Hospital Ethics Bill Planned

By MIKE STANTON Journal Staff Writer

Lt. Gov. Charles J. Fogarty says he wants hospital executives held to higher levels of accountability to prevent, among other things, expense-account abuse.

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PROVIDENCE – iticians outraged by expense-account abuses at Roger Williams Medical Center vowed yesterday to pursue legislation imposing a strict code of ethics on hospital leaders in Rhode Island.

Lt. Gov. Charles J. Fogarty said that he plans to submit legislation to hold executives and directors of Rhode Island hospitals to higher standards of “transparency and accountability.”

Meanwhile, Sen. Elizabeth Roberts, D-Cranston, chair of the Senate Health and Human Services Committee, vowed to hold hearings on the legislation, and she hopes to hear from representatives of Roger Williams.

Fogarty and Roberts were reacting to a story in The Providence Sunday Journal regarding thousands of dollars of inappropriate or “highly questionable” expenses by Robert A. Urciuoli, the president of Roger Williams, including golf trips, family dinners and stays in luxurious hotels such as The Breakers in Palm Beach, Fla.

An internal hospital review in 1998 documented the expenses, and concluded that Urciuoli “may have committed a serious fraud upon the hospital” when he billed $5,998 for an eight-day trip to the Scottsdale Princess Resort in Arizona.

Urciuoli, who acknowledged that there was no health-care conference, conceded that he had made “a bad error in judgment.”

The hospital’s board of directors voted to keep Urciuoli. He repaid $16,000 in expenses, and later agreed to a civil settlement with the Rhode Island attorney general in which he reimbursed the hospital $85,000 that it had paid a Boston law firm for the internal review.

The hospital yesterday released a statement defending its actions that cited several reforms that it adopted as a result of the internal review. Those steps include independent audits of Urciuoli’s expenses and authorization of all his expenses by the chairman of the board and the hospital’s chief financial officer.

“The policies adopted by the board and as a result of the reforms initiated in 1998 have been successful,” the hospital statement said. “There have been no questions of financial misappropriation in nearly 10 years.”

Urciuoli and the hospital are targets of a federal grand jury investigation into Roger Williams’ hiring of former state Sen. John A. Celona as a consultant in 1998.

Last month, the hospital board placed Urciuoli on paid leave pending the outcome of the investigation.

Legislation on the way

Fogarty said that the legislation he plans to introduce will seek to address not only Urciuoli’s actions, but the actions of the board.

“We need to make sure, and the public expects, that our health- care dollars are spent the right way,” said Fogarty. “It’s important that boards be aggressive in their oversight so that we don’t have negative stories like this develop that undermine public confidence in an important health-care institution.

“I’m not here to point the finger of blame at Urciuoli or Roger Williams, but to make sure that this never happens in Rhode Island again.”

Roberts said that it was “discouraging” that the leaders of a nonprofit hospital such as Roger Williams, which delivers health care to the poor, “were not working for the good of the public and the patients they are there to serve.”

Fogarty, who chairs the Rhode Island Long Term Care Coordinating Council, said that he was “astounded when I saw the outrageous list of expenditures” by Urciuoli.

“Unfortunately, as we have seen with Blue Cross in Rhode Island and Enron and WorldCom nationally, some of these higher-ups think that a company is their private domain,” said Fogarty. “One of the biggest outrages is that many Rhode Islanders who are struggling to pay their premiums, or have lost their health insurance, have to read about these expenditures by a nonprofit health-care institution.”

Fogarty and Roberts said that they will model legislation after a 2004 law imposing ethical reforms on Blue Cross & Blue Shield of Rhode Island. That law, prompted by Journal disclosures of ethical controversies involving then-Blue Cross president Ronald Battista, required the board of the state’s largest health insurer to adopt a code of ethics.

Fogarty said that he will also ask state regulators whether new legislation is required to increase financial disclosure requirements on hospitals regarding executive pay and expenses.

Roger Williams said in its statement yesterday that the hospital “is open to any legislative review.” Hospital officials said that they would appear before legislative committees “to outline the extensive steps that the hospital has taken during the past eight years to ensure the highest standard of financial accountability.”

The hospital also noted that it had adopted the recommendations of F. Dennis Saylor, the former federal prosecutor who conducted the 1998 review of Urciuoli’s expenses.

Among the steps to increase board oversight, it said, were hiring a compliance officer and creating a compliance plan, establishing a hot line to receive ethics complaints, and mandating employee training.

The board also abolished the President’s Fund, which Saylor said Urciuoli had used to pay his expenses at local clubs, for his participation in golf tournaments, and for charitable donations.

And the board required that Urciuoli’s expenses be approved by the hospital’s chief financial officer and the chairman of the board. An independent outside auditor conducts annual reviews of Urciuoli’s expenses “to ensure reasonableness/compliance.”

“These reforms included a number of policies that protected the hospital from future abuse,” the hospital statement said.

Kate Coyne-McCoy, a longtime Urciuoli critic who helped lead a coalition of community groups against Roger Williams’s proposed 1997 merger with Columbia/HCA, encouraged the General Assembly to act.

“The unmitigated gall of Urciuoli taking his family on a vacation to Arizona and charging the hospital, when Rhode Islanders were struggling to pay for prescription drugs or treatment for breast cancer, is amazing to me,” she said. “Taking his family to dinner? Give me a break! I have a corporate American Express card in my wallet, and if I ever used it for personal expenses not even approaching the level of what Urciuoli spent, I’d be fired.”

Fogarty’s efforts to impose a stricter code of ethics on hospital directors “should be applauded,” said Coyne-McCoy. “The General Assembly should pass the reforms with great speed. It is time for Rhode Island to make health care for all a top priority.”

mstanton@projo.com/ 401-277-7724