeal.

The practice continued operating. In early 2024, SLHV announced a strategic partnership with Heart and Vascular Partners, which provides operational support and capital to expand services and open additional locations while preserving provider autonomy.⁸ As of early 2026, SLHV operates seven office locations across the St. Louis area, and several of its cardiologists were named to St. Louis Magazine’s 2026 Top Doctors list.⁹

1
Medscape. Judge Dismisses Cardiology Practice Lawsuit Against SSM Health
2
Becker’s ASC Review. Cardiology Group Sues SSM Health for $50M Over Lost Hospital Privileges
3
MedPage Today. Docs Fight Back After Losing Hospital Privileges
4
The Hospitalist. Docs Fight Back After Losing Hospital Privileges
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AMM Communications. St. Louis Heart and Vascular
6
Medscape. Docs Fight Back After Losing Hospital Privileges
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Cardiovascular Business. Judge Dismisses Cardiology Practices $50M Lawsuit
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SLHV. SLHV Embarks Upon New Partnership With Heart Vascular Partners
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SLHV. St. Louis Heart and Vascular