Comment: Note this quote from the article:
“‘Aggregator cap’. Health care providers do not necessarily make more money for longer hospice stays. That’s because hospices are subject to an ‘aggregator cap’, which limits Medicare and Medicaid payments based on the yearly average hospice stay, the FBI said. If patients live longer than that, the provider can be forced to pay back part of their payments to the government. ‘Hence, hospice providers have an incentive to enroll patients whose hospice stays will be short relative to the cap’, an agent wrote in the affidavit.” [N. Valko RN, 17 May 2016]
The owner of a Frisco medical company regularly directed nurses to overdose hospice patients with drugs such as morphine to speed up their deaths and maximize profits and sent text messages like, “You need to make this patient go bye-bye,” an FBI agent wrote in an affidavit for a search warrant obtained by NBC 5.
The executive, Brad Harris, founded the company, Novus Health Care Services Inc., in July 2012, according to state records. Novus’ office is on Dallas Parkway in Frisco. No charges have been filed against Novus or Harris. Harris, 34, did not return messages left with a receptionist and at his Frisco home.
Harris, an accountant, told a nurse to overdose three patients and directed another employee to increase a patient’s medication to four times the maximum allowed, the FBI said.
In the first case, the employee refused to follow the alleged instructions, the agent wrote in the affidavit. The document does not say whether the other three patients were actually harmed.
Harris also told other health care executives over a lunch meeting that he wanted to “find patients who would die within 24 hours,” and made comments like, “if this f— would just die,” an FBI agent wrote in the warrant.
An FBI spokeswoman declined to comment on the investigation.
Novus’ website says the company offers hospice and home health care services.
“We have a saying at Novus, be fast and treat people the way we would want to be treated,” the website says. “This encourages us to go the extra mile to make patients feel comfortable and secure about their special needs and requests.”
Health care providers do not necessarily make more money for longer hospice stays.
That’s because hospices are subject to an “aggregator cap,” which limits Medicare and Medicaid payments based on the yearly average hospice stay, the FBI said.
If patients live longer than that, the provider can be forced to pay back part of their payments to the government.
“Hence, hospice providers have an incentive to enroll patients whose hospice stays will be short relative to the cap,” an agent wrote in the affidavit.
The FBI said its investigation into Novus started in October 2014 and initially focused on allegations that for the previous two years, the company recruited patients “who did not qualify for services” and charged the government for services that were not medically necessary.
The investigation revealed that “as part of this scheme, Harris, who has no medical training or licenses, would direct his employed nurses to overdose hospice patients with palliative medications such as morphine to hasten death, and thereby minimize Novus’ [paybacks] under the cap.”
The FBI’s search, for emails and other electronic documents, was executed in early February but the paperwork was obtained Tuesday by NBC 5.
The warrant refers to an FBI raid of Novus’ offices in September 2015, but court records related to that search could not be found and appear to be under seal.
The FBI said investigators had interviewed several Novus employees.
One worker said Harris himself decided which home health care patients would be moved to hospice.
“He did this by having employees who were not doctors sign the certifications with the names of doctors also employed by Novus,” the agent said. “If a patient was on hospice care for too long, Harris would direct the patient be moved back to home health, irrespective of whether the patient needed continued hospice care.”
In a lunch meeting, the FBI said, Harris asked two health care executives to “find patients who would die within 24 hours” because that would “save my ass toward the cap.”
Speaking of one of his patients, Harris said “words to the effect of, ‘If this f— would just die.’”
Another Norvus employee told agents that in late 2013, Harris sent a text message asking the worker to “administer an overdose of medication to a hospice patient … by increasing the patient’s medication dosage to approximately four times the maximum allowed.”
The employee did not comply with the request because it would have killed the patient, the FBI said.
One worker said Harris regularly directed nurses to “overdose hospice patients when they have been on hospice service for too long” by sending text messages like, “You need to make this patient go bye-bye,” the FBI said.
The search warrant required that a data storage company that Novus had hired, Smarsh of Portland, Ore., turn over all of Novus’ emails and medical records.
The company turned over the information the same day, according to court records.
In the warrant, signed Feb. 3, the FBI said it was investigating health care fraud, false statements relating to health care matters, and obstruction of a criminal investigation into health care offenses.
The FBI said it searched Novus’ offices on Sept. 17, 2015, and seized 18 DVDs of the company’s emails. Another 44 were subpoenaed from the attorney of a former unnamed executive.
Agents needed a password to read the emails, according to the records. Smarsh turned over the password along with a hard drive and account and search histories, records showed. Smarsh, who is not accused of any wrongdoing, did not respond to a request for comment.
An FBI agent investigating the case said he was working with investigators from the Department of Health and Human Services’ inspector general’s office.
HHS administers the Medicare program, which provides health benefits for people 65 and older.
Medicaid, which is funded mostly by federal tax dollars and administered by the state of Texas, provides health care for poor people.
[29 March 2016, Jamie Knodel, by Scott Gordon, KXAS-TV (NBC-5), http://crimeblog.dallasnews.com/2016/03/frisco-hospice-owner-urged-nurses-to-overdose-patients-to-speed-their-deaths-fbi-says.html/