Internal emails obtained by the ABC15 Investigators show SimonMed, one of the Valley’s largest medical imaging providers, operated unlicensed and unregulated by the state health department for nearly six years after the state rescinded a policy statement that allowed the company to qualify for a special exemption from licensing.
“As far as I know, right now, they [SimonMed] are moving to get licensed at all their facilities," said Tom Salow, assistant director of licensing at the Arizona Department of Health Services.
The changes come following months of reporting by the ABC15 Investigators regarding concerns raised by Valley residents at SimonMed Imaging Centers.
ABC15 also questioned how one licensed physician could provide care at SimonMed’s more than 60 Arizona locations and therefore qualify as a private medical office exempt from health department licensing.
“When we were aware that maybe they met the criteria for licensing. We worked with them to get them into compliance,” Salow said.
Other incidents at SimonMed locations
An ABC15 Investigation in October exposed how an Arizona inmate and prison guard were stuck to an MRI machine in May of 2022 at the SimonMed in Avondale.
Then, an Arizona woman filed a lawsuit after records show she was accidentally injected with the sedative Valium at the Thompson Peak SimonMed Imaging Center in Scottsdale. The patient says it led to a life-threatening overdose during an MRI scan in 2021.
Both incidents raised serious questions about patient safety but were never investigated by the health department because without a license the agency said it doesn’t have the authority to investigate complaints or take enforcement action.
“If you're exempt from licensing, we don't have oversight. We can't. It's not an optional oversight. It's we can't,” Salow said.
Internal emails provide road map
Hundreds of internal emails ABC15 obtained through an open record request detailed telling conversations among top-ranking leaders at AZDHS, and for the first time explained how SimonMed went unregulated by the state health department for years.
The emails go back to 2018 and focus on the state’s decision to grant SimonMed what’s known as a private office exemption from licensing.
It's an exemption health leaders started questioning last summer, according to the emails.
The Bureau Chief of Medical Facilities Licensing wrote in an August 2023 email, “This is why we should be regulating SimonMed. An inmate and guard got stuck in the MRI machine. That’s pure negligence on the part of the tech.”
In another email, the same employee wrote, “I think what you are seeing is the total lack of oversight. These poor patients have essentially been denied their rights and they have had no way to report the facilities.”
“I don’t know about a lack of oversight. I believe at the time we believe that we did not have oversight,” Salow said in response to what his colleague wrote in the emails.
The internal emails show SimonMed filed for a private office exemption six years ago and the state granted the exemption in 2018, which means there has been six years of little oversight.
According to the emails, SimonMed only qualified for the licensing exemption after the health department rescinded a substantive policy statement earlier that same year related to what qualifies as a private office under Arizona law.
The old policy said to be considered a private office, and therefore exempt from health department licensing, a doctor had to “provide patient care at the facility at least eight hours per month.” Which was something SimonMed's sole owner at the time, Dr. Howard John Simon, couldn't do, according to emails.
However, once the state removed the eight-hour-a-month requirement, emails show SimonMed filed for an exemption from licensing at all of its, at the time, nearly 50 facilities.
“It was determined that they met the exemption,” Salow said.
Salow was not a part of the licensing team when SimonMed filed the exemption in 2018, it happened under a previous administration.
But as the health department was trying to figure out why SimonMed wasn’t licensed last year, the Bureau Chief of Medical Facilities Licensing wrote in an August 2023 email, “I do not believe the SimonMed meets the definition of private office, but I understand they may have been involved in getting the SPS taken down,” referring to the policy statement the health department removed in 2018.
“From my understanding, one entity didn't push for it. One entity may have had us reevaluate whether or not we can do that, but ultimately the department decided that they wanted to rescind that, and that the statute is clear enough,” Salow said.
ABC15 asked SimonMed directly if they were involved in getting the substantive policy rescinded, but the company didn’t answer the question.
SimonMed locations licensed in Arizona
Currently, 16 SimonMed locations in Arizona are now licensed with the health department. The agency said that an additional 48 SimonMed Imaging Centers will be licensed with the health department in the next two weeks.
“It gives us oversight. We will inspect the premises on a regular basis,” said Salow. “And if there is a complaint about care provided in those facilities that's under licensing authority, we can investigate.”
SimonMed sent a statement that didn’t address ABC15's reporting but said in part, “Every physician, technologist, and piece of imaging equipment in a SimonMed facility is licensed and regulated. Our facilities and practitioners are subject to numerous licensing and accreditation requirements, with which we comply.”
But up until recently, SimonMed Imaging Centers were not licensed with the state health department.
“We have always had a constructive and cooperative relationship with our regulators and continue to heed their guidance,” SimonMed said in the statement.
