CM Narcisse on medical malpractice defense contracts and costs

In medical malpractice, the executive plan includes additional baseline funding of $4.3 million starting in fiscal 2026,

increasing to $5 million by fiscal 2030 for expenses associated with medical malpractice defense contracts.

Is it correct that H&H contracts with 12, 15 different law firms for medical malpractice defense?

Yes, so the budget just corrects to what the existing use has been.

And the $20 million represents a major decrease from what it historically was before we started working so hard to handle these cases well.

We actually work with 17 firms, and it's because medical malpractice is very specialized.

So you need a different firm if it's an...

orthopedic injury versus a pediatric injury or in an obstetric case.

So what's the total budget for FY 2026 and 2027?

2026 is 21.3 and 27 is 21.4.

Essentially the same.

Does this funding only cover payment to law firms or does it cover payouts and settlement?

Only to lawyers, law firms, it's not the payouts.

So there's other money for the payout?

That is correct.

Are the contracts with these law firms IFPs?

What is the timeline for a contract?

How did H&H choose which firms to contract with?

So contracts are five to six years.

We do bids, but we also pay attention to how responsive the law firm is to us.

And often you can do a better settlement if you're very responsive as opposed to leaving it for a long period of time.

And we also try to make sure that we have the right firms for the right kinds of cases because they're so different.

I'm assuming they are from our city?

Yes, yes, they're 100%.

Okay.

How do you evaluate the slow firms and how often do you, yes, I think you just lead to that six on bid.

Yeah.

You got that already.

In finding savings, did you assess the medical malpractice contract to find efficiencies?

Yes.

Well, the biggest efficiency is that we have our own lawyers, and so that's made a huge difference.

And then we only have to gain help when we need specialty help in an area that is unusual or requires a lot of expert witnesses.

How many medical malpractice suits were filed against H&H in 2025?

How does the number?

compared to the past years, which H&H location or service areas received the most medical malpractice complaint?

So the closeout cases is 450.

Most of the med mal, as you would expect, come from the large hospitals.

The highest number involved the emergency department.

Lowest number come from the long-term care settings.

And about half of the cases we settled before trial.

They're settled before trial?

Yes.

Okay.

That's the goal, actually, because otherwise you just rack up lawyer fees and it's not going to the person.

And many years.

Which H&H?

Okay, got that.

Have you looked into the possibility of hiring in-house counsel instead of relying on outside firms for medical malpractice?

We mostly have in-house.

We only have in-house.

Yeah, yeah.

We only use contracts for the very specific kinds of cases that require that kind of expertise.

Okay.

And they're very good, the inside counsel.

Yeah.