Nine bidders have expressed interest in taking over physician services in its emergency rooms, Jackson Health System announced Tuesday.

In the first step of a process that has been heavily criticized by Jackson’s unions and some county commissioners, the lowest bid for the main contract — services for adults at Jackson Memorial Hospital — came from Paragon Health, a Fort Lauderdale company, which said it could supply physician services for three years for $20.4 million.

By far the highest bid came from the University of Miami Miller School of Medicine, which said it would provide adult services for $55.5 million for three years.

Some Jackson board members have noted that UM might have an advantage in the bidding process because a state law gives sovereign immunity to its doctors practicing at Jackson, meaning any malpractice judgments against them are likely to be far lower than those against other non-Jackson doctors.

Jackson spokesman Matthew Pinzur said the UM bid had been rejected because it did not properly follow the specifications in Jackson’s request for proposals.

Another Jackson spokesman, Edwin O’Dell, noted that the bids were preliminary. Because of a board motion, management won’t take further steps before January “unless labor and management come to an agreement sooner.”

Managers and union workers have been discussing ways to make the emergency room operations more efficient.

The bidding process at Jackson generally involves several steps, with an independent selection panel scoring the quality of services proposed under the bids, followed by negotiations with finalists to determine the best price and services.

Some political leaders and SEIU Local 1991, which represents Jackson’s ER physicians and other healthcare professionals, have complained vociferously that the move to outsource ER physician services is the first step in an attempt to privatize the public hospital system, which receives more than $300 million annually in sales and property tax revenue.

On the Miami-Dade County Commission agenda Thursday is a proposal from Commissioner Barbara Jordan concerning commission involvement in Jackson’s out-sourcing attempts.

Other companies that submitted bids are EmCare of Clearwater; Apollo MD of Fort Lauderdale; Sheridan Emergency Medicine Services of Sunrise; the Schumacher Group from Lafayette, La.; EdCare Management of Hollywood; Oracle Staffing Solutions of Key West, and Maxim Physician Resources of Dallas.

All entities except UM and Oracle submitted separate bids for ER services for adults and children at Jackson Memorial, Jackson South and Jackson North. UM submitted bids only for services at Jackson Memorial. Oracle offered proposals only for Jackson South.

The Herald obtained the bid documents in response to a public records request.