Linda Joy Adams: 2010

1. OWCP: gets the claim first.
2. Federal Blue Cross/ Blue Shield gets it next
3. Medicare gets it last.
Attached are copies of health plan info ( cards) and letters.
You may need to file paper claims.
Medicare, by law, is supposed to pay conditionally when a 'situation' such as what has happened to me occurs. Medicare Secondary payer recovery unit is to collect the monies back from the primary payers, not the provider nor the patient. This is why its so crucial for each claim to be coded or submitted as a conditional payment to medicare so no overpayment liability and no need to file continuous appeals to get rid of an overpayment liability caused by the mass confusion by a few spewing gossip and rumors' to be circulated as " facts of the case." Thanks to all that have provided medical care in a trying situation.
Civil Rights complaints have been filed against those causing the problems, not the providers, in this.

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providers as they would have access to protected info on claims of many beneficiaries and could file more easily.Congress has made contractors immune from any criminal liabilities and internal audits.Often, govt contractors are subsidiaries of international conglomerates and our nation and tax monies are unprotected when thefts and abuses occur. The general counsel for Medicare has researched this, along with the justice dept. False Claims and Civil rights seem to be the only legal vehicles available. Appeals often go unheeded inside the contractors who have been given the authority for the first two levels The Miami Medicare hearing office is the subject of complaints of missing files from a multitude of attorneys and other appellants as a 'contractor' prepares the files and filings are not even logged in on arrival. Several of mine are now missing that had to be appealed as the Independent Reconsideration Contractor has no legal authority to rule on the issues involved. Wisconsin Physicians doesn't even have someone to process a reconsideration for Oklahoma appeals.And won't even respond to the intitial appeals that were filed in 2007. When appeals do proceed upward, their is reluctance to provide the claims processing file as it reflects the wrong doings of the contractor who has violated the terms of contracts to uphold the laws and constitution.

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Those who have tried to 'persuade' billing personnel to circimvent the legal line-up as payments might be made faster; have often found themselves caught in a convoluted processed that has only caused a prolonged problem, underpayments in the amount paid and overpayment liablities when Medicare has paid primary. Lest one forget: Medicare officials don't make decisions on workers comp claims. One, documnted filing, shows that a high level CMS official told a billing party to ignore the OWCP claims that had just been filed on a new secondary issue.My attorney has always advised me that if a doctor refers to a condition as related to the accepted case; file a claim on any new diagnosis or related condition. Too many billing personnel have been badly 'led astray' on whom to bill. Even the Medicare computer is only accurate @ 10 minutes every 2 weeks and then is illegally altered by the contractor that maintains it and get the official posting form US Dept of Labor. "Everyone has had it altered" including Federal Blues, Vangent ( 1-800-Medicare), OPM, and CMS officials. None of whom has access to the official records. Too often, billing personnel have been erroneously advised to use a phony claim number to circumvent the Medicare billing computer. SSA and the FTC have tried to get them to shut the use of phony claim numbers down for years as its: misuse of ssn for 'theft.' Yes, high level officials have actually advocated 'theft.' And criminal investigators are currently assigned as in 8/08, the 'local' claims processors started turning each claim into 17 and I have no evidence that any provider got and cashed the extra checks, yet the offline, hidden computer system shows they did. A System they ae not to be using and is hidden from even the contract auditors. The initial pays were for every bill back at least to 1/06 and the total by stealing my cliams and ID are @$4 million. I'm asking every large provider for assisstance on a false claims act as 500 witnesses state this is not just on my records and a large

Date of Injury: 1/10/1989

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that OWCP should be billed first. She did not overturn Medicare ALJ's 2008 and 2009 decisions that there are two primary payers before Medicare. OWCP and Federal Blue Cross/Blue Shield. Since all my medical bills and either for an accepted condition at OWCP or are for pending secondary/tertiary claims; OWCP should be asked for a formal ruling first. Currently the local manager at OWCP is trying to get problems resolved as their contractor ACS-Xerox has never posted my file and most of subsequent filings and are giving out erroneous info as to whom should be billed as they are off-line of the official US DEPT OF LABOR computer file that shows permanent medical benefits. They were ordered to not input oxygen claims as this is the treatment that automatically awarded permanent medical care under a 1980's law that was passed so that Injured Federal workers would no longer have life -sustaining treatment obstructed on an accepted claim by official 'abusing their power.' Currently, ACS-XEROX has 11 years of oxygen claims that have never been processed since they govt the govt contract. Being offline, some have received erroneous denials that have to be reworked per the appellate judges remand orders of 2/09 when they set aside the false decision that I'd never returned to work in 7/90, which I did. And The three judges ruled: Ask me for the facts of the case since every pending file is either missing or incomplete due to these 'abuses.'

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To Medical providers and Suppliers:

I have three health plans. All need to be sent claims. Misinformation has been spewed about by officials and others that have no direct knowledge of the facts nor the ruling by various agency officials based on the law and the facts. Many have missed filing dates but i have filed papers that protect every party's time limits to file. Compounding the problem is that those you often contact for correct info have themselves given incorrect info and have also had the official computer files either altered or refuse to allow official decisions to be posted. Govt contractors are often off-line of the official systems. Part of the problem is traced to an individual at US Dept of Labor who was convicted in the jack Abramoff bribery scandal last Spring.So, much of what has occurred at high levels has been an intentional abuse of power which is considered a crime as well as civil rights violations. Every claim has had to be appealed when paid by improper party to get rid of overpayment libilities to you and me.On 9/29/10 Medicare Appellate Judge Morrison: case M09-1409 ruled that OWCP