What a Waste
Does one person’s voice make a difference? A Rhode Island woman has been fighting for nearly a year to find out why taxpayer-funded supplies for her disabled daughter have repeatedly arrived damaged and unusable. And who’s paying for the replacement costs? We went to Senator Jack Reed’s office, which is trying to get answers as well. And now, Jim Hummel finds, the case has caught the attention of a Medicare fraud and abuse unit.
This week: a Rhode Island woman’s trying to find answers. Why are supplies for her disabled daughter - paid for by Medicare - arriving repeatedly damaged? And are taxpayers eating the replacement costs? We’re on it, Senator Reed’s office is on it and now so is a Medicare fraud unit.
Becky Kelsey is in a great mood this Monday afternoon,laughing and smiling for her mother Jodi. It is a lighter moment in what can often be challenging days.
Becky - who is 33 and lives at home - has a severe form of cerebral palsy. She can’t speak or walk, has pulmonary issues and a seizure disorder. And for the past 20 years, she has been on a feeding tube.
Kelsey: ``The particular formula she’s on is called Promote. It has a certain amount of vitamins, nutrients, all of the good stuff she needs for age, her size.’’
Jodi Kelsey says that until last summer Absolute Respiratory out of Johnston had the contract for the Becky’s formula and other supplies - all paid for by taxpayer-funded Medicare - and delivered directly to their door. That all changed last summer.
Kelsey: ``I’m thinking that Medicare is trying to save money so they put out a bidding system and the company we were using did not win the Medicare bid, so we were given a list of different places.’’
Jodi chose Lincare, a large national company with a local office here in East Providence.
Kelsey: ``They own a company called Enteral Central, which is where their enteral care comes out of, which I believe is in Arkansas. When we started a year ago they really didn’t know much about enteral care - I actually had to bring a Mickey Button in, which is the button that goes into to my daughter in order for her to be fed.’’
Hummel: ``They didn’t even know about that?’’
Kelsey: ``They didn’t even know what it looked like. I had to speak with somebody in Florida, then they switched me over to somebody in Alabama, and then the food comes out of Arkansas.’’
Hummel: ``So the East Providence company is not so local.’’
Kelsey: ``Not at all.’’
But the biggest problem was the cans of formula were arriving damaged. And not just a few.
Kelsey: ``We’ve gotten orders of 150 cans where there’s probably been anywhere between 25 and 50 cans dented. The first few months we got it there were cans random all over the place, crushed, dented - the other supplies were also in those boxes, and those were just loose all over the place.’’
Of the 150 cans she most recently received - Jodi counted 68 that were damaged.
She has kept extensive notes of her conversations. Even though there has been no money out of pocket, for her, Jodi has had spent countless hours on the phone to get replacement cans after the manufacturer of the formula told her to throw the dented cans away because their sterility could be compromised.
Kelsey: ``It’s a waste, number one, that they’re telling me to do that. And my first question was: `Are you charging Medicare twice for cans that I’m throwing away?’ They said no. And I’ve asked them time and time again to wrap the loose cans too - why is this happening? They sot of started blaming UPS. There were two months where we started getting frozen cans. And we’re not supposed to be using anything that’s frozen. And they were frozen.’’
Jodi took video on her phone one day in January.
Kelsey: ``We never, ever had that problem before. So it wasn’t just the dented cans, it was frozen cans.’’
Hummel: ``And you had to throw those out.’’
Kelsey: ``And we had to throw those away.’’
Hummel: And so every time you’ve called they’ve made whole, for you.’’
Hummel: ``Have some of the replacement cans been dented?’’
Kelsey: ``Umm, hmmm.’’
Hummel: ``So do you every catch up?’’
Kelsey: ``Never catch up.’’
Hummel: ``but the shipments keep coming.’’
Kelsey: ``Yeah, every time I call, but I have I have to call all the time.’’
Jodi filed a complaint with Medicare in January but heard nothing back.
Kelsey: ``And I know I’m one person I can’t fight Medicare by myself. I can’t fight Lincare by myself.’’
Now it appears she doesn’t have to. Two weeks ago we contacted Senator Jack Reed’s office, which has assigned a staffer to look into her case. The office - which in turn contacted the Centers for Medicare and Medicaid Services - has been in touch with Jodi daily, sometimes several times a day.
The Hummel Report has learned a Medicare fraud and abuse unit has opened up an investigation into Jodi’s complaint.
Hummel: ``Do you think you’re an isolated case?’’
Kelsey: ``No, because when I’ve called them I have this one girl I’ve spoken to the last couple of months and I think she’s fairly new there and she’s doing everything within her power. She said to me `I get a lot of phone calls recently about this same kind of thing.’ I don’t’ care whether the insurance company picks it up or not I’m still not going to give up that fight - this shouldn’t be happening to a consumer, to someone who already deals with enough on a day-to-day basis, and then I have to stop and make a phone call every single month to say what are you doing?’’
Jodi called Linacre so many times, the company did its own investigation - of her.
Kelsey: ``There was a time when the order was being sent to the local Lincare for them to check to make sure I wasn’t just saying that these cans are dented.’’
Hummel: ``What, like you’re going to scam them and get extra cans?’’
Kelsey: ``Exactly why would I bother, you know?’’
Hummel: ``When it’s being paid for anyway.’’
Kelsey: ``Right, and they were getting dented cans.’’
Hummel: ``So they know.’’
Kelsey: ``They absolutely know; they absolutely know, then they stopped doing it, oh they’re not going to do that anymore. I have probably spent hours and hours every month just making phone calls, calling UPS, calling Enteral Central, calling Lincare, going over to Lincare, talking to their regional manager, who did nothing, trying to talk to people in the warehouse, bringing in those cases of formula, going through every single one, when the order comes. I’m not going to let this go because I want to see an end, I want to see a resolution I want to see them do something right. When it comes to my daughter, or probably any of my kids, but mostly Becky because I’ve been fighting with her for 33 years, you it right, you want to make your life a little easier and you want the right things to be for her. I don’t want her to get a bad formula and get sick: so I just keep going.’’
And hope that those efforts eventually pay off.
Jim Hummel for The Hummel Report.