Newswire

The Life Matters Media Newswire aims to serve as a comprehensive portal of all news related to end of life decision making and care. We aggregate stories from other media outlets in one place- here, where you can access them easily. We also strive to produce original content covering stories we feel are receiving scant attention.


New Jersey Debates ‘Death With Dignity’

A New Jersey legislative panel has advanced a bill that would allow physicians to prescribe life-ending medications to some terminally ill, mentally competent adults.

The New Jersey Death with Dignity Act, based on a 1994 Oregon law, passed the Assembly Health and Senior Services Committee 8 to 4. The bill must pass the full Assembly and Senate before heading to Gov. Chris Christie.

If passed, prospective patients with a life expectancy of six months or less would be required to prove they are capable of making their own end of life decisions. Hospitals and doctors would not be required to participate.

After two verbal requests, patients would submit a written request for the life-ending medication. The request requires the signatures of two witnesses. Fifteen days must pass between the patient’s initial verbal request and the writing of a prescription. Patients would be guaranteed the freedom to rescind their request, and they must self-administer the drug.

“This discussion is about revisiting a statute last looked at in 1978 that never took into account an individual’s right to control their body and their circumstances,” said Assemblyman John Burzichelli in a press release. “Like society, medicine, palliative care and hospice services have changed dramatically since then. While there are many choices available right now that may be right for certain people, there is one more choice, not currently available, that deserves an honest discussion.” Burzichelli, a Democrat, sponsored the legislation.

A similar bill advanced to this point in the previous Legislature, but it was never was brought to a vote. Christie’s office declined to comment on the possibility of a veto.

A 2012 Fairleigh Dickinson University PublicMind poll found 46 percent of New Jersey voters supported “Death with Dignity,” while 38 percent opposed it.

The legislation has faced strong opposition from religious and disability-rights groups.

Courtesy WikiMedia Commons

Courtesy WikiMedia Commons

Marie Tasy, executive director of New Jersey Right to Life, calls the legislation “bad medicine.” “Clearly there are ways to alleviate a person’s suffering without eliminating the human being, and that is the path I hope our state will take,” she said. “The bill doesn’t protect patients, there is a lot of room for error. There is no oversight once a medication is prescribed, and it is a recipe for elder abuse.”

Tasy’s concerns are echoed by Not Dead Yet, a national disability rights group that opposes all forms of aid in dying legislation. Diane Coleman, president and C.E.O., told Life Matters Media she believes that advances in pain medicine have made the legislation unnecessary. “Palliative care options work, and there is no need to cross this line and drastically change the law that can become a risk to so many others,” she said.

New Jersey criminalized the practice in 1978, but physician-assisted suicide is legal in four states: Oregon, Washington, Vermont and Montana.

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Passages Hospice Founder Pleads Not Guilty

U.S. District Court of the Northern District of Illinois. Google Maps.

U.S. District Court of the Northern District of Illinois. Google Maps.

Four former high-level employees of shuttered Passages Hospice LLC entered a plea of not guilty to health fraud during an arraignment Monday in the U.S. District Court of the Northern District.

Seth Gillman, 45, a partial owner who founded the company in 2005, was first charged in January with health care fraud and conspiracy to defraud the government. According to prosecutors, Passages knowingly over-billed the government by millions of dollars on unnecessary hospice care for seniors.

In May, fraud charges were brought against Gwen Hilsabeck, who served as a co-administrator; Carmen Velez, who served as the director of clinical services and director of nurses for the Chicago region; and Angela Armenta, who served as director of certified nursing assistants for the Chicago region.

The defendants, each released on bond, appeared before U.S. Judge Thomas M. Durkin. A trial date has been set for August 7; Passages Hospice, a corporation, will likely enter a plea then.

According to prosecutors, Gillman, Hilsabeck, Velez and Armenta participated in an elaborate scheme “to cause Passages Hospice LLC to submit false claims to Medicare and Medicaid for medically unnecessary hospice care, namely, hospice care for patients who were not terminally ill and hospice care that did not qualify for general inpatient care.”

Between August 2008 and January 2012, Medicare paid the for-profit hospice company more than $90 million for hospice services, including more than $20 million for general inpatient services. From 2006 to late 2011, Passages submitted claims for about 4,700 patients to Medicare and Medicaid.

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Gillman, Hilsabeck, and Passages allegedly paid bonuses to nursing directors and certified nursing assistant directors employed at the company in order to increase the number of patients receiving general inpatient care. In 2012, Medicare’s daily reimbursement for general inpatient care was $671.84; the daily payment for routine care was much lower, $151.23.

One former employee told LMM she quit after realizing that something felt wrong.

“I left the company a few months before the indictment, after I couldn’t ignore my gut,” she said, asking not to be named as she continues to work in a similar industry. “I was in the dark about the fraud, but I knew deep down I couldn’t be a part of that company anymore. I was appalled to find out how many people were involved in the deceit. I was lucky enough to leave on my own for another job, but my coworkers and friends weren’t. They’re still fighting for pay, vacation time and 401K contributions owed to them.”

In February, Passages closed in light of the allegations against Gillman. The hospice operated in four states, yet the majority of services were provided to Illinois seniors. Earlier that month, employees told LMM that they vowed to continue operating for patients’ sake.

According to the FBI, federal agents have interviewed patients, family members and more than 30 former and current Passages employees. Several reported the allegedly fraudulent billing and marketing practices to Medicare and law enforcement.

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More Charged In Passages Hospice Fraud Scandal

More high-level employees of shuttered Passages Hospice LLC have been charged with health care fraud, according to an indictment released by the U.S. Attorney’s office.

Fraud charges have been brought against Gwen Hilsabeck, who served as a co-administrator; Carmen Velez, who served as the director of clinical services and director of nurses for the Chicago region; and Angela Armenta, who served as director of certified nursing assistants for the Chicago region, according to an indictment filed in the U.S. District Court of the Northern District.

Seth Gillman, 45, a partial owner who founded the company in 2005, was charged in January with health care fraud. According to prosecutors, Passages knowingly over-billed the government by millions of dollars on unnecessary hospice care for seniors.

According to the indictment, Gillman, Hilsabeck, Velez and Armenta participated in an elaborate scheme “to cause Passages Hospice LLC to submit false claims to Medicare and Medicaid for medically unnecessary hospice care, namely, hospice care for patients who were not terminally ill and hospice care that did not qualify for general inpatient care.”

Seth Gillman

Passages Hospice Founder Seth Gillman. Honorable Mention in the 2013 Torch Awards for Marketplace Ethics, hosted by the Better Business Bureau. YouTube.

Between August 2008 and January 2012, Medicare paid the for-profit hospice company more than $90 million for hospice services, including more than $20 million for general inpatient services. From 2006 to late 2011, Passages submitted claims for about 4,700 patients to Medicare and Medicaid.

“Give patients everything they need, even that little extra that makes life worth living,” Gillman told Life Matters Media in November during the unveiling of an end of life care initiative backed by the National Institute for Nursing Research.

However, federal prosecutors allege Gillman was not so selfless.

Gillman, Hilsabeck, and Passages allegedly paid bonuses to nursing directors and certified nursing assistant directors employed at the company in order to increase the number of patients receiving general inpatient care. In 2012, Medicare’s daily reimbursement for general inpatient care was $671.84; the daily payment for routine care was much lower, $151.23.

According to the FBI, federal agents have interviewed patients, family members and more than 30 former and current Passages employees. Several reported the allegedly fraudulent billing and marketing practices to Medicare and law enforcement.

In February, Passages closed in light of the allegations against Gillman. The hospice operated in four states, yet the majority of services were provided to Illinois seniors. Earlier that month, employees told LMM that they vowed to continue operating for patients’ sake.

All four individual defendants, and Passages, are scheduled to be arraigned June 2 in U.S. District Court. The defendants were charged in an 18-count indictment.

Each count of health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine. Conspiracy to obstruct a federal audit and making false statements regarding a health care benefit program each carry a maximum sentence of five years in prison and a $250,000 fine. Restitution is mandatory.

Gillman, an attorney who told LMM he founded Passages after witnessing his grandmother’s poor end of life care in a south Florida hospice, was the corporate agent, administrator and one-fourth owner of Lisle-based company. Passages did not operate its own inpatient facility, instead deploying nurses to visit hospice patients in nursing homes and private residences.

Hospice is generally care provided in a patient’s home, but it can also be provided in a center, hospital, nursing home or other long-term care facility for people facing illness near the end of life. The number of hospice patients served has risen more than 25 percent during the last five years from 1.25 million in 2008, according to figures published by the National Hospice and Palliative Care Organization.

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We Obtained Indictment Of Seth Gillman, Passages Hospice Fraud Scandal

We Obtained Indictment Of Seth Gillman, Passages Hospice Fraud Scandal

View the indictment here

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Special Senate Committee Talks Advance Care Planning

Jennie Chin Hansen, C.E.O. of the American Geriatrics Society

Jennie Chin Hansen, C.E.O. of the American Geriatrics Society, moderated the roundtable meeting

During a roundtable meeting hosted by the U.S. Senate Special Committee on Aging, industry leaders called for an increased role among care providers to help more Americans complete their advance health care directives.

An advance directive may take many forms, such as a living will or power of attorney for health care. They help ensure one’s end of life wishes are carried out in the event a patient is unable to communicate. However, the vast majority of Americans have not planned for the end of life, according to recent findings published in The American Journal of Preventative Medicine.

“For frail elders, advance care planning for care preferences is particularly important and ensures that families, the physician, and other health care team members understand and act in accordance with a person’s wishes when it comes to the type of care that he or she would like to receive,” offered moderator Jennie Chin Hansen, C.E.O. of the American Geriatrics Society. “National and state policies should encourage patients and those who care for them to engage in advance care planning discussions.”

Paul D. Malley, president of advocacy group Aging with Dignity, said he urges both haste and caution as more providers help their patients plan in light of the Affordable Care Act.

“We must act with haste, because American families can’t wait. They need help navigating the system and navigating the expression of their wishes,” he said. “Caution, because I think as the best health care systems are working to improve care at end of life, there may be a focus on systems and processes that don’t make room for the individual preferences.”

Although the shift towards electronic medical records may help some physicians and care providers better learn their patients’ wishes, Malley said he believes there is still no replacement for the role of loved ones in end of life decision-making. “It is important to understand our roles, and our respective biases,” he said. Aging with Dignity distributes the popular Five Wishes collection.

Daniel OBrien, senior vice president of Ethics, Discernment and Church Relations with Ascension Health, offered a Roman Catholic perspective.

O’Brien said he believes comfort and care for the dying should be a primary goal of health care. “Palliative care, in particular, is one specific approach to care for patients with serious illness that we must support and grow, because it focuses on caring for the patient as person, regardless of diagnosis,” he said. “It focuses on identifying and addressing the goals of care that are meaningful to them.”

Ascension, the nation’s largest Catholic health system, has been working with the Florida Conference of Bishops’ Committee for End of Life Care on a POLST (Physicians Orders for Life Sustaining Treatment) form modified to address concerns under Church teachings.

“Bishops in some states have opposed POLST legislation outright, mostly due to specific problematic features of the POLST paradigms in those states,” O’Brien said. “After making recommendations to add a few additional protections to the form, the majority of the committee recommended to the Bishops’ Conference that we allow piloting of our edited POLST in our Catholic hospitals.”

POLST forms are medical orders, and are more detailed than conventional living wills or advance directives. They allow patients to indicate preferences regarding resuscitation, intubation, intravenous antibiotics and feeding tubes. The forms are intended for patients in their last year of life, and they can follow patients across care settings. More than a dozen states have officially endorsed versions of the POLST form.

The Senate Special Committee on Aging was first established in 1961 as a temporary committee, but was granted permanent status in 1977. Although the committee has no legislative authority, it studies issues and investigates reports of health fraud and abuse. Sen. Susan Collins, D-Maine, is a ranking member.

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