BOSTON — A 76-year-old Whitman woman who spent five years on in-home hospice care is now at the center of a controversy that sparked a complaint to the feds about potential Medicare fraud involving the nationwide health care company that cared for her.
Patricia Marble and her family contacted FOX25 Investigative Reporter Eric Rasmussen in May after she left in-home hospice care – assistance she had received since 2011 and services supposedly meant for people at the very end of their lives.
“We thought she had six months. So, we're grieving... We're devastated,” her daughter, Marissa Bragg, told FOX25. “My mother wasn't dying.”
Marble is still very much alive.
Marble told FOX25 her regular doctor diagnosed her with terminal COPD and recommended her for hospice care. She signed on with Beacon Hospice, a subsidiary of Amedisys, in 2011. She remained in the company's care until May of this year.
"I feel free," Marble told FOX25 Investigates shortly after she left hospice care. "I feel I don't have that cloud of being intimidated."
FOX25 met with Marble a second time last month and she said she was feeling much better after she stopped taking the opiates administered by the hospice workers.
“They just fed me the medication and I just took the stuff like she told me,” Marble told FOX25 Investigates. “It was surreal. All of a sudden, this nurse turns into running my household.”
Marble said she is mad, telling FOX25, “They took away five years of my life.”
Federal complaint filed
Amedisys, the health care company which provided hospice care for Marble, is now facing a complaint filed with the Office of Inspector General for the U.S. Department of Health and Human Services.
And it’s not the first time the company has been accused of wrongdoing.
Amedisys paid $150 million to the federal government in 2014 after the company was accused of improperly billing Medicare for home-bound patients. The company admitted no guilt in that settlement with the Justice Department.
Marble said she trusted the company’s workers so much that she didn’t question the long list of drugs they administered to make her comfortable.
Those drugs include fentanyl and morphine, according to medical records shared with FOX25 Investigates.
“The hydrocodone they sat next to her and told her she could take one whenever she was in pain,” said Bragg.
Bragg said she went against the hospice nurse’s orders and finally took her mom to an outside doctor earlier this year.
A nurse case manager with Marble’s new doctor called the Office of Inspector General for the U.S. Department of Health and Human Services to report potential “hospice fraud,” – which can involve the misuse of Medicare tax dollars, according to medical records obtained by FOX25.
An official at the IG’s Office said it cannot confirm or deny any ongoing investigations.
[ >>Read Amedysis' full statement to FOX25 ]
The hospice company’s response
Amedisys declined repeated interview requests – even after Marble signed a medical privacy waiver – but in a letter to FOX25 said Marble was “found eligible for hospice care by at least five different doctors, including two of her personal physicians.”
Amedisys attorney, former Bulger prosecutor Brian Kelly, said company doctors prescribed Marble’s medication in “full compliance with federal and state law” and said that Marble was prescribed fentanyl by her personal physician more than two years before her initial admission to hospice. Kelly called allegations that she was discouraged from seeing an outside physician “completely false.”
Marble also received visits “every 60 days” to “assess her continued eligibility for hospice,” according to Kelly.
Kelly told FOX25 Investigates that Amedisys is also fully cooperating with U.S. Attorney’s Offices in Massachusetts and West Virginia, which have issued subpoenas for information about the company’s hospice operations.
Medical ethicists have raised questions about the details of Marble’s case.
“It’s inconceivable that could go on for five years,” said George Annas of the Center for Health Law, Ethics and Human Rights at Boston University. “
Annas told FOX25 hospice care is typically limited to those with six months or less to live.
“Hospice for five years just doesn't compute,” said Annas. “There's something clearly wrong there.”
For more information on how to protect a loved one considering hospice care, go to www.medicare.gov/what-medicare-covers/part-a/how-hospice-works.html