RogerRabbit
Master Chief Petty Officer
Joined: 05 Sep 2004
Posts: 748
Location: Oregon
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 Posted: Wed Mar 30, 2005 3:50 pm Post subject: Schiavo Attorney Felos No Stranger To Medicare Fraud |
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http://www.theempirejournal.com/0311051_schiavo_attorney_felos_n.htm
| Quote: | Schiavo Attorney Felos No Stranger To Medicare Fraud
© The Empire Journal
Fraud in the court and fraud in the hospice.
Five years ago this month, Florida’s most vulnerable adult was transferred without court order and without the proper written certification to the Hospice of Florida Suncoast at Woodside in Pinellas County.
According to records obtained by The Empire Journal , it appears that not only is there indication of a scripted plan for premeditated murder but insurance fraud in the Terri Schiavo case.
In March, 2000, Michael Schiavo and his attorney, George Felos, secretively relocated Terri Schindler-Schiavo from the Palm Gardens Nursing Home to the hospice without court order and without notifying her parents.
George Felos also conveniently forgot to give notice to the court and her parents, Mary and Robert Schindler Sr. that he was chairman of the board of directors at the Hospice at the time and had been since at least Jan. 31, 1997 and perhaps earlier.
George Felos also forgot to tell the court that at the time that Terri Schiavo was unlawfully entered into the Hospice of Florida Suncoast Inc. that the federal government was actively trying to recover nearly $15 million paid to the corporation in a fraudulent Medicare payments because patients certified as terminally ill were not in fact terminally ill and ineligible to be admitted to the Hospice under Medicare.
Terri Schiavo, 41, was severely brain damaged as the result of mysterious circumstances at her home on Feb. 25, 1990. Her estranged husband, recipient of nearly $2 million in money from medical malpractice claims and living with another woman, claims that his wife would not want to be kept alive by a feeding tube. He and Felos have engaged in a decade-long contentious court battle with her parents. Michael Schiavo has refused the Schindlers’ offer to grant him a divorce and take all monies in the case if he will relinquish guardianship of their daughter and Schiavo has reportedly refused several other monetary offers to get on with his life and allow the Schindlers to take care of their daughter. (see settlement offer at www.terrisfight.org or http://www.theempirejournal.com/greer_schiavo_articles.htm
The Empire Journal has learned that Terri Schiavo was entered into the hospice without the proper written certification. Such certification must be signed by both the attending physician and the hospice medical director and include a written statement that a beneficiary is terminally ill based on medical evidence that supports a life expectancy of six months or less. In Terri’s case, not only is the medical evidence lacking but the attending physician did not sign the certificate as required.
Under federal law, in order to qualify for hospice care and Medicare benefits, there must be a proper certification of terminal illness which is lacking in this case.
Federal regulations require that medical records be maintained for every individual receiving hospice care and services. The beneficiary has four election periods for hospice care and must be certified terminally ill for each of these periods, two periods of 90 days each, the third period of 30 days and the fourth period, an indefinite term.
According to the Office of Inspector General of the U.S. Department of Health and Human Services, the Hospice of Florida Suncoast of which Mary Labyak is chief executive officer knows all about ineligible individuals being entered into hospice care and Suncoast receiving Medicare reimbursements to which they were not entitled.
And so does George Felos.
According to records The Empire Journal has obtained from the U.S. Department of Health and Human Services, the federal agency has initiated collection procedures against the Hospice of Florida Suncoast to recover some $14.8 million which they say was unlawfully paid to the hospice as a result of fraudulent claims made for Medicare reimbursement for patients that were not terminally ill and therefore not eligible for hospice care. According to the 2004 annual report of HHS filed Dec.31, 2004, the agency has initiated collection procedures against the hospice.
The federal agency has been trying to recover the Medicare overpayments made to the hospice since May, 1997 at the time when Felos was chairman of the board.
The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services conducted an audit of the Hospice of Florida Suncoast Inc. during 1995. The objective of the review was to evaluate hospice eligibility determinations for beneficiaries that remained in hospice care more than 120 days. OIG also determined the amount of payments made to the hospice for those Medicare beneficiaries that did not meet the Medicare reimbursement requirements.
Federal auditors have been cracking down on hospices like Florida Suncoast that seek Medicare payments for treating the terminally ill when the patients aren’t on the brink of death-----such as Terri Schiavo.
The review included medical evaluation of Suncoast eligibility. It was determined the 176 patients were not eligible for hospice care and 118 were unable to conclusively determine their terminal illness.
The final audit report issued in August, 1996, determined that Suncoast had received improper Medicare payments totaling $8.9 million for 176 ineligible beneficiaries. SEE THE DOCUMENT
Another $5.9 million was paid to Suncoast for the 118 beneficiaries for whom IOG was unable to determine whether a terminal illness existed at the time of admission to the hospice. These problems occurred because hospice physicians made inaccurate prognoses of life expectancy based on the medical evidence in the patients’ file or because the evidence was not sufficient to determine that the beneficiary was terminally ill. In addition to financial adjustments, IOG recommended to Suncoast that the intermediary, in their case Aetna Life and Casualty Insurance Co. in Clearwater, coordinate with the Health Care Financing Administration (HCFA) in providing training to hospice providers and physicians on eligibility requirements for hospice beneficiaries and conduct period reviews of hospice claims to ensure the hospice is obtaining sufficient medical information to make valid eligibility determinations.
However, at least in the case of Theresa Marie Schindler-Schiavo, it appears that the hospice did not do so and she was admitted into the hospice without the proper medical evaluation, without the proper written certification, without the diagnosis of a terminal illness and at a time when the chairman of the hospice board, George Felos was part of the administration refusing to repay the federal government $14.8 million already received in fraudulent Medicare claims. Only Judge George Greer’s death order issued Feb. 11, 2000, made Terri Schiavo terminal---not her medical condition.
U.S. Department of Health and Human Services
FY 2004 Performance and Accountability Report |
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"Si vis pacem, para bellum" |
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