Reward for champion fraud-fighter: unemployment
By Christine Jordan Sexton
8/12/2008 © Florida Health News
TALLAHASSEE – It took Linda Keen only six months to go from an “indispensable part” of the leadership team at the Agency for Health Care Administration to being out of work.
A review of Keen’s state personnel files shows no clear reason why the inspector general was forced out of her position in July by AHCA Secretary Holly Benson, whose office has been vague on why Keen was forced to resign.
The one thing that did happen between Keen’s last evaluation and her resignation: Benson, a Republican former legislator from Pensacola, became secretary of AHCA, the agency that controls Florida’s $16-billion Medicaid program.
The previous secretary of AHCA, Dr. Andrew Agwunobi, had nothing but high praise for Keen. “In my opinion, she is the best agency inspector general in the state of Florida,’’ he wrote in January, praising her efforts at combating Medicaid fraud and abuse.
“Linda’s efforts have saved millions of dollars for Medicaid,” Agwunobi wrote. He said Keen, working with the federal government and state attorney general’s office, helped coordinate three successful Medicaid sting operations in South Florida that “enhanced the agency’s reputation for combating fraud.”
Another document—a 2008 joint report on Medicaid fraud issued by AHCA and the state Attorney General’s Office—credits Keen for beefing up the state’s efforts to snuff out fraud and abuse. She established a special legal unit charged with recovering Medicaid funds that were billed in error or as a deliberate scam.
Agwunobi also praised Keen for her “independent evaluation” of the state’s Medicaid Reform pilot – a critical report that prompted him to recommend against expanding the controversial program beyond Northeast Florida and Fort Lauderdale. It so happens that his replacement at AHCA is the House member who pushed the Medicaid Reform project through the Legislature at the request of former Gov. Jeb Bush.
Benson has said little about Keen’s July 8 departure, which caught many people by surprise. “Management teams change over time,” Benson told Florida Health News.
Since coming to AHCA in March, Benson said, she has brought in a new information technology director and a new chief for the statewide center that collects and analyzes health information.
Benson denied that Keen’s critical report on Medicaid reform played into her departure. “Her report is one of many that will be considered,” she said.
Contacted at her home, Keen, 54, declined a request for an interview. She said her time at AHCA is part of her past.
Dr. Les Beitsch, who worked with Keen for several years while he served as the deputy secretary at the Department of Health, predicted that Keen’s departure will have a “chilling effect” and may deter other inspectors general from developing critical independent evaluations lest they lose their job.
“I think it will make them think before signing their names to it,’’ said Beitsch. “That’s not how you want government to operate. You want critical independent thinking.”
Florida law requires each state agency to have an inspector general, whose office performs audits, investigates wrongdoing by agency employees, and conducts management reviews. While an inspector general serves at the pleasure of the agency secretary, state law also says that an agency head must submit plans to fire an inspector general in writing to the governor before acting. An AHCA spokesman said Benson did not notify Gov. Charlie Crist in writing because Keen resigned.
Crist said he did not know why Keen was forced out but stood by his choice for AHCA secretary. “I have faith in Secretary Benson and how she has handled the department and I support her,’’ he said.
Keen holds both a master’s in public health nursing from the University of Illinois at Chicago and a law degree from Valparaiso University in Indiana.
Michael W. Garner, president and CEO of Florida Association of Health Plans, came to know Keen when he worked in the Senate Health Regulation and Health Policy committees of the Florida Legislature.
“Linda was real gung-ho. She was out there and she was willing to get things done,” said Garner. “Linda was never afraid to ask the tough questions, and I know she ruffled feathers over time.”
Keen’s 13-year career in state government started in 1995 when she became the executive director of the Correctional Medical Authority, the panel that audits the Department of Corrections inmate health care. Her August 2000 evaluation at the CMA said Keen was “instrumental” in producing a special report on the issues female prisoners face when incarcerated. The report was written in 1998 after two female prisoners committed suicide.
Dr. Robert Windom, who was the late President Ronald Reagan’s assistant secretary of health, also praised Keen, whom he met at the CMA.
“Everybody liked Linda,” said Windom. “She was well organized. She was very highly thought of when she left.”
Keen left the medical authority to become the inspector general at the Department of Health, where she worked for a handful of secretaries: Dr. Robert Brooks, Dr. John Agwunobi (Andrew Agwunobi’s older brother), and Dr. Rony Francois, who now works in Louisiana with former AHCA Secretary Alan Levine.
Again, her evaluations at the DOH were excellent.
But her best evaluation may have come in January when Andrew Agwunobi said it was “particularly impressive that Linda has quickly become an integral and indispensible part of the agency leadership team while at the same time establishing herself as an inspector general par-excellence with the strict independence necessary for her to fulfill this role.”
That evaluation notes that Keen’s report on the Medicaid Reform pilot became a “trusted reference for statewide discussions on the subject. The recommendations from her report significantly influenced the agency’s legislation and operational decisions regarding the rollout of Medicaid reform.”
--FHN’s Tallahassee correspondent, Christine Jordan Sexton, can be reached at cjordansexton@hotmail.com. Free-lancer Gary Fineout also contributed to the reporting. To reach an editor, contact carol.gentry@FloridaHealthNews.org.
