The U.S. Department of Justice has been asked to investigate the closures of two Trumbull County hospitals in March.

Among the issues: Medicare and Medicaid billing practices and the possible misuse of federal funds meant for patient care.

U.S. Reps. Dave Joyce, R-Bainbridge, and Michael Rulli, R-Salem, expressed their concerns to U.S. Attorney General Pamela J. Bondi with the closings of the former Trumbull Regional Medical Center and Hillside Rehabilitation Hospital. Republican U.S. Sen. Jon Husted co-signed the letter dated Wednesday.

With the approval of federal bankruptcy court in Houston, Insight Health System assumed control of the two hospitals and affiliated properties in September from Steward Health Care.

Insight Health pointed to issues with Steward Health and its failure to release government funds as one reason for suspending operations.

“The closures resulted in the loss of Trumbull County’s sole behavioral health provider, which has hindered thousands of Mahoning Valley residents — particularly those living in underserved and rural areas — from accessing this necessary health care,” the letter states. “In addition to the loss of access to care, nearly 700 Trumbull County staff were abruptly placed on furlough.

“The lack of transparency in the decision-making process, and the apparent disregard for community impact, have raised serious concerns that warrant independent scrutiny.”

The letter touched on a transition services agreement between Insight Health and Steward Health. It also highlighted Steward Health’s administrative fees it charged Insight Health as the latter worked to obtain Medicaid and Medicare licenses.

“It was also claimed that there may have been instances of Medicare and Medicaid fraud or abuse in connection with the operation of these hospitals, all leading to the closure of the Trumbull facilities,” the letter states in referencing an Insight Heath memo released to staff in March.

The Ohio legislators are asking Bondi’s office to investigate four matters: Medicare and Medicaid billing practices from September 2024 to March; whether federal funds for patient care were “misused, diverted or fraudulently reported”; “the transparency and legality of communications provided to local officials, hospital staff and the general public”; and Steward’s financial and operational decisions during the transition to Insight Health ownership through the suspension of operations.

“If fraud or abuse played any part in this outcome, it is essential that those responsible be held accountable,” the letter states. “The citizens of the Mahoning Valley deserve answers, and we must work collectively to ensure that such closures are not allowed to proceed without rigorous scrutiny.”

Approximately three weeks earlier, Warren Mayor Doug Franklin asked Ohio Attorney General David Yost to look into Steward’s use of Medicaid funds.

“Specifically, we request that you investigate Steward’s practice of withholding Medicaid payments from Insight and paying themselves and other vendors with Medicaid funds rightfully belonging to Insight Trumbull,” Franklin’s letter states.

“Steward continues to control and restrict the bank accounts in the bankruptcy where Medicaid, Medicare, and other government funds are deposited. Steward has refused to release these funds to Insight Trumbull which are necessary to fund the operations of the hospital. It is our understanding that it is illegal for Steward to withhold Medicaid payments from the provider providing services (Insight Trumbull),” his letter states.

A Howland official also weighed in.

“We would encourage any type of investigation by our officials into Insight’s closure,” Howland Trustee James J. LaPolla Jr. said Wednesday.

He said trustees want to see Hillside return to operation or that a suitable buyer be found so that the facility can reopen.

In a last-minute addition to their agenda, Howland trustees voted to support the investigation at Wednesday’s regular meeting.

“The closures have been a loss of jobs for many people — many of whom resided in Howland Township, encompassing different facets of our township population,” LaPolla said following passage of the resolution. “Hillside Hospital was the foundation of the medical services in our township and is one of the older medical facilities in Trumbull County; it’s historic, as it once was the tuberculosis sanatorium.”

LaPolla deemed Steward’s mismanagement to be a “tremendous loss” to not just Howland, but the county as a whole.