Let’s Kill the Unprofitable Ones; Hospice Owner Accused of Poisoning Patients

According to an affidavit from an FBI agent, the owner of a hospice outside
Dallas told his nurses to poison patients so they would die faster.

Hospice Owner Accused of Telling Nurses to OD Patients So They Would Die

It sounds like something from a horror movie. An NBC affiliate in Dallas
is reporting that the FBI applied for a search warrant to collect evidence
against a local hospice and its founder and owner. We do not know where
the FBI got its information (I’m a lawyer who represents whistleblowers,
and my bet is on a whistleblower who filed a qui tam suit). But according
to an article in the
Dallas Morning News, the FBI agent’s affidavit makes hair-raising allegations of
hospice fraud, such as:

• The owner told his nurses to overdose patients on painkillers like morphine
  – up to 4x the normal amount — so they would die;
• He sent bone-chilling comments about patients who had been on hospice too
  long. Really scary stuff, like: “You need to make this patient go
  bye-bye”;
• He asked sales reps to find patients who would die within 24 hours.
• According to the FBI, the owner exclaimed – you can almost picture
  him, moaning, with his head in his hands – “If this f— would
  just die!”

Why, why, why?

Ok, I can’t answer the “evil” part of this. Why would
anyone do this? Since when do patients become nothing but dollar signs?

But I can answer the question of why it makes financial – not moral
— sense for a hospice owner to kill off patients.

Isn’t It Illogical to Kill Off Your Patients?

Put aside the fact that most medical providers get into the business because
they want to help patients, not hurt them. Make the heart-sickening assumption
that someone gets into the medical field to make a profit, and is willing
to kill patients if it will pump up the dollars.

But even the evil want to make money, right?! Surely even a malevolent
medical provider would not want to kill off patients! After all, medical
providers, from hospices to doctors to hospitals, get paid for treating
live
patients, not dead people.

To get the whole picture, you have to understand the incentives Medicare
has set up – and why.

Medicare Has Made Rules to Try to Prevent Fraud by Hospices

Medicare and Medicaid dole out big bucks for hospice care, which includes
items the agencies would not normally cover, on the presumption that hospice
will be reserved for patients who are about to die.

Unfortunately, Medicare discovered that hospices were badly abusing the
rules by collecting hefty payments for treating patients who were nowhere
near dying.

To address the hospice fraud, Medicare came up with some logical, very
practical rules. For example, Medicare set an “aggregate cap”
on the amount a hospice could collect – spread across all its patients
– in a given year. See
42 C.F.R. § 418.309. From Nov. 1, 2015 to Oct. 31, 2016, the aggregate cap will be
$27,820.75 per patient.[1] In other words, a hospice that treats 100 patients can get a maximum of
$2,782,075.00.

The hospice can make bigger claims for Medicare payments for some patients
as long as it makes correspondingly smaller claims for caring for other
patients. The key is the average, not the amount per patient.

In very stark and completely inhuman terms, patients are a financial “asset”
to a hospice right up until the point that the hospice has received an
average of $27,820.75 for caring for them. But when the hospice’s
average goes too high, it faces losing money on patients who live longer.

Where is the FBI’s Information Coming From?

We don’t know how the FBI learned about the horrifying allegations
against Novus Health Care Services, Inc., in Frisco, Texas. At this point
we only know that an NBC affiliate in Dallas is reporting that the FBI
applied for a search warrant to collect evidence against Novus and its
founder and owner, Brad Harris.

Sure, I’m biased since I represent whistleblowers, but the FBI’s
affidavit has lurid, insider details, and my guess is that the FBI has
information from a whistleblower.

I hope it turns out the FBI’s concerns are unfounded. But if these
accusations end up being true, and if a whistleblower did file suit under
the False Claims Act, the whistleblower will be entitled to 15-30% of
any money the Government recovers as a result of hospice fraud –
not to mention a peaceful night’s sleep.