Daily Recap 1/16/13: DC Standd off: President Obama Born In Topeka Ks;Cold and sunny day! And will the New law do any good to stop the thefts of Medicare and the horrible abuses of their contractor, Medicare coordination of benefits.
Medical Blocked for Loved one!!
Every two weeks US dept of Labor posts the insurance info to the Medicare computer owned by the contractor Emblems health by contract which stipulates that NO info posted is to be changed. It posts my active duty status, and the Federal Workers compensation which is permenant and Federal Blue Cross Blue Shield my other primary depending on diagnosis and Medicare is secondary. ( all my bills are either already covered for life or psnding approval and never reviewed due to Affiliated computer services- Xerox's CEO blacking and suppressing the last three appellate agency judges who basically said that there has been so much felonies against me and my files that US Dept of labor that thereby one is to ask me for the facts of the case and reconstruct my file fotrit to be worked from my records. There are NEW items pending since 1989 in some instances that have never ben paid nor reviewed for payment and other issues pending. Iif not suppressed and lied about their lucrative contract up for renewal should have been blocked by the orders on my case as it documented what others have also complained about,too This was witheld from US dept of labor by Lynn Blodgett and the official have no idea what context the decision is given in and that everything was to be reinstated and worked forward to permanent disabiliity. One claims examiner did send a letter to that effect just before she retired and her decision has been ignored, too. I had sent a certified letter to them but one can't send anything to a govt officer , as it goes to the contractor ACS and they deicde if it ever is seen as this also happens with the judges remand orders. They sent it to be posted and it disappeared, I can't Given them anything direct as they don't have the authority to accept anything direct, I can't give, mail OR fax to the regional US dept of Labor Office of OWCP as must be sent directly on to ACS in London Ky who is still acarrying out the orders of the convicted crminal in the Jack Abramoff bribery scandal who left in 2005, who told me my file wold not be posted as I was old and claimed a Mr Or Ms OPM said I was to die and not post it.
My family is on my Federal blues policy which the taxpayer pays 75% of the premiums for us to have. When Doyle retired, and got Medicaire and dependent also picked up Medicare, too through entitlement on his record.
Both have Fed Blues as primary due to my status and Medicare secondary and the dependent has state Medicaid also, but it shoudld rarely ever have to pay any thing, although in the past it was the secondary before Medicare was obtained.
So all three of us have illegally had our records messed with by Emblem Health in violation of their contracts with CMS and US Dept of Labor and until the law was signed by the President a few days ago,is enforced; no way to make them stop since Sec of HHS Donna Shalala suspended enforcement of the condiitonal payment law back in 1994, and letting the whole insurance industry do as they pleased and they proceeded to make Medicare primary as Medicare Coordination of Benenfits did any thing they asked ansd accepted lies and and false info and changed the legal line up. Since 1/12, they have been deleiing the Fed Blues off the entire feami';s records and one of the depenedent's;bills had been picked and up paid by medicaid and the State of OK is due a refund , too from Blues. This is HCS Illinois Blues who also is the Blues for OK, NM and TX and only Ill has done anything about and did get 25 million back for State of ILL for doing the exact same thing that happpened on our loved. Since I get special help on my Part D Medicare the State of Ok is also paying for my workers compenation medication.And My letter to Aetna Part D was posted here a few weeks ago and they are treating as a greivance, but no word yet as the CEO did take the situation seriously as I'd been told there was no recovery of monies from the primaries on Part D medicare yet, and there wasn;' in the beginning. so Congress passed laws allowing the theft of medicare, but supposedly this has been corrceted but no one seems aware of it or how to make it happen. Trillions are owed back to Medicare by all the various insurances scmpanies and health plans that have commited blatant fraud and abuses of power against the patients and the taxpayer. with the medical providers and suppliers and pharrmicists cuaght int he cross hairs. Amount is form insiders who work with this and can do nothing.
So our loved one had a doctor's appt this AM and noone asked for ins info, and the last visit ended up with appeals that that have yet to be answered as Trailblazers paid prrmary for medicare and not Fed Blues. There contract was not renewed after insiders said a trillion dollars stolin over the last decade, and Novatis has our packet and I talked to a person there, although they didi n't want to talk to patients, I insisted as 1-800 Medicare knows nothing and has withheld thousands of fraud reports inclouding the 500? filed on Ttrailblazers and Palmetto GBA another SC Blues subsidiary and not sent them in to OIG's Director in violation of their contract.. For over a decade Trialblazers had no problems getiing medicare coordiantion of benefits to alter the records and make Medicare pay for all the bills, and they are a subsideary of SC Blues who now owns Cigna govt services, renamed CGS; and South Carolina Blues' subsidiary pmedciare partners was involved in stealing the claims and and turning them into multiple claims up until they lost the contract. $4 million on me alone and the 500 witnesses said it was pervaseis but General Dynamis that owns them now will nt let them reprot fraud any more at 1-800 Medicare
My records are so messed up I can't get Part B medicare for Co pays and have bills in collctions as I can't pay them.on the co pays.The Hearing file was stolen out of the McAlaester Hearing office by ACS and disappeared and the SSA computer hacked into and hearing even deleted as that hacking has been going on for over a decade and SSA seems unconcerned that the system is not secure. No one at SSA can access the system to delete an appeal and shouldn't. as a decision needs to be made and entered. but AVS has taen the same control there of files and data.
So after the doctor appt the next stop was the pharmacy at Walmart.where they couldn't access any info to say our loved one had any kind of ins. Doyle had forgotten that the state had changed Part D Medicare ins cos for this year and no card had come, yet, but No Fed Blues was on there and sometimes in the past Blues would get billed and they would ask for the big co pay, which Part D is to iack up almost all of that.Part D with special help replaced the state Medicaid or it probably would still be paying everything., and almost is under Part D So they came home, and I made a phone call
First to wal mart and the loved ones Social security number was provided and they found the new info, and I had pulled out the letter that had come but they were able to pull it up. But No Fed Blues is one the records.
This patient has a few more days of medication, but if one has problems and no transportation and no one to assist, what happens when one goes off their meds and serious complications occur? Another 22 mile trip will need to be done to get the meds but Walmart has no idea how to do a conditional payment so that Part D pays but Blues will be asked for a refund to Medicare/ This is the Law HR 1063 that was just signed this week after 19 years of theft because MCOB, since 1999 has facilitated it in what the US atty's office called the biggest organized crime in the history of the USA, a RICCO case. Without MCOB altering the records, all would have been forced to do conditional payments and the govt, by the law passed in the early 1980's is required to enforce it and get the money back, not the patient and not the medical provider begging on the phone at their billing services.
Compounding all this, and the resulta for our family are already showing bizarre results; is that a Doctor pharmacy, even if they are willing to spend the time, can't call MCOB any more, they have to pay a 'cleaning house to access the computer system and they are doing nothing but being another party passing on the altered fraudulent info. Since 4/09, there is only a few minutes every other Tues morning at 7 AM CST, thet the info is correct before MCOB illegally alters it unitl the next official postng that is never to be altered.. from the illegally altered mess. And getting paid big bucks to pass on the erroneous info and doing nothing to aid in stopping the fraud. against the patients and medical provider
HR 1063 TESTED and Failed
I called the new Part D plan and the loved one said it was all right for me to talk to them. They had received no info from MCOB about the Blues and did send a card, and they are going to consider this as a grievance so there can be a formal answer and appeal. rights. They had never heard of conditional payments, but one of the persons there was aware of the new law but didn't realize that our case was exactly what it was all about. Many don't! They think its like one who has medicare gets in a car accident and has bills and Medicare pays and codes it so that when the ins co settles medcare can say how much is owed back. That is not conditional payments under original 1980's law, but Medical Subrogation, something very diffreent. Conditional payments is when one already has the coverage and these illegal 'games'
are played to get out of paying when its very obvious, or even not so obvious and a detemination has to be made, by but not by the one committing the blatant fraud. as has been happening on many and few udnerstand that THE PATIENT IS LIABLE FOR THE STOLEN MONEY even though we can't arrest any one or cancel a govt contract or shut down an illegal operation. How can the patient do what the govt can't? And there is no waiver one can get as Micahel Astrue, Commissioner of Social Security agreed to give these kinds of waivers, where the patient provides NO income or resource info, and has refused to implement it since he signed it in 2005 with Sec of HHS Tommy Tompkins, who resigned sonn afterwards. I filed form 632, but no one has processeed and its felony disappearances seem oblivious to SSA's OIG who takes their orders form the Comm as to what they can investigate and ACS who did it more than once. Not one Sec of HHS since has seen to it being implemented, which would allow the patients to get out from under the laiblity they ca';t control. Since I've conducted medicaire fraud investigations, I could never say , I didn't know like most could if it would be accepted. Its 'tricky' as one as to make sure allt he ins are on the papers one signs for medical care or they could come back and say you lied and are liable.
I then called Medicare fraud line at 1800 HHS Tips, they say are now federal emplyoees but werent in the past;, but Blues is also partnering the fraud office and many of them are doing the stealing. I was giving the info and got hung up on as soon as I mentioned MCOB to thme This happened many times, I did get the id number of the person doing this once, and then she started defaming my character and I was only trying to get her to take the report and she refused to do so. Finally saying they were forbidden to take a report on a partner of medicare even though the phone menu recording said they could and she agreed it did say so, but they really are in cross hairs there. . So something is really amiss in that office.
I then called OIG Director Levenson's officei n Washington DC and got rebuffed there at first and finally did get someone to listen as I said I wanted to get this on record as iwanted the $1000 dollarr a day fine assessed times 3 each day the system is giving out false info and causing so much harm and what happens in an emergency and there is no ins on my records except the owcp and ACS lies and says I do';t have any when I have permanent coverage and they used to say I had a million dollars. These postings must be getting around as I got some comments made in respose along the way and some are getting exposed, but some don't like it either to be 'found out.' I really am sickened from laying in bed propped up on pillows conducting the criminal investigation that should have been completed and monies recovered a decade ago when this all got started in earnest after HCS Blues of ILL obviously colluded at the same time to steal Medicare.
In the meantime I had called Walmart ethics dept about the local pharmacy not having the info to do a conditional payment, and got Global Compliance a subsidiary of Goldman Sachs interlocked with ACS Xerox to take the report and they hung up on me several times and would not take the report. They were happy to complsin about the local store but not about them not being given the proper info to bill and walmart's pharmacy headquarters should have this. But my letters and appeals to the attorny for the last several years have never ben answered and nothing changes.A Company worth 40% of tnation's wealth is not doing what they can to stop the theft of Medicare.
REGULATION DIDN'T WORK
A regulation from Medicare over a year ago was to end this and didn't. If the patient informs the medical provider as to who is primary and secondary,etc. then the medical provider has to use that info and if the info received form MCOB differs they are to ask for a conditonal payment or the medical provider or walmart is liable for the overpayment. There were n openalties and nothing to stop the provider or pharmacy from abuse of powerr by the medicare contractor and no way to fight back against a crooked contractor.as the govt puts doctor and patient as the ivestigatora and enforcers of the law, and its an impossibility and Congress must have known this when they passed this mess? I really don't; want to hear any more whining from them about Medicaire going broke when they did it.and are still allowing it.
I ended up leaving a message for our new congressman, to find out whom to report this to as OIG won't take i a report and I want to make sure every claim paid is prepared and the fines get assessed against the real culprit MCOB and ACS, in my case. And called Sen Coburn's office and they transferred me to a staff person n DC who is going to have some one call me, and ussually does';t occur. When asked what I want, I said the fines assessed and whom do I file with to see the everything is in order when the regs get passed to ask and fine?
PRESIDENT OBAMA BORN IN TOPEKA KS: So we are in a stand off in DC, first a new law should have been understood that the end of stealing Medicare, by the ins industry and partners of Medicare has come to an end, but the message has not circulated yet. Question is what US Senator put a hold on this law from being voted on for almost two years since passed by the House? Hope it wasn't one of mine?
I'm also sick of the stand off on the gun bills. Like the fake birther issues when all they had to do is get the real records out of Topeka Ks and end it but they wouldn't be able to collect money and keep on using it as an excuse to demean the president of the usa who was not told where he was born and of who as far as I know!
Congress should have passed a bill to tighten up gun shows and also renewing the assualt rifle bill when it ran out. OR write new laws to reflect what the people wanted. They didinot do so through the end of the Bush administration and for 4 years of Obama's adminisiatration. So today with many people begging for somehting to be done and the nation arming itself with threats by some enraging the masses to the hilt and to the point the local police have had trouble finding ammo for their guns to protect us in case of danger;. The president signed an executive order. DID Congress take that and start voting on what part they wanted to keep and what to amend, etc. No we have some entering letters of impeachement for the executive order being signed when the fault is Congresses for taking NO ACTION ! Its ludicorousu to have to go through a back ground check at a store and not at a gun show. My suggestion is that one who wanted to purchese shoduld be able to get a permit on line,o r through a central place like a US Post office, ahat would be good for 90 days, then buy the gun and seller would provide the reigistiration number and use the permit to register the gun, etc.
We have people buying guns that really must not know how to use them and some terrible accidents could occur over the frenzy. And the worse, as I wrote eyesterday is interpretation of the second amendment as a racist amendment because the South wanted it. I do';t like guns and don't want to ever be put in a self defense or protection situation for my familly to ever have to kill someone. But, do';t take away my right to do so , ift imes go intoo compete chaos, which is what Congress is allowing to happen when they can't come to some common sense agreements on any thing. Its a miralce HR 1063 got passed, but obviosly its not being interpreted as the original conditional payment law intended, or is it? Its a step to stop the complete demise of Medicare which is nt broke but being stolen daily by the partners of Medicare in collusion with their ins and other industrial military complex share holders and some of them are the govt contractors and partners.This didn't start wth Pres Obama, and some of the problems started much earlier than Pres Bush, but laws and agreeements to do something get done and follow through by Congress to see its done and carried out.
THE CONSTITUTTION OF THE UNITED STATES ARTICLE I SECTION 8 (continuation phrase by phrase analysis)
"To provide for calling Forth the Miitia to execute the Laws of the Union, suppress Insurrections and repel Invasions."
There is the constitutional mandate to act with force inside the USA. In more recent time the National Guard is uaually the one called in, but in 1969, that was federalized even though states are in a partnership of sorts. There is notmention of an FBI or DEA or ATF or OIG's in the constitution and I suggest that this is what is being referred to here, The federal govt can have federal law enforcement to make sure laws ore obeyed, Congress needs to reread this in light of what I just finished posting. with the taxpayers monies being blatantly stolen and the general welfare of the people suffering form it. What's an insurrection? I think its what we call domestic terrorism and the feds are to stop it, but didin't push their way in back in 1/89 when my office was under attack as a Federal office; and still have not investigiated and prosecuted any one, as far as I know, Althoug two said three were indcictments. And protect the borders from invasions and it doesn't say armed invasion. Again, Congress has waited since 1988 to pass realistic immigraition reform so the powerful and wealthy can exploit the trespassers onto American soil and in more recent time armed bad guys making there way in along with 'good people' wanting a better life and a job. who should have a legal way to come, or NAFTA should have been signed with a guaranateed minimum wage by all the countries signing it that want to export goods to The USA. Slavery and exploitiation by unscrupulous that have gained great pwoer has been allowed to destroy humanity and needs to be stopped so the people's welfare becomes the 'prime directive'. Agenda 21 should address the fairness and equity and individual rights of all and stop inhumanity to each other. Why can;' a company with 40% of the nations wealth , as is reported' not be able to take the responsibility to see their pharmacy clerks know how to send in a claim so that the taxpayers monies are protected and the party legally lible is paying the bill. Great wealth comes with even greater repsonsibility to humanity. The blessing of wealth means they have been given the power position to do great good. I pray for the Walton family that they see to to do this. There are a lot of model projects they could do to help their employees, and prove to Congress what does. work. Why doesn't Walmart have a family clinic for all but the most severe iilnesses and injuries and pay to maintan it and get a waiver from Affordable care act and show everyone else how it can be done. Then have some kind of catastrophic care policy when more specialized care is needed? TOMORROW: Back to Agenda 21 and Soil Bank laws.Linda Joy Adams 1/16/13
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