Lana Barnes was the surrogate in the most famous medical futility case in Minnesota. She insisted on non-indicated treatment at many Minneapolis area hospitals before one hospital challenged her in court and had her replaced as her husband's substitute decision maker.
Last week, Lana Barnes was convicted of Medicaid fraud in connection with her husband's care.
The key question to me is if her quest for futile care for her husband was mostly just misguided, or if it was all along an attempt to make money for herself. Perhaps the former evolved into the latter. I hope that was the case.
ReplyDeleteAnecdotes are tricky things.
She could have been convicted of a state felony (for altering an advance directive).
ReplyDeleteI need to check whether she could be convicted of Medicare fraud (for causing the federal government to be billed for treatment not "medically necessary"). The intent requirement for the latter would be met, because she knew her husband did not want the treatment (dialysis, ICU).
This case certainly demonstrates the need for some neutral out-of-the hospital/network Committee to define and clarify "medical futility" upon which medical treatment can be legally denied by the hospital.
ReplyDeleteAs you have said only 5% of these disagreements about life-extending medical care are NOT settled in the hospital between the parties involved -- but there must be some kind of procedural due process for the 5%.
If treatment is deemed to be "medically unnecessary" isn't this treatment then "medically futile? But, of course, "medical futility" is defined very narrowly under existing law, if defined all!
If Mrs. Barnes, indeed, did alter an advanced directive and this is a felony, why, THEN, is it not a felony for "hospitalist" physicians to place "oral" unilateral DEFAULT DNR CODE STATUS in the charts of elderly/disabled patients to limit treatments that they KNOW or suspect will not be reimbursed by CMS and the private insurers?
Isn't this also FRAUD?
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ReplyDeleteMedical Billing & Coding
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