HCA lawyer, former FBI Director candidate, tells AG Stein to quit investigative demand

ASHEVILLE – A high-powered Washington D.C.-based attorney representing HCA Healthcare sent a blistering response to North Carolina Attorney General Josh Stein’s office, objecting to the regulator’s recent demand for documents regarding oncological, emergency and surgical services provided at Mission Hospital.

Alice Fisher, a general counsel at Latham & Watkins, which has offices in 29 cities around the world, submitted the letter to representatives from the Attorney General’s office Nov. 7.

Fisher asserted that Stein’s office improperly used its authority to request 41 sets HCA of documents as it investigates whether the Nashville-based for-profit company violated the commitments it agreed in its 2019 purchase of the Mission Health system.

More: NC Attorney General: HCA Healthcare failed to comply with Mission purchase contract

“Even if the Attorney General now believes that the (agreement to buy Mission Health) has been breached, a potential breach of contract simply is not a valid basis for an investigation by (Stein’s office) pursuant to North Carolina’s consumer protection statute,” Fisher’s letter reads.

Fisher maintains that Mission is currently, and always has been, in compliance with the agreement. She is requesting that the NCAG withdraw the investigative demand.

“Our office strongly disagrees with the assertions HCA has made in its letter, and we will be responding appropriately,” NCAG spokesperson Nazneen Ahmed said in a statement.

Stein, a Democrat, is running for North Carolina governor.

A. Fisher Ltr to S. Moore_11.7.23 by Mitchell Black on Scribd

Prior to joining Latham & Watkins, Fisher worked as assistant attorney general for the criminal division of the U.S. Department of Justice. She also chaired the National Procurement Fraud Task Force. Reuters reported that she was one of the candidates for the director of the Federal Bureau of Investigation in 2017, under President Donald Trump.

Stein’s office followed a request for documents up with a letter to Dogwood Health Trust saying that HCA violated the agreement to purchase the hospital, specifically pertaining to its commitments to maintaining oncological and emergency room services.

Mission Hospital spokesperson Nancy Lindell did not respond to Citizen Times questions beyond Fisher's letter.

Fisher took issue with the timing of the letter, which the NCAG submitted three days after the investigative demand. She wrote that the letter did not have “specificity or support.”

Stein’s office did not answer a Citizen Times question about how specifically Mission is in breach of its emergency services commitment to the purchase agreement. Its office had been sending letters to HCA leadership, threatening that the condition of its oncology services could breach the terms of the contract. The only general cancer doctor employed by HCA, Michael Burke, will finish his work at the hospital Nov. 26.

Fisher wrote that the NCAG’s actions support a one-sided narrative advanced by some of the most vociferous health care providers in the community, pointing to the physicians who signed a letter in support of the care HCA provides.

She wrote that the NCAG’s concern with emergency services was problematic because Stein’s office fought to prevent Mission from receiving a Certificate of Need for an acute care hospital. AdventHealth received certification. Mission appealed. Fisher wrote that the acute care hospital would relieve stress on the emergency department by providing more beds for inpatient beds, which would allow Mission to free-up emergency department beds faster.

The Citizen Times previously reported that patients arriving at Mission Hospital in ambulances can wait hours to receive care, preventing a patient with an emergency from receiving treatment and keeping paramedics from addressing 911 calls. Emergency service leaders and hospital staffers said that an overtaxed emergency department and understaffed hospital keep patients from being treated, admitted and discharged efficiently.

More: County to Mission: 'ER situation unsafe, unsustainable;' new ambulance wait time policy

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Fisher wrote that state law allows the NCAG to file investigative demands under the state’s consumer protection statute. She argues that purchase agreement compliance does not fall under that statute but is a contractual issue.

Fisher ends the letter by noting that Mission reserves the right to challenge the investigative demand in court, as well as take on “any other improper action taken by your office.”

Mitchell Black covers Buncombe County and health care for the Citizen Times. Email him at mblack@citizentimes.com or follow him on Twitter @MitchABlack. Please help support local journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: HCA Healthcare says Josh Stein's investigative demand is improper