VA HOSPITAL PATIENTS MURDERED BY NURSE

VA patients are not murdered as a rule, but when such depravity occurs, it might be wise to note and remember the tragic circumstances. It might help us to recognize dangerous people and situations, and minimize the possibility of repetition in the future. Here are the facts as reported by Adam Gorlick of the Associated Press on March 14th:

A former nurse at a veterans hospital was convicted Wednesday (March 14th) of murdering four patients with drug injections in what prosecutors said was an attempt to impress her boyfriend with the way she handled emergencies. Kristen Gilbert, 33, of Setauket, N.Y., could get the death penalty. Massachusetts banned capital punishment in 1984. But the case was tried in federal court, where murder can be punishable by death, because the crimes took place on federal property at the Veterans Affairs Medical Center in Northampton (Massachussets). The jury reached its verdict on its 12th day of deliberations. In addition to the four murders, Gilbert was found guilty of giving injections to two other patients who did not die. She left the courtroom without comment. Both the defense and the prosecution are under a gag order.

The jury will return on Monday, March 19th to begin hearing evidence on whether she should get the death penalty. Prosecutors said Gilbert injected patients with overdoses of epinephrine, or adrenaline, which sent their hearts racing out of control. They said she wanted to attract attention, especially from her lover, a hospital security guard. The boyfriend, James Perrault, said she once she told him, "I did it! I did it! I injected those guys with a certain drug." But later, Gilbert told him she was only trying to make him angry, Perrault said. They were breaking up at the time. Perrault also testified that Gilbert used to grind her hips into him during medical emergencies.

Prosecutors said she also once climbed atop a patient and straddled him, apparently so Perrault could see her garter belt. Gilbert's lawyers blamed the emergencies and deaths on natural causes, saying the patients were already ill. And they argued that she was falsely accused by co-workers who were upset she was having an extramarital affair with Perrault. "Every single one of these people had a coronary disease, were at risk for a coronary disease or at risk for sudden cardiac death," defense attorney David Hoose said in closing arguments. "If you start out looking at these cases with a suspicious eye, then you'll find suspicion."

The former nurse was charged with first-degree murder in connection with four deaths. She was found guilty of first-degree murder in three of those deaths and was convicted of second-degree murder and assault in the fourth death. She was also charged with assault with intent to kill in the case of three other patients who were allegedly given injections but did not die. She was convicted in two of those cases and acquitted in the third. "I'm really, really happy," said Susan Lessard, daughter of 66-year-old Stanley Jagadowski, who died in 1995… although Gilbert had confessed to the murders to both Perrault and her estranged husband, her lawyers attacked those confessions, saying she made them while hospitalized because of the stress of the murder investigation.

Once again, we're compelled to say, you just can't make this stuff up.

TRICARE FOR LIFE (TFL) UPDATE

Under the new Tricare For Life (TFL) program, Tricare will be a second payer to Medicare when services are covered by both programs. However, some health care services may be covered by one program and not the other.

Services that are covered by both Medicare and Tricare: When a beneficiary receives medical care and/or medical supplies that are a benefit of Medicare and Tricare, Medicare pays first and Tricare pays the Medicare deductibles and copayments.

Here are the details:

MEDICARE PART B COVERAGE (Hospital Services)

When a beneficiary is hospitalized in a Medicare-approved facility, Medicare pays the allowable amount and Tricare pays the deductible and any cost share for the first 150 days of hospitalization. The beneficiary pays nothing. After 150 days, Tricare becomes the primary payer, covering 80 percent of the Medicare allowable amount in network hospitals and 75 percent in non-network facilities. The beneficiary is responsible for the remaining 20 or 25 percent not to exceed $3,000 per family per fiscal year.

When a beneficiary is admitted to a skilled nursing facility after three days or more of acute hospitalization, Medicare pays all approved charges for the first 20 days. From the 21st through the 100th day, Medicare pays all but $99 per day. Tricare pays $99 per day on the beneficiary's behalf. The beneficiary pays nothing. After 100 days of skilled nursing care, Tricare will pay 75 percent of the Medicare allowable charges and the beneficiary is responsible for the remaining 25 percent, not to exceed the catastrophic cap. In the rare event that a beneficiary does not meet Medicare's three-day hospitalization requirement, Tricare becomes the first payer and the patient is responsible for the deductible and cost share up to the $3,000 maximum.

MEDICARE PART B COVERAGE (Medical Services)

Services that are payable by both Medicare & Tricare - When a doctor provides a service covered by Medicare and Tricare to a hospitalized or out-patient beneficiary, Medicare pays the entire bill except for the Medicare annual deductible ($100) and the beneficiary's cost-share (20 percent). Tricare pays the deductible and cost share and the beneficiary pays nothing. (Note: Even if the doctor does not participate in Medicare, he/she is prohibited by law from charging the beneficiary more than 115 percent of the Medicare allowable amount.)

Services that are payable by Medicare, but not Tricare - When a beneficiary receives care that is covered by Medicare but is not a benefit of Tricare (chiropractic services, for example), Medicare pays the allowable amount, minus the Medicare deductible and cost-share. Tricare pays nothing. The beneficiary is responsible for the portion of the bill not paid by Medicare.

Services that are payable by Tricare, but not Medicare - When care is a benefit through Tricare, but is not covered by Medicare, Tricare becomes primary payer. The beneficiary must pay the Tricare deductible and cost-share, just like an under-65 retiree, but there is a limit to what the beneficiary must pay. Once the beneficiary pays cost-shares and deductibles equal to $3000 per fiscal year (sometimes called the "catastrophic cap"), Tricare pays 100 percent of the allowable charge for covered services. In this case, the beneficiary will receive a bill for, and be legally obligated to pay, the Tricare deductible and cost share. Generally, the Tricare deductible is $150 per person or$300 per family per fiscal year.

When a beneficiary receives medical care in a geographic location (overseas, for example) not covered by Medicare, Tricare is the beneficiary's only medical benefit. Tricare will pay for services and supplies, but only if they are "covered." The beneficiary is liable for the Tricare deductible and cost-share in the same manner as an under-65 year old retiree.

When a beneficiary receives care in a non-DoD government facility (a VA health care facility, for example) for which no Medicare benefits are available, Tricare pays the beneficiary's legal liability minus the Tricare deductible and cost-share. The beneficiary is responsible for paying the deductible and cost- share just like an under-65 year old retiree.

[Source: FRA News-Bytes FEB 01]

"VETERANS DAY" UNDER FIRE

Here comes Congresswoman Sheila Jackson Lee (D. Texas) with the bizarre notion that there are too many "Veterans Days" to celebrate. On January 3rd, she introduced H.R. 62, a bill to establish election day in presidential election years as a legal holiday. Here's how she proposes to accomplish this. She would move "Veterans Day" to "the Tuesday next after the first Monday in November in 2004and each 4th year thereafter".

Wow! Even a suggestion of such manic manipulation is "chutzpah", in plain New Yorkese or any language. What a bummer.

On top of the sacrifices already made during active duty years, if "Sheila gets her way, proposes that veterans, and the nation, would have to sacrifice yearly observance of the traditional November 11 Veterans Day to once every four years and making it a legal holiday for voting, not veterans.

H.R. 62 is now in the House Committee on Government Reform, where it will no doubt die as a testament to "Sheila's" most ignoble legislative effort.

Folks, you just can't make this stuff up!

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