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Suit claims ex-state official had rules rewritten to help Steward

Then-health and human services secretary John Polanowicz in 2014.
Then-health and human services secretary John Polanowicz in 2014.Joanne Rathe/Globe Staff/File/Globe Staff

In June 2014, two executives from Steward Health Care System visited John Polanowicz, then the state’s health and human services secretary. They were far from strangers — Polanowicz had previously worked for Steward — and they chatted about golf and children, according to another person at the meeting.

Then Polanowicz handed his visitors a draft of a new policy that would give Steward an avenue to open a heart center, sidestepping a statewide moratorium.

This encounter has become a key element in a lawsuit brought by a Steward competitor against the Massachusetts Department of Public Health. In a recent sworn deposition, a former high-ranking health department employee who attended the meeting said Polanowicz told his guests he wanted to make sure the new policy gets “us what we want.”

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The lawsuit contends that Polanowicz directed health officials to essentially rewrite the rules to allow Steward to build the cardiac center without a legitimate public health reason.

In a written statement e-mailed by a Steward spokesman, Polanowicz defended himself, saying the deposition contained “unfounded speculations’’ that are “demonstrably false.’’ The spokesman said hospitals routinely meet with officials and comment on proposed policies.

The deposition from Deborah Allwes, former head of the health agency’s Bureau of Health Care Safety and Quality, provides a glimpse into the behind-the-scenes agendas and disagreements that can shape policy changes.

And it raises questions about whether Polanowicz may have given special attention to a company he had worked for — and eventually would work for again — despite his assurances that he treated Steward the same as any other provider.

Under questioning from the attorney taking her deposition, Allwes said she was sure Polanowicz said “us’’ during the June meeting, which she took to mean him and Steward. Polanowicz told the Globe that he spoke on behalf of the state and “the best interest of patients’’ in every meeting, and that any suggestion to the contrary is “ridiculous.’’

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Before then-governor Deval Patrick appointed him health and human services secretary in January 2013, Polanowicz led Steward’s largest hospital, St. Elizabeth’s Medical Center in Brighton.

Polanowicz said that partway through his tenure as secretary — which included oversight of the Department of Public Health — Steward asked him to come back. He filed a conflict-of-interest disclosure form with Patrick’s office in August 2014. He wrote that during a dinner that month, a Steward executive asked him to lead Steward’s hospital division. Polanowicz reported he told the executive he planned to remain as secretary until Patrick’s term ended. He stated in the form that if a specific Steward issue came before him for review, “I would recuse myself.’’

It was several months after that, Allwes testified, that Polanowicz got involved when Steward’s request to use empty space for the heart center was absent from the agenda of the Public Health Council, an appointed board of physicians, academics, and consumer advocates that must approve such projects.

According to Allwes’s account, Cheryl Bartlett, the public health commissioner at the time, called a meeting of several department employees and said Polanowicz “was very upset that we didn’t include [the Steward request] on the December docket, and so we had to include it.’’

Cheryl Bartlett (center), then the state’s public health commissioner, denied claims made in the lawsuit.
Cheryl Bartlett (center), then the state’s public health commissioner, denied claims made in the lawsuit.Aram Boghosian for The Boston Globe/File 2014/Globe Freelance

Reached by phone, Bartlett said she does not recall making that statement, and said Polanowicz was no more focused on the Steward issue than any other policy question. Allwes’s attorney, Mark D. Smith, said his client would not comment for this article.

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About six months later, in June 2015, Polanowicz changed jobs again — returning to Steward as executive vice president of network, insurance, and physician operations.

Under Massachusetts ethics law, a state employee who is negotiating a job with a company cannot take part in decisions regarding that company. But Jeff Hall, the Steward spokesman, pointed out in an e-mail that the meeting with the two Steward executives occurred two months before the job offer. And, according to Hall, Polanowicz was not involved in getting Steward business on the Public Health Council agenda.

The lawsuit against the state and Steward was filed in October by Southcoast Hospitals Group, which runs heart centers at Charlton Memorial Hospital in Fall River and St. Luke’s Hospital in New Bedford. A Suffolk Superior Court judge dismissed the case against Steward, but the case against the state is proceeding.

At issue is cardiac catheterization, in which a slender tube is threaded through a major blood vessel into the heart to diagnose a blockage. Demand for the procedure has been declining. State rules require each laboratory to perform at least 300 catheterizations a year, in the belief that medical teams make fewer errors when they perform the procedure frequently.

The health department adopted a moratorium in 2008 to prevent new catheterization units from opening within a 30-minute ambulance ride of an existing one. But in July 2014, the department adopted a narrowly written exception allowing Steward to open a unit at St. Anne’s Hospital in Fall River.

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Southcoast said the loophole threatens public safety because doctors won’t get as much experience with the procedure if patients are spread out among more hospitals. Southcoast wants the decision to give St. Anne’s a license reversed.

Hall, the Steward spokesman, said “Southcoast continues to grasp at straws’’ to “preserve their monopoly and limit access to patient care’’ in a region with a high incidence of heart disease.

Steward has countersued Southcoast in federal court for antitrust violations, alleging that the organization has defamed Polanowicz.

Polanowicz was “certainly engaged more with hospitals than his predecessors did, as he has more experience with hospitals than his predecessors had,’’ Hall said. “That’s part of the job” of health secretary.

Even after Polanowicz left state government in January 2015, the issue continued to roil Beacon Hill. Governor Charlie Baker appointed a new public health commissioner, Dr. Monica Bharel, who was previously chief medical officer for the Boston Health Care for the Homeless Program. The loophole that benefited Steward was suspended that month, but later Bharel allowed implementation to proceed.

Dr. Monica Bharel replaced Bartlett as public health commissioner.
Dr. Monica Bharel replaced Bartlett as public health commissioner.Commonwealth of Massachusetts

Allwes, a nurse with a master’s degree in business administration, said she told Bharel she didn’t think the cardiac unit was appropriate from a public health standpoint. According to Allwes, Bharel responded that it was not up to the department to dictate who could offer catheterizations, but that the “free market’’ should decide.

A Department of Public Health spokesman, Scott Zoback, said the agency does not comment on active litigation. The agency “takes seriously its established oversight role in ensuring patient health, safety, and appropriate access to care,” he said in a written statement.

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Allwes and Bharel also disagreed about what Allwes should include in a general monitoring report about Steward to the Public Health Council. In July 2015, Allwes said, Bharel told her she no longer had confidence in Allwes’s ability to lead the bureau, and that she could resign immediately or be fired.

Eileen Sullivan, the department’s chief operating officer, said in her deposition that Bharel fired Allwes because Allwes gave her incomplete or inaccurate information about several issues. But Allwes said in her deposition that she believes she was let go for pushing back against Bharel and “taking a stand.’’ She is now chief of operations at Cape Cod Healthcare’s physician hospital organization.


Liz Kowalczyk can be reached at kowalczyk@globe.com. Follow her on Twitter @GlobeLizK.