Following questions about whether he was overbilling taxpayers, a consultant advising Jefferson Parish on its efforts to lease its struggling public hospital in Marrero has purchased a full-page ad in a New Orleans newspaper claiming that the bad decisions of two parish councilmen and the hospital CEO had cost taxpayers even more money.

Joshua Nemzoff’s letter — published in The Times-Picayune on Wednesday — took aim at Parish Councilmen Chris Roberts and Elton Lagasse as well as West Jefferson Medical Center CEO Nancy Cassagne, all of whom have had contentious relationships with the consultant since he was hired in February 2014.

The letter said Roberts and Lagasse quickly endorsed leasing the hospital to LCMC Health although HCA’s bid was valued at about $430 million more.

The letter also accused Roberts and Lagasse of campaigning to drive HCA to withdraw its bid before the Parish Council agreed early this year to lease West Jefferson to LCMC. The result, Nemzoff said, was to “cheat” the parish out of money.

Lagasse didn’t respond to Nemzoff’s letter.

Roberts accused the consultant of fabricating issues “in an attempt to justify over $1 million in fees” he is owed by the parish. He cited a February email from Nemzoff congratulating Roberts on getting “a fantastic deal” for the parish. And he noted that leasing West Jefferson to HCA would have required getting approval from HCA affiliate Tulane University Medical Center, which this year blocked HCA’s attempt to lease the parish’s public hospital in Metairie.

Nemzoff’s letter lambasted Cassagne for having what he said is a fully funded private pension worth more than $500,000 while the West Jefferson hospital’s general employee pension plan is underfunded by $70 million. He again attacked Cassagne’s decision to pay $225,000 in bonuses to two hospital executives — one of whom has since left — at a time when West Jefferson is “hemorrhaging money.”

Cassagne called Nemzoff’s letter “simply inaccurate.” She has defended the bonuses as attempts to retain key hospital personnel.

Roberts said West Jefferson’s executives earn much less than they would working for other local hospitals.

Nemzoff’s letter came after a WVUE-TV story questioned the level of detail in the invoices for which he’s billed the parish. Members of the Parish Attorney’s Office have said they have adequate documentation backing up the work for which Nemzoff has billed.

Around the time the station’s story ran, Nemzoff alerted parish officials that unaudited numbers the hospital had reported earlier about its financial performance were inaccurate.

A preliminary financial statement had said the hospital generated about $15 million in cash in 2014. An audit released in June then revealed it actually generated about $5.5 million last year.

After originally agreeing to lease West Jefferson for a minimum of $225 million in payments over 45 years, LCMC last week dropped its bid by $25 million. The Parish Council accepted the lower offer Monday, and the deal awaits the state attorney general’s approval.

Nemzoff’s ad asks when Cassagne realized the preliminary information about the hospital’s finances was wrong. Cassagne said her staff adequately alerted all parties that the hospital’s unaudited financial figures might change drastically.