The Keys to Forging Pertinent Partnerships

General counsel Steve Burres keeps Rotech Healthcare Inc.’s legal costs down by keeping its partnerships honest

Long before he joined forces with Rotech Healthcare Inc. in January 2014, Steve Burres had a fondness for the medical industry. He previously worked with large hospital systems while in private legal practice, and he also knew from past experience that he had a knack for efficiency and a solid sense of how long certain practices and procedures take.

These experiences helped Burres develop a keen eye for cost discrepancies, one that would eventually benefit all of Rotech—once Burres moved into more of a leadership position there, at least. So he paid close attention, and he waited.

“When I did get in a position where I could question the bills, I used my past experience as a guide and finally said, ‘Enough is enough; this abuse has been going on too long,’” he says.

Rotech is a leading industry provider of CPAP machines, home oxygen therapy, and other medical equipment and services. As such, Burres has a wide range of responsibilities: in addition to overseeing the legal department, he is the secretary for the entire company and handles matters dealing with the board of directors.

On top of all this, he also manages all active claims—litigation and workers’ compensation—leads equipment repossession projects, negotiates with insurers, drafts contracts, and negotiates leases for all of Rotech’s 400 locations nationwide.

While other companies may have a team of lawyers, Burres is the only lawyer at Rotech, making his handling of the legal department all the more impressive. He cites hard work and well-honed time management skills, but Burres also relies on three factors to successfully navigate murky waters and come away with the best partnerships: expertise, cost, and integrity.

Expertise is a factor, he says, because in a highly regulated, specialized industry such as healthcare, the ability to keep up is always critical. Cost is another, since overcharging is prevalent among several law firms—especially larger ones, in Burres’s experience—and he doesn’t want Rotech to fall victim. “We seek explanations [for overages] and keep them in our arsenal,” he says. “We may let them complete the project assigned, but we won’t give them the rest of our business if we notice abusive time-keeping practices.”

“We always like firms that want our business. You can’t teach hungry. It’s an innate quality that lawyers either have, or they don’t.”

Case in point: Burres recalls a law firm that not only rewrote a legal brief twice—billing fifty hours for each writing—but also billed for having its paralegal check over the same document. “If you’re paying for the lawyer to write it, you’re paying for the research, fact-checking . . . you’re paying for it all,” he notes. “I’m not paying someone to check someone else’s work. That’s what we felt was abusive. And we eventually fired them.”

Integrity is the third key, and as a somewhat more straightforward concept than trust, it has to do with respecting the way a business operates. “Trust is harder to weed out than integrity,” Burres explains. “Trust you can mask. Integrity comes out in the bill.”

Of course, solid answers to questions—that is, “an answer we need, and one that’s not drawn out”—are a good indicator of a firm with which Burres enjoys working. Reciprocated appreciation and respect go a long way, as well. “We always like firms that want our business,” he says. “You can’t teach hungry. It’s an innate quality that lawyers either have, or they don’t.”

While he ideally has all three keys at all times, Burres acknowledges that it’s easier said than done in certain situations. Medicare is one example, while litigation for car accidents and workers’ compensation is another. “When a Medicare expert is needed, it comes at a cost,” he explains. “There’s not much you can do about that. If you don’t want to pay the high billable rates, you will likely not get a lawyer with the necessary expertise you need to handle the issue.”

These are the instances, he says, when he must be sure to manage time as well as money. “If it’s a small issue, I tell the law firms [in advance] that I don’t want a certain action to go over five hours,” Burres says. “And if it has to go over, they need to call me and tell me why. In all honesty, when they know you’re looking at the bill, they work more efficiently.”

Across-the-board efficiency has certainly worked in Burres’s favor thus far, considering Rotech’s legal department has come in at about 20 percent under budget annually since he’s taken leadership. And that’s with his in-house staff comprised of only three people: himself, one paralegal, and a risk manager. With that kind of success, it’s easy to see why Burres feels no need to hire additional staff. That is, unless Rotech itself were to upgrade in size—an idea he finds quite appealing.

“I know my peers have departments with around eleven or twelve lawyers, and I’m just one,” he says. “But if we continue to grow and expand in the marketplace, I can see an argument being made to successfully grow my department.”

For the time being, though, Burres is pleased with what he and his team are able to accomplish on a daily basis. “I think everybody’s always looking to trim costs, and when it happens, I think it shows your added value,” he says. “There has to be a mutual respect for one another to get things done, and I think we have that in the Rotech legal department.”