Here’s a case of a doctor with known and provable innocence paying the price for a plea. Nathaniel Brown, MD, 62, was a family physician in Cleveland, Mississippi who was medical director of two hospices. He is a friend of a friend. He explained to my friend why he was going to take the plea, even though he was warned not to.

What were his reasons? A lawyer was supposedly going to cost him $200,000.  He was told he might get 10 months of prison time if he took the plea. No fine was mentioned. He said he could do 10 months, then get out and get his license reinstated. So he pleaded guilty to the charge. Little did he know.

On August 10, 2017 he was sentenced to serve 39 months in federal prison and ordered to pay $1,941,254 in restitution to the Medicare program. The $1.94 million he was charged in restitution was the amount paid by Medicaid to the hospice centers, not to him.  So he was lied to. Acting United States Attorney Robert H. Norman, DHHS Agent Derrick L. Jackson, FBI Agent Christopher Freeze, and Mississippi Attorney General Jim Hood bragged about their success.

Also of note, Sandra Livingston, 66, the owner of Milestone Hospice, pleaded guilty in 2015 and was sentenced to 36 months in prison and ordered to pay $1,098,639 in restitution. Interesting how the government can get repaid twice for the same money by charging 2 different people in a “conspiracy”. The indefensible charge of “conspiracy” has become the #1 method of putting innocent people in prison today.

DHHS-OIG Agent Derrick L. Jackson warns medical professionals involved in hospice in Mississippi “The message I would send is this: You will eventually end up in federal prison just like the defendant in this [Ms. Livingston’s] case.” After Dr. Brown’s plea DHHS-OIG agent Chris Covington said “More indictments? Absolutely guaranteed. Put all your money on black; it’s going to pay off.” This attack was part of the government’s “Hospice Storm”, an effort focused on Mississippi, but with their success, is becoming a national focus.

What was Dr. Brown’s “supposed” crime?  He was the medical director for 2 hospice programs—Milestone Hospice owned by Ms. Livingston, and Sandanna Hospice.  He pleaded guilty to conspiracy to commit healthcare fraud for referring patients who were “not hospice appropriate” to hospice which led to $1,941,254 in Medicare payments (according to the government, but which probably involved all patients). Brown also admitted to receiving $47,750 from the hospices. That was probably the salary for doing his job.

Dr. Brown had documentation showing that all of his referrals were appropriate but chose to cop a plea. As a result, the government gloated. DHHS Agent Jackson sent out another warning to doctors saying “The verdict today should send a clear message.”

What is the message? That message should be understood by every physician in the country–Opt out of handling government insurance. The government is using the hard working backs of compassionate physicians to fund replacement monies for the national deficit.

Dr. Brown pleaded guilty to one count of conspiracy to commit health care fraud. The “fraud” was based on the fact that once the patient got hospice care, they didn’t die. Is that a warning to other hospice administrators?  You bet it is. And it is a part of the government’s legal genocide. In other words, “Folks, you better make sure these old people die, or you’ll pay.”

According to the government, one sign of hospice fraud is the share of patients that don’t die while under hospice care but are instead discharged. More Medicare beneficiaries leave hospice care alive (20.6 % in 2014) in Mississippi than in any other state in the country. The national average is 11 percent. The government wants to blame that on fraud with the hospice owners so that they can reclaim the money and fill prison beds. South Carolina is probably also in the government’s sights since they discharge 18.3%. My suggestion is that it is an indication of poor citizens not receiving medical care until they are at a critical crossroad, and hospice saves their lives. Often people have to stand on the edge of their grave to modify their lifestyle. That can reverse their direction 180o. But if you can read between the lines, as a hospice owner or doctor, saving lives is not in your best interest.

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