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Thursday, April 7, 2011

violations of civil rights page 33: Request to reopen based on facilitation and lack of access to Federal Workers compensation?obstruction of cliams process by Affiliated Computer Systems,ACS and acceptance of Medicare Coordination of Benefits

Office of the Assistant Secretary
for Administration and Management
Washington, DC.
11-EM-071
Julia Mankata- Tamakloe
Chief office of External enforcement
Civil Rights Director
 CC: Lorraine Dawson:
                                          REQUEST TO REOPEN AND REVISE AND NEW VIOLATIONS SINCE FILING

                           Thanks for recognizing that Medicare Coordination of Benefits, a US Dept of Labor contractor has violated my civil rights in obstructing the process of my Health care claims and causing physical and financial harm as that is what has occurred .
As for Affiliated Computer Systems; not being an attorney I didn't say the "magic words" of my civil right to present and have access to the federal workers compensation process has been denied.
It is  easy to get ' bogged down in the merits of the case.' I did state that my complaint to you has nothing to do with the merits of the case. The meirits can't even be discussed or decided because of the obstruction of facilitation and lack of access to the process by Affiliated computer systems who has abused their control of the flow of all 'paper  and filings' on a federal workers compensation case. Whether i have a submission I wish to have a decision made on , or a medical providers or supplier, or the highest appellate judges in the agency.
 On 3/28/2011, I received a decision from my claims examiner Teresa Davis that proves the case. She was allowed to have bits and pieces of my file that is in the custody of Affiliated computer services in order to 'manipulate the decision" She didn't even have the original filing and documents witch  the violator, ACS, Affiliated computer systems has had submitted to them many  times and are part of the original file before they took over. was there in 6/04 in boxes that arrived from the appellate judges and disappeared before posted, They were  resent and never processed per their contract and SEC of  Labor's office giving permission to resubmit to ACS  and ACS deciding not post again. BUT deciding to post bits and pieces instead to mislead and cause physical and financial problems.
I have had access only to the appellate judges, as one can submit documents directly to them and by pass ACS; however, in order for their orders to be carried out, ACS has to  get their submissions and post my file so that my claims examiner and others that implement those orders can do so.
That has been then continual violations by ACS since they got the contract.
Also, ACS receives and is to process all claims for payment of medical bills, and other out of pocket expenses. They have decided , to pick and choose which ones they want to process. They currently have 11 yeas of oxygen invoices  that were filed timely over the years and have chosen to NOT process those. Their employees, including office manager in Tallahassee, FLA that its because: they will be paid and bring the disparate offline system they have set up to charge OWCP for processing paper, on line with the official department of labor computer system and  have claims processed based on what has been decided in the past and in my case permanent medical coverage. I have been denied the right to have even a doctor bill processed. Many times, the ACS call center intentionally lies to medical providers and suppliers and claims never get submitted. That is denial of access to the process. and causes us to have to file appeals and beg Medicare or FEHB insurer to collect the money back due to creating overpayment liablities against me and my estate and familiy's bills are obstructed and unfacilitated over this
I've  had 22+ years of periodically my files disappearing inside the US dept of labor offices. ACS was contracted with to prevent ' someone' from interfering with the process of a civil right to have security on ones submissions and submissions by others to the file so that decisions can be made on the merits of the case and the case flings. Now The US dept of labor offices, except for the judges, who can't implement their orders, from having the files, or submissions nor even the judges orders  set up in a computer file that is in a reasonable order that is uniform for every claimant so that decisions can be made and judges orders carried. out. ACS has refused to do so in my case and has decided I should have disparate treatment. They are not the decider of fact, they are to treat my file like all others, secure it and process the medical claims in a reasonable time and in accordance with their contract. its a violation of my civil rights for them to decide to hold back the ones they discriminately choose not to process and then ' throw it in my face saying: because they will be paid.
Please reopen the case against Affiliated Computer services A Xerox company  because I am being denied the right of access to the claims process and the facility to file a claim.
Since I filed the initial complaints with the Civil rights office at US dept of labor and the contract compliance civil rights complaint, I had  a medical incident that required  a filing of  new CA1's an CA'2' claims with the US dept of labor. and presented evidence to support that these were  secondary/Tertiary issues to the  original injury case.  It states on line that I could mail them directly to the local regional office in Dallas. However, when I called to verify that the claims examiner had them. -They are not allowed to keep files in the us dept of labor offices, whether arriving by fax, mail or hand delivery. They can take no action on the claims until they are sent to ACS and they process them into a computer file. No one was allowed to make any decision on them until ACS got them first. Since ACS has never set up my original claims file ,  my clams examiner has no idea what medical conditions in the new claims are secondary or a Tertitary issue in the original. This is denial of access to the process. My claims exaimner never knew any claims had arrived before 3/28/2011 as the mail room forwards them on immediately to ACS in London KY.
Likewise, on 3/28/11, the claims examiner made a decision without my entire  claims file available, based on individuals wanting  and wishing certain things would happen on my case that are not the deciderer of fact. My claims examiner, according to the ACS contract, shouldn't have even had access to the collections letter from Medicare secondary payer recovery  nor the bits and pieces she had that weren't relevant to the issue she was deciding. She wasn't even aware anything else was pending and has been  for years. One reconstructs the file for the judges as they can get submissions direct, then the files disappear except for what ACS wants the cliams examiner to see and then nothing gets processed and there is in essence no facilitation of right to the claims process. She had nether the original filing nor the medical documentations and letters from doctors that pertained tot eh issue. The appellate judges knew there was an on- going civil rights problem with ACS and my files and individuals had a personal interest in the outcome of my case that they should not have and definitely should not be allowed to make files disappear, etc. to cause what they wanted to occur. That is why ACS has the contract, to ensure security and equal treatment.  Even the file reconstructions coming to ACS to be posted for the case to be worked are not posted per the contract and Teresa Davis was given bits and pieces to manipulate the outcome rather than the file being available in the order and completeness that the Judges had available and then the claims examiner and even the ACS bill paying call center and processing unit in Fl can have to process claims. they have decided to create, an overt act of disparity, an offline computer file and post wrong info that some third party should pay, when none exists and the file shows it. This is retaliation to mislead every medical provider/ supplier and cause on- going obstruction of medical care and creating havoc in trying to obtain life= sustaining medical care. Medicare was able to obtain the internal document form the us dept of labor, that ACS has withheld from the local regional office. And Lynn Blodgett, president and CEO conviently  ' neglecting' to inform Christina Stark , the new reigonal manager last year that what he was accessing had not been updated since before ACS took over so she didn't have a clue what had transpired in submissions from me, the judges or anyone to the case. The US Dept of labor can't control their own contractor? and my rights are violated over it. they decided that they want their money back for paying bills that were already approved by owcp. Prior requests sent to ACS in ' 05, 07 and '08 were disregarded and never posted to a computer file so that those who would respond could do so. I've asked for a copy of the contract, but any contract that violaties ones civil rights would not be legal. If anything, judges remand orders  would be the highest  agency authoririty to set up my computer file as others are. In essence it denies me the right of process to even have appeal rights when those  orders ' disppear' so they can't be carried out.
 The claims process can't be accessed when ACS won;t let it occur As recent actions clearly demonstrate.
No government contract would be legal that allows any individual to coerce the contractor into treating anyone disparately and discriminating against them. My rights to have my file processed and faciliate my access to those rights have been usurped by ACS.
I and designated representative should be  able to discuss this page or that page  of my file when discussing or  having decisions made. ACS has prevented this from occurring.  This is not about a claims examiner making an erroneous decision or allowing herself to be ' duped/'.  If ACS was  not discriminating then the claims examiner would have had access to the file and any decision would have been based on the submissions and judges orders in the file. At present, gossip and rumor is rampant BECAUSE the file has been withheld form the parties that need to carry out the judges orders. I have sent repeated requests to ACS and even to Lynn Blodgett to make arrangements for my file to be reconstructed, per the judges, orders, so that the claims process can be accessed and any decisions rendered by the US dept of labor office of federal workers compensations would be based on the file. Resubitting a 50, 000 page file with issues needing initial deicison back to 1989(judges refer to this) and many reconsiderations unawswered that should be posted and worked since ACS  got the contract is meaningless and money spent I don;'t have it if will still not be posted and recent actions show  the behavior won't change and has gotten more retaliatory./If the claims examiner missed  reading a report or there is a disagreement on interpretation of a doctors report or medical test then she  wold have the report or test to refer to when I filed a reconsideration. I have had to file such and am referring to reports and tests that she can't look at because ACS has not allowed her  to  have access in a manner equal to others. I should be able to  refer to Dr Ciechanowski's report of 12/06 and discuss what he said. I should be able for  her to see the  positive methacholine challenge tests of '92, '94,'99, '04 and the attached doctor reports in discussing  a permanent disability  as well as the published medial journal articles that discuss what the reports mean. This access to the claims process has been denied me repeatedly since ACS took over and is doing so now. My claims examiner doesn't even know why my wage loss was ceased because that part of the file is not available to her of a noncontroverted, accepted, established case with permanent medcial benefits aready established. When the judges set aside, the reason for my wage loss being stopped:, saying I did return to work in 1990 and to accept my records showing this ( includes EEOC sanctions against my agency); the local officials had no idea the importance of those few words when they ruled in 2/09.  Form 521 should have been filed with OPM and wage loss reinstated.  How could they know, when the claims process was denied by ACS not getting the file set up and I waited a few months, heard nothing and proceeded to send a certified letter to ACS's office in London  Ky and it was never posted to a regular file so that the local officials could answer it. I asked to have some kind of stem or process set up to reconstruct the files. Even faxing to the us dept of labor local office will not be seen until ACS gets them and psots the file. The Judges said ask me for the facts of the case: the facts are humongous and includes why a medical bill from 1989 should be paid, and never looked at yet and why certain medical conditions should also be accepted on secondary/tertiary issues filed, one of which goes back to 1991 and has became permanent and medically related. But until ACS allows me to proceed with the claims process, no discussion written or verbal can occur as the claims examiner has to be able to see the same page or report or test that I am  referring to. How can one do a permanent disability when the accepted medical conditions aren't even allowed to be known by the claims examiner because the file is withheld that lists them on the page one she had been denied access to, to process the case.  The claims process isn't just being allowed to put a claim in the mail and be received. its the allowance of that being made availble to the party that has the authority to make a decision on a claims or any other filing or even judges remand orders.
ACS has continuosly and consistently violated my rights in the obstruction of the process of my claims so that the claims process is continually obstructed. Since ACS has to receive all submissions from me or even the judges, I ' ve had no access to facilitation of my case with ACS. Even more blatant retaliation is for them to give bits and pieces or decide what bills to input to a ' dummy' offline disparate file.  It would be More honest to have created no computer file at all and tell all who ask? we have decided not to set up her file because we wish to discriminate and control the outcome of her case. instead they are paid to ' pretend' to process the submissions in a disparate manner which is not legal. ACS is not the decider of even payment of a medical bill, as a recent memo to doctors states: make sure the ICD-9 code is on the form. If it matches as one of diagnosis put on the form, then the bills are paid, if not it isn't. This seems to be a way to justify what  has occurred on my case because of the  access to the claims process over with medicare. often diagnosis codes have been manipulated to circumvent a collection letter back to ACS which is where it is sent by medicare and other health plan cliams processors.  This mean every claim has to be seen by the claims examiner  due to the violations of my civil rights by Medicare coordination of benefits facilitating discrimination over at their company. And each bill processed must receive appeal rights and noen have been issued to me for the bills they did input. I did appeal and no answer. My claims exaiminer hasn't even seen them as Christina Stark said she had nothing but a file of some transactionsn( not copies of the pages, etc.) after 1998 availble to her when Lynn Blodgett contacted her after my repeated attempts to contract him led me to publish a letter to him in the washingtonpost.com on blog page comments  page.
The history of why Affiliated computer Systems was given the contract was to ensure violations of civil rights did not occur and that all claimants would be treated equally and not have files go missing in order to manipulate outcomes. In a Federal office this is a felony. And the felony investigation of disappearance of my fles in the us dept of labor office in Dallas, TX  on my case ( others I'm not privy to)by the US dept of labor's Office of inspector general resulted in ACS getting the contract as they could not ensure security of my claims files which had repeatedly ' gone missing' since 1/10/89 at opportune times for someone wanting to alter the outcome on my case.And that is withon other federal offices and agencies. ACS 's contract should have ended that illegal activity and as sson as a submission arrives be scanned in on a computer file that's on line and set up so anyone needed to work or discuss the case knows where to access info. Other agencies and companies can do this in a systematic order. Medical report from 1996, reqeust for schedule award filed in 1996, particualar test from this provider or that one, should be able to be accessed in a reasonable  and efficient manner.And the ICD-9 codes of the  multiple accepted conditions which were on page one ,left side of the paper file and submitted by me from copies I'd received should be avialable first and foremost. along with award letters and even the file trasfer letter in '97 for the Philadelphia office clearly explained what needed to be done in the case and that a occupational asthma was establinhed that none seems to know since ACS took over. The judges have now ordered that my reconstruction of the file be accepted.
They have violated my right to have my claims processed and have blocked the facilitation of my claims process.
                  

2 comments:

Linda Joy Adams said...

UPDATE: Life endagered. You must be billed; ACS hiding oxygen claims. Lincare, Rhema need OK to come. All About Mobiity did file, waited and then billed Medicare. Since 1/08,you owe Blues back for partial pay. Non O@ bills sent back,refers to missing million. Appeals unanswered. Medicare sent you bills,% ACS; ignored.
Medicare HR 1063 to enforce; no one immune not Director Dodd nor CEO Lynn Blodgett. Unsuspends original law, since '94. Medicare Appellate judge M09-1406 led to HR 1063. Affirmed approval for life liquid O2, agreed with your official docs ALJ got from you. that FECA AND FEHB are current primary as active duty and FEHB is other primary for self and family. Medicare wants monies back from YOU ,not us. ACS forbids claims examiner to see records.
Your judges orders ignored to ask me for facts, reconstruct from my records process/pay etc. in 2/09. After 6/04 orders were too. and entire filed disappaeared not posted. SSA stopped cooperating as they were lied to about a settlement and retired and nothing they need to do on our signed agreement by ACS et al. Worse is, prior Acting Comm of SSA intefered with Dib claim there and made up a dignosis my reocrds plus pulmonologist consult OK sent me to before the illegal orders. System hacked too..
HR 1063 unsuspends the orignal law with penalties and fines for al of this has led to the theft of Medciare as they have had to pay our bills pirmary for all but a few items and they can do so only if reocovery is complied with from the primaries. Contractors are to uphold the law and must not follow illegal orders if given. What has occurred is a theft of Medicare as non compliance of your contracts has effected that both at ACS-Xerox and Medicare Coordination of Benefits.Indirectly , Its also a theft from FEHB Blues as ACS-Xerox et al. as OPM contractor misinforms them and they act as such, too. And Sub -contractors of ACS Lincare and Rhema are not allwed to help me live as they are denied their billing rights on a service already approved for life but hidden from view by non inputting of claims for years.
I REQEUST A REOPENING AND LORRAINE DAWSON INVESTIGATOR FOR CONTRACT COMPLIANCE OFFICER AND CIVIL RIGHTS INVESTIGATOR AT US DPT OF LABOR GETS E MAIL OF DAILY NEW VIOLATIONS OF CONTRACT TERMS AND NON FACILIATATIONS OF THE CONTRACTED JOBS as higher ups AT US DEPT LABOR OBSTRUCTED THE CLOSING OF THE GATE THAT LED RIGHT DOWN THE CORRUPTED PATH TO 9/11/01. The implications of a collapse of our systems of governance causes harm to more than one individual. We add new
events be accepted from same entities and the subcontracts with Rhema and Lincare so oxygen may be provided and other needs met.
My life is now held together with Krazy glue and Gorilla Tape and lay oxygen tank down to let liquid run to the top for pressure then raise for me to live and our son gets it filled at the only gas ocmpany in the area that still fills medical oxygen for an individual patient.
It was theft of my paper file parts in Dallas Reg office to make it look as if I did not return to work in 7/90 which started this several years ago and led to ACS getting the contract to provide security not worse corruption.
1/11/13 Hr 1063 signed into law with fines and penalties and Director Dodd could be subject to fines for not allowing his investigators to enforce laws against their own offending contractors and in turn the sub contractors Rhema and Lincare orderd to not be paid and refuse service to me. Lincare is preferred as ther local emloyees have been most gracosu throug all of this and just needs the OK to come. Rhema would be accepted if not Lincare as geting OK for service should take pressure off of her and my plea to live.I CHOOSE TO LIVE AND INVOKE THE TERI SCHIAVO LAW which puts the onerous on the Federal govt to see its done.
Linda Joy Adams 1/16/14 ( spell check not working)

Linda Joy Adams said...

UPDATE; The US Department of Labor has a constitutional obligation to over see the actions of and stop the misdeeds of its contractors and never question them even when their own judges have ordered for them not to be believed over me as they did in 2/09 and ignore my repeated begging for justice to be done and them obeyed. New acts is appears to hack their offline systems to be able to file a false report and not repay Medicare for bills Medicare paid back to 8/1/00 on me that are FECA's approved benefits. Even the resurrected archived records have been ;scrubbed' to make it appear FECA never paid for home liquid oxygen back over 22 years when they put me on it for life, Triggering the 1988 labor law that locked me in for permanent and 100% MEDICAL BEENFITS and paid for liquid home oxygen before Affiliated Computer Services took total control of FECA in 2002 with no internal audits nor criminal investigations nor SEC funding for government contractors in the COUP OF 2002. This is the ultimate betrayal of a government to its citizens as even life itself is placed in constant danger. Linda Joy Adams 8/29/16