You're reading...
End of life, Law, Medical ethics, Medicine, Money and Finance, Politics, Public Policy, Texas, Texas Advance Directive Act

Updated information on TRTL, end of life, and money

One Texas Right to Life (TRTL) lawyer has posted an update on Facebook about the “rescue” of Mrs Carolyn Jones. I’m afraid that, as with the declaration that another patient was “slain,” TRTL is gaming the Medicare funding and Texas medical systems for political purposes.

Emily Cook, General Council for TRTL, wrote that she worried that “funny business clinically would happen as we moved her” from the hospital where Mrs. Jones has been admitted for over 6 months, where the docs had weaned her off the ventilator and wanted her to transfer to a more appropriate level of care facility over 2 months ago.

Emily says TRTL spent their own money (*see my last paragraph) to put her in a private ambulance and take Mrs. Jones to another hospital ER. That hospital couldn’t provide dialysis, so they in turn transferred her via ambulance somewhere else, to yet another hospital until admission can be arranged at the nursing home.

Even Lawyer Cook admits that the first move wasn’t “legit.”

Cook-ing the system

There were comments on various sites that the original hospital had refused transfer. However, from what I’ve read, it’s likely the hospital was refusing to be complicit with “patient dumping.” For a hospital to knowingly discharge a patient for the purpose of transferring to the ER of another hospital without (or even with) the acceptance of the transfer from the docs at the other facility is highly irregular, and likely goes against Medicare regulations.

Mrs. Jones’ Medicare funding for the original hospitalization is bound to have run out some time ago. Normally, Medicare will allow 90 days per admission, with an extra 60 “reserve” days, once per person, per lifetime. The patient is responsible for part of the bill from the first day of admission, and for the total hospital costs after the eligible days.

But there are still Medicare regulations to deal with in the case of “Medicare eligible” patients, even when they aren’t paying.

As to the refusal of the original hospital to accept private payment for in-hospital dialysis, there were 2 issues: Medicare funding about privately payment for covered services and the probability that the physician-patiebt relationship would be reset, along with the 10 days in the statute.

Medicare makes it very difficult and risky for everyone to navigate the private pay process. When I had a question in my private medical office about whether Medicare would cover something, we had the patient sign an informed consent agreement and an acknowledgement that the patient might have to eventually pay if Medicare denied the service. Then we performed the service, filed the charge with Medicare, waited to be denied, and then tried to Bill the patient. I gave away a lot tetanus vaccines and removed a lot of moles and warts for free to avoid the risk of “fraud and abuse” from the likes of Janet Reno.

The same risk would have applied if the hospital had privately charged Mrs. Jones’ Dialysis.

I don’t believe the first new hospital is at risk for a charge of “dumping” if they documented a legitimate reason. However, both new hospitals will be able to charge the Jones copays and co-insurance. They may also find Medicare coverage limited because of the way Mrs. Jones left the original.

Another, discussion has concerned the delay in funding from Medicaid:

“Medicaid limits 2019” (a .PDF)

I certainly don’t know the Jones’ financial circumstances, and I may have over estimated the maximum income in early speculation. However, there are strict maximum Medicaid income and asset levels. These vary according to age, disability, and marital status. (Even the government bureaucratic Leviathan doesn’t want the spouse if a nursing home patient to end up indigent.)

In my experience, the social workers and benefits experts at hospitals and nursing homes are experts at negotiating and translating the bureaucracy. In addition, the disabled Medicare eligible person will have access to a benefits specialist. I’ve never had a hospital discharge and nursing home admission blocked by this “paperwork.” Certainly not for months at a time.

*TRTL hasn’t updated their Carolyn Jones fundraising numbers since last week. That “Family Assistance Fund,” part of their 403(c) PAC, (AKA the Educational fund”), has been posted as a little over $33,000, since last Friday.

I hope TRTL assists the Jones family with what is certain to be several enormous hospital bills. As long as they pay the bills directly, the funds won’t be counted as income to Mrs. Jones.

About bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)

Discussion

Comments are closed.

@bnuckols tweets

Click here to get your “Choose Life” license plate

Rick Perry RickPAC

Yes, I'm still for Governor Perry!

RickPAC

What to read around here

Archives

SiteMeter

%d bloggers like this: