Broward Health, the taxpayer-funded health care system that serves Fort Lauderdale and the northern two-thirds of the county, may finally have put an end to the huge legal fees and dysfunction that took money away from medical services for people in need.
By firing one law firm, cutting the fees of another, and voting to hire a new general counsel, Broward Health believes it already has saved the public millions — and it’s just getting started.
“At the board level, we have brought a new, high level of transparency in our legal fees,” said Andrew Klein, chairman of the board of the North Broward Hospital District, which oversees Broward Health.
In October, Broward Health’s board fired its controversial general counsel, Lynn Barrett, who had spent millions of dollars on self-selected outside law firms, hired lawyers charging as much as $1,000 an hour and, according to critics, directed law firms to launch merit-less investigations into her rivals.
In the three years Barrett served as general counsel, Broward Health spent more than $15 million in legal fees with only three outside law firms. In addition, Broward Health gave payments totaling $6.4 million to a separate law firm serving as a government-mandated Independent Review Organization.
“Our legal bills were outrageous,” said Klein, who also is managing attorney of Klein Law Group. “Clearly we didn’t have enough insight into how the money was being spent and what firms were getting paid.”
“Our prior general counsel was not providing — and to some extent resisting — that insight,” he said.
On Wednesday, Broward Health’s board voted to hire a new general counsel, Linda A. Epstein, to oversee the internal legal department and outside law firms. The new general counsel will be tasked with ensuring the hospital system stays in compliance with a federal agreement (known as a Corporate Integrity Agreement ) that allows it to receive Medicaid and Medicare reimbursement. Epstein has a background in healthcare litigation, risk management and medical malpractice defense.
Just prior to the vote for general counsel, Broward Health board member Ray Berry said Epstein’s background is what the hospital district needs at this time. “The most dangerous thing today is for us to be in non-compliance with the Corporate Integrity Agreement because the government can pull our Medicare and Medicaid funds,” he said.
Going forward, the legal department will handle more legal work internally, require a reduced public service rate from its law firms, and have policies to ensure the legal work is well distributed, Klein said.
Along with general counsel, Broward Health has a hired a new law firm to act as its Independent Review Organization until a mandated oversight agreement ends in 2020. When the federal government found ethical problems at Broward Health in 2015, it fined the public hospital system nearly $70 million and required an independent auditor to keep an eye on procedures, policies and operations for five years.
Gino Santorio, the new CEO of Broward Health, says the change in the audit organization will save the hospital district millions of dollars. Records show Baker Donelson, a law firm with roots in Tennessee, charged a total of $6.4 million since 2015 for an average of $1.96 million a year, without providing Broward Health’s board supporting details of the charges. In contrast, the new firm, Meade Roach & Annulis, will get paid about $90,000 total for the remaining 15 months the hospital system is required to be under review.
Baker Donelson did not take its termination well, sending a letter to the Broward Health board claiming the hospital district’s management fired the firm in retaliation for a report it was about to submit. “No material reason exists for the purported termination,” writes J. Scott Newton of Baker Donelson, who did not respond to requests for comment.
Broward Health believes it is justified in the termination, explaining in a letter to the federal government that this change in the review organization is about cost savings and competence. The attorneys assigned to Broward Health at Baker had no prior experience as an IRO, according to Klein, who added that the lack of experience caused Broward Health to file a compliance document late.
The newly hired IRO firm, Meade Roach, works in this role for other hospital systems, too. Steve Ortquist, a partner at Meade Roach, said experience is important in this type of oversight.
“If I were in position of hiring an IRO, I would want someone with experience,” Ortquist said.
Earlier this week, Klein and Santorio met with the Office of Inspector General, which enforces the Corporate Integrity Agreement that places obligations on Broward Health. “They believe we have gotten our compliance house in order, and we are enthusiastic about carrying out our mission to provide health care,” Klein told the board at its meeting on Wednesday.
After several years of problems at the public hospital district, a turnaround appears underway. Significant concerns had included illegal physician kickbacks that led to a federal fine, the suicide of a former CEO, a mass exodus of doctors, bills left unpaid, contracts left unsigned, and accusations of a toxic work environment created by the former general counsel. Over the last six months, Broward Health has brought in a new CEO and executive team, signed pending contracts with vendors, completed building projects and improved morale.
“We are working to ensure the administration is where it needs to be, the board leadership is where it needs to be, and to make sure our focus is on health care,” Klein said.
cgoodman@sunsentinel.com, 954-356-4661, Twitter and Instagram @cindykgoodman