[Warning – This post is extremely graphic and disturbing. It details the gruesome death of a 14-year-old girl at the hands of trained healthcare professionals. This post, written by attorney Brian Mahany, originally appeared in the National Law Review.]
Medicare fraud is a national problem. The FBI claims it has become an epidemic. Over $80 billion per year is lost to healthcare fraud. Even if you receive Medicaid or Medicare, you are still paying for all this healthcare fraud. Whether from higher premiums, higher co-pays or higher taxes, Medicare fraud affects everyone.
In most cases, the fraud is economic. Increasingly, however, there is human cost. Sometimes that cost means the loss of a human life.
Makayla Norman was a beautiful 14-year-old girl battling a deadly disease. She suffered from Cerebral Palsy. Caring for someone needing constant medical care is expensive. Unless you are very wealthy, sooner or later Medicare or Medicaid winds up paying for care. The story was no different for Makayla’s family. They couldn’t afford her needs for skilled home nursing care.
On March 1st, 2011, Makayla died. At the time of her death, she was just 28 lbs. Because she couldn’t speak or move, she was totally dependent on her caregivers. To say they let her down is an understatement.
Not only did Makayla weigh just 28 lbs., she was covered in filth and open sores from “ears to ankles.” Her diaper hadn’t been changed in quite some time. Her colon was so impacted with fecal matter that she had a noticeable bulge. She was also infested with lice.
One of her caregivers, Mollie Parsons, is currently serving a 10-year sentence in connection with her death. Four other people were also prosecuted in connection with Makayla’s death including her own mother, her physician and two nurses.
Everyone agrees that the story is tragic but some readers are wondering what this has to do with Medicare fraud. This week Mollie Parsons was arraigned on charges of criminal healthcare fraud. Medicare paid Parsons to care for Makayla six days per week, 8 hours per day. Dayton, Ohio police detectives say Parsons only showed up 3 or 4 times per month, however. On some of those visits she wouldn’t even come inside but would honk the horn so that Makayla’s mother would go outside and join her in shopping trips.
On the night of Makayla’s death, Parsons allegedly noted that Makayla was in good health. Obviously, that wasn’t the case.
During the 2011 homicide investigation, Dayton Police homicide Detective Rebecca Rose testified that Makayla “was a skeleton with skin draped over it. It was horrific.”
In connection with the death, two nurses were also criminally charged. The two were to have supervised Makayla’s care and insure that proper services were being delivered. Makayla’s doctor, Margaret Edwards, was convicted of failure to provide for a functionally impaired person.
Fast forward to 2015 and the Justice Department has filed federal Medicare fraud charges against Parsons. A nurse, Kathryn Williams, was charged federally for making false statements on a medical assessment form.
According to Parsons’ indictment, prosecutors say she frequently billed Medicare for private duty nursing services that were never performed. Worse, she lied on assessment forms so that it appeared Makayla was healthy.
Although already serving a 10-year sentence on state charges, Parsons now faces four felony counts of Medicare fraud. She could effectively spend the rest of her life in jail. The statutory maximum sentence for Medicare fraud is 10 years per count but judges can exceed the cap if the fraud resulted in death or substantial injury.
Obviously, all the prosecutions in the world won’t bring Makayla back. Defense counsel may argue that she probably would have died by now anyway because of her severe ailments. That doesn’t mean that Makayla needed to suffer so badly According to the indictment, Parsons’ mistreatment may have gone on for two years.
Anyone who says Medicare fraud is a victimless crime only has to read this story.
Most Medicare fraud stories come to light because of whistleblowers, dedicated healthcare workers who speak out about greed and fraud. Unfortunately, here it appears that the people who were charged with watching over Makayla’s care may have been negligent themselves.
The federal False Claims Act pays whistleblowers up to 30% of whatever the government collects from wrongdoers. Most whistleblowers aren’t in it for the money, however. They come forward because they want to make a difference.
Any number of people could have stepped forward and blown the whistle on Makayla’s deplorable conditions and her lack of care. No one did. Anyone sitting on the fence and wondering whether to step forward and report problems need not wonder any more.
Whistleblowers can make a difference.