More than half the payments approved by the board of the Maryland Criminal Injuries Compensation Fund went directly to health care providers, who often depend on a single law firm to handle the process.
Baltimore attorney Fred A. London secured more than $3.7 million on behalf of nearly 600 crime victims who filed for assistance in a 4 1/2 -year period ending in August last year, an analysis of board data shows.
London does not just represent the applicants. He also works for the hospitals that treat and bill them.
The University of Maryland Medical Center and the Johns Hopkins Hospital each contract with London as a debt-collection agent, referring patients with unpaid bills to his firm, according to the board and officials of the hospitals.
If he determines they might qualify for compensation, his firm helps them fill out applications. If requests are denied, he argues their cases during appeals. He or other lawyers with his firm have represented more than 200 clients before the board, data show.
The dual nature of London's arrangement has twice prompted members of the board to ask the Maryland attorney general's office whether it poses a conflict of interest. It does not, the office has twice replied, most recently last year. No conflict of interest exists as long as London discloses his relationship with the hospitals to the crime victims, a spokeswoman for the office said.
London did not respond to numerous requests for an interview.
"This is a patient-advocacy function," said Keith Persinger, senior vice president for finance at the University of Maryland Medical Center. "We feel that's key, that the patients know their options."
About 64 percent of money from the fund goes directly to hospitals to cover victims' medical bills, the analysis of data showed. London has secured $2.3 million in compensation paid to the University of Maryland and affiliate medical providers, including the Maryland Shock Trauma Center, and $1.2 million for Johns Hopkins Hospital and its affiliates, data show.
Persinger said London is paid "a few" thousand dollars each case. "We're paying a fee for him to be the patient advocate, regardless of the outcome," Persinger said.
He added that, because the victims fund is the payer of last resort, London attempts all other sources, such as insurance and government assistance, before applying to the fund.
"As a patient advocate, our role there is to provide a service to our patients to try to qualify for insurance," Persinger said. "This fund just happens to be a minor part, but one of the available options."
A Hopkins spokesman said London's firm is among a number of companies that help patients apply for Medicaid. "Sometimes when the hospital was not aware that a patient was a victim of a crime, these companies discover this fact and assist the patient" with a criminal injuries compensation claim, the spokesman, Gary Stephenson, wrote in an e-mail.
Robin Woolford, the board's executive director, said he sees nothing wrong with London's dual role because almost no funds go directly to his firm.
Attorneys who file applications on a victim's behalf can apply to the board to receive $50 dollars an hour - a fee that would be taken out of the victim's award. London almost never applies for the fee, board data show.
Woolford added that, at the insistence of the board, London files for all types of compensation, such as funeral expenses and lost wages, not just hospital bills.