Departmental Appeals Board, HHS for medicare and personnel matters: Miami Medicare hearing office.
Attached are pages that explain what is on going since 9-29-2010 since the only final, formal decision has been rendered on a few claims paid by Cigna Govt services: Case M09-1406. It appears, the next case on the Trailblazers claims ended up in front to the judge with none of the file and none of the previous decisions) from the Miami medciare hearing office. There was no final decision as no appeal rights, etc. Also, what was re caped would be theft of the medciare trust fund if carried out. surely the judge would not be advocating that. After the first two ALJ decisions on it seems files increasingly disappeared out of both the Appellate office and especially the Miami hearing office where the govt contractor ( ACS?) doesn't even docket in arrivals and attorneys all over the country are complaining to the staff about files not left intact. I'm doing the best i physically can to meet filing dates on a : death panel decision that has put my life in jeopardy and caused great physical and financial hardship in filing papers and appeals and intermediaries ignoring them. I've asked for an against equity and good conscience waiver of any overpayment liability but its never answered at any level. There are several hearing requests pending in the Miami Hearing office and no formal answers to any appeals other than the first one. It seems that the letter sent from the Dallas CMS office by a high level official who has been instrumental in on-going violations was the source of the next letter, the only source. its documented she has; asked me to withdraw my federal workers comp claims so medciare could pay my bills, and has had the official line - up changed at medciare coordination of benefits in violation of their contract agreements to have security on an official records which three judges at CMS have affirmed and 9 judges at the US dept of labor. No one explains o medical billing personnel of the legal option of conditional payments which medciare is required by law to enforce even though a former Sec of HHS suspended enforcements and set up ' contracts.' We've seen, according to some inside experts, over a trillion dollars of medciare truest fund used to pay bills that were never coded for recovery from the primary payers. MSPRC still doesn't seem to understand that they are to enforce the laws against existing primary payers and stop their shenanigans to get out of paying when the law, judges, and entitlements are approved for them to be the primary payers. The last three US dept of labor judges said in 2/09 : ask me for the facts of the case as they were well aware of the ongoing problems with their contractors and CMS's as gossip and rumors got passed around as facts. Most of my bills should be getting paid by OWCP, secondary /tertiary issues should be getting their initial review and appeals if needed to clarify issues. The request for scheduled award and permanent disability field in 1996 should have been approved long ago, but the substantial medical evidence is ' missing ' along with the entire case file at ACS and MSPRC doesn't even seem to know what my accepted medical conditions are listing a few musculoskeletal secondary claims only even after sending a detailed ( including the accepted occ asthma and other related accepted conditons) and lengthy recovery letters in '05, 07 and 08 which were ignored. My official personnel file is missing and rank and file employees can't seem to figure out my status which has not officially changed since going from HHS to owcp jurisdiction in 10/94. This was before any w-2' s were issued by SSA as an independent agency. I went to work1/10/89 and something terrible happened beyond by ability to control or stop.( others could have) I have an established , non- controverted case on my 1/10/89 and why all the violations? Three times I tried to work at great physical peril to my life with EEOC sanctions against HHS-SSA for violations that are not enforceable against another federal agency. Now, for profit contractors have taken over control of our govt programs and our civil rights have ' disappeared' along with all my files.
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Follow ups sent periodically and to date no reposnse. No civl rights exist , no constitutional rights exist. Linda Joy Adams
UPDATE: Multiple Heaings pending. Some appeals never had a Hearing and are at the Appellate judge asking the cases be remanded back.
We ask for remand for all claims for all of us to be coded as conditonal and implementation of HR 1063 signed into law 1/11/13 to enforce recoupment form primaries. A combined mega Hearing is requested involving A, B and D claims. This would avoid what did happen before with some of us notifed of one hearing and the judge given another one and nothing ever got heard after M09-1406.
HR 1063 is requested to be implemented.
The Hearing o
Setting aside the requirement of liquid oxygen suppliers hiring a respiaratory tech would make others which exchanged filled tanks to ocmpete for areas. And all should be allowed to sell supplies and empty tanks if the patients has to go to gas company to get the oxygen to stay alive and that should be reimbursable, too. Forcing suppliers to take all patients might meet with resisitance. I have always gotten along well with the delilvery persons.
The only issue on M09-1406 from three suppliers was to set aside the suspension of enforcement of the Conditional payment law which had been in effect since 1994. M09-1406 led to HR 1063 being passed, but not yet implemented.
Before you are claims denied since 1/08 as there was no supplier. There has been no break in oxygen care for 18 years.
Although not required, as approved for life for liquid oxygen by Medicare and others; an oximeter reading of 88% was gotten in 7/13 when an echo stress was done,
Medicare's list of suppliers is not accurate.
My current tank is held together with Glue and tape and must lower it at times to get oxygen to flow to top. When it goes,so does right to live. No way to get it replacced with current situation surely was never the intent of CMS.
M09-1406 said to recover from Federal workers comp.
CEO Lynn Blodgett and his company ACS-Xerox will not input over a decade of timely filed oxygen claims with Federal Workers comp where I have permanent medical with them due to life time need for liquid oxygen. Other claims use some kind of code no one undertands on an 'offline' system not connected to the official one as ACS has refused to post my file so items can be processed and paid since they got the contract even though Medicare's 'common working file' shows the permanetly approved medical direct from the official system.
DESTRCUTION OF RECORDS does not cease legal rights..
only had a few patients . Mine had 6 another in our area had 3.Yet, the large companies with new 'exclusive rights' could refuse service for those already covered. Many like me have life threatening side effects from the ozone emitting and less than therapeutic levsl of oxygen from the consntrators. Tried recently with and severe inflamation, so the approval for life for liquid is very medically real. We ask for over turn of supplier having to hire a respiratory tech which makes no medical sense and already covered under home health type services if needed. from a medical provider for such.
There has been no break in use of liquid or compressed oxygen for 18 years when owrkers ocmp put me on it for life and file got riffled and ACS took over and woudl not post my file so any one coudl work it and pay claims.
I choose to live and invoke the Teri Schiavo law, as my life is endangerd at present due to not being able to replace a tank or get suppliers due to current situation created back in 1/08.
My life is currently held together with Krazy glue and gorilla tape and have to lay the tank down perodicaly to get the oxygen to flow to the top in order for my life to continue. This may soon not work either and death will be imminent. Like many, I do not have the funds to buy a new tank of $2500+ wihtout medciare paying conditonally and even thugh many medical suppliers in our area accept medicare, they are not permitted to sell an empty tank or supplies even if medicare or ins isn't billed.
Linda Joy Adams
NUMEROUS APPEALS ARE PENDING AT BOTH LEVELS, BUT SINCE 2009 THEIR PARTNER ACS ET AL( CEO LYNN BLODGETT HAS NOT LET ME GET NEAR ANOTHER JUDGE TO RULE AGAINST THE ILLEGAL AND UNETHICAL TACTICS ONGOING AS OCCURRED BY 4 JUDGES IN 2009 IN MULTIPLE AGENCIES. MORE OF THE OVERTHROWN GOVT TO DENY ACCESS TO THE JUDICIAL BRANCH OF GOVT FOR THE CONSTITUTIONAL POWER THAT CAN GIVE ONE ON THEIR CASES AS WELL AS GETTING LAWS CHANGED THAT THE RULINGS EXPOSE THE NEED FOR AS OCCURRED WITH HR 1063 AND THEN TURNED OVER TO THE CULPRIT TO ENFORCE? Linda Joy Adams
UPDATE: THE LAST HEARING APPEALED AND APPEALED LAST YEAR HAS HAD NO RESPONSE and that is added to so many pending for over 6 years now at the hearing and DAB levels where hearings DID NOT GET HELD AND WE ASK FOR A REMAND FOR THEM .. Issues in all of these affects many and in some cases millions, some of whom have died waiting for some kind of justice and none comes. The back lof is tremendous as there is no real appellate decisions that are done in Medicea and now in some SSA matters either before one gets to a real judge. who can apply the laws, and subpoena info, etc. As most are now being done by the international cabal of contractors and what they can do is not a real legitimate kind of appeal where laws and rules and policies are applied to what is being appealed. Many times the contractors have no access to know what those are as they are not allowed to use them but must use what Lynn Blodgett et al wishes the laws of the land to be. We are in a stalemate of mud and corruption and cannot move forward and fix bad laws and regulations as no one can get through the administrative appeals process, where before the COUP OF 2002 the real government could often change policies when appeals were filed and injustices in the current laws and policies and regulations came to light that contradicted the intent of laws passed by Congress.
Its why we have seen major thefts occur inside and with the collusion of some bad contractors. And Congress tried to overturn the 2010 Hillary care law 38/ times as they have no input from the real government how to 'fix' without the real facts, data from the contractors running it and the kind of appeals we have pending not being allowed to be heard, by Lynn Blodgett's companies putting the files together for the judges and never doing so if the issues are not ones he et al wishes to get before a judges and throw light on horrific injustices going on that the real government has no 'official' knowledge of in the COUP of 2002 budget was taken away by Congress to do real internal audits of them at the same time they self posed an unconstitutional gag order not to mention, contact or have a contractor testify so they can fix parts of the law and stop the blatant thefts and gross injustices going on no one is allowed to 'officially; say .And GEORGE SOROS IS SAYING HE IS GOD AND HE TRICKED THE WHOLE USA AND OVERTHREW AND LYNN BLODGETT ET AL WORKS FOR HIM. I do not know who is at the boss of Lynn Blodgett as he is he one who has personally lied and withheld files and data and in is in defiance of 38 federal agency judges including Medicare's on M09-1406 AFIRMING I AM APPROVED FOR LIFE FOR HOM LIAUED OXYGEN BUT ITS FECA'S BILLS NOW AND FOREVER AND HAS BEEN that is still the current statues of affairs as nothing is going to change unil he obeys the US DEPT OF LABOR JUDGES AND does as three appellate judges orderd done to asks me for the FACTS AND LETS ME RECONSTRUCT FILES FROM MY RECORDS AS SO MY CLAIMS EXAMINERS CAN PROCESS AND PAY ITEMS GOING BACK IN SOME CASES TO 1989 ALONG WITH MY REQUEST FOR PERMANENT DISABILITY AND SCHEDULE AWARD SO I CAN RETIRE. BUT HE HAS OVER 15 YEARS OF OXYGEN INVOICES NO INPUT AS THEY WOULD BE PAID AND FECA PUTTING ME ON HOME LIQUID OXYGEN 22 YEARS AGO IS WHY I HAVE THE PERMEANT 100% FECA MEDICAL UNDER THE 1988 LAW EVEN THOUGH NOT YET RETIRED. and he says 'LET HER DIE' AND HAS DONE EVERYTHING HE CAN THAT WOULD NOT GET REAL LAW ENFORCERS INVOLVED TO CARRY IT OUT. Inside collusion seems probable but no budget from congress either since the COUP of 2002 for them to find out. Linda Joy Adams
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