Trailblazer Health Enterprises Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments as Required Audit (A-07-10-02776) 06-10-2014 Click the link to a report on Trailblazers and an audit done with Medicare monies not accounted for.
COVER LETTER FOR FILE RECONSTRUCTIONS
This is not the missing trillion dollars estimated by the 500 witness who helped document all of that, but there efforts and reports never made it to DC to be docketed in as its against partners of Medicare where the worse corruption is occurring as even the few scam artist providers could not steal a 100 million with out in side collusion or pure negligence of due diligence.
I was getting ready to reconstruct all of the our files illegally destroyed at Recovery Coordination and at Novitas, or never answered back from Novitas which we sent via certified mail n 12/12 when they took over from Trailblazers who turned one clams into 17 and was using and illegal offline system and phony Medicare claim numbers, including 17 to pay each and only one pay got to the Doctor, etc, and even that is not Medicare's bill for self and family on my federal Blue Cross Blue Shield policy according to the Medicare judges, the law, and Emblem Health contract terms with HHS and Us dept of labor which posts accurate info and no one is to alter it.
Any hassle by any one over getting bills, paid, Medicare pays and codes it for recovery and sends it over for the govt to enforce its own laws which had not occurred since 1994 when Sec of HHS Donna Shalala suspended the enforcement of the conditional pay laws and said the insurers industry could 'police itself; and set up these postings from employers and agencies, etc,,, That is not bad, but no one is to alter them. I want them left alone,
When coded a conditional payment then neither the patient, their estate, nor the doctor, etc. who provided the medial care or prescription is over paid at all for its has been the govt's responsibility to enforce the laws and be the police over it, if needed. The patients have been asked to be police for 20 years and that ended 1/11/13 with HR 1063 signed into law to now have the authority to enforce the laws against criminal activity such as between Emblem health international and their deals with insurance companies to alter the common working file so medical provides can't have the truth of whom to bill first and then be fined for billing Medicare and not getting it coded for recovery,
The facilitator of the theft which alters the records now has the recovery authority to assess the fines against the medical entities they tricked for what they themselves caused.
yesterday I got a response back from a persons on the coding council made up of various entities and some from the insurance industry. (ANOTHER GOVT CONTRACT)
THERE IS NO WAY TO ELECTRONICALLY CODE A CLAIM TO SEND IT TO RECOVERY. NO CODE FOR PRIMARY WON'T PAY RECOVER MONIES etc. THE SOFTWARE DESIGNER HAS NOW FACILITATED MORE TRILLIONS OF DOLLARS OF THEFTS TO OCCUR? BECAUSE HHS IS SO BIG NO ONE EVEN KNOWS THE BASICS OF STOPPING BLATANT THEFTS ANY MORE?
Some time ago while still recovering from my heart etc., still not back, not getting enough oxygen last summer for 3 weeks until we fond out how to use glue and Gorilla tape to make this oxygen tank work as no one with a Medicare card and workers comp involved can get oxygen of any kind now within a 100 miles of us over the terrible corruption going on with the govt contractors in control and not HHS management,?,
I learned that the Recovery Unit at Emblem Health International ( formerly Group Health which holds the major controlling govt HHS contracts)had destroyed all the records on me including their recovery letters they sent out and never followed up on , because CEO Lynn Blodgett of ACS a Xerox front company; said I'd gotten a workers comp settlement and retired. A nice competent sounding woman there actually said that, and we have to reconstruct all the files and there is a 7/1/14 deadline for self reporting. all to do so and Novatis has not yet done it for us as they have the packet we sent them on what Trailblazers had done and stolen and there are 17 claim numbers to collect on they created And the woman had no idea there was an employer group health plan also involved on all three of us and they got that fraudulent info too to act on from another component of their company.
As I reported to HHS OIG contractor interlocked with some of the thieves, but required to do so if a real investigation was finally started after 14 years to not obstruct it; today.
What the woman repeated of what was said by her superiors seemed to elude her. If there was a workers comp settlement, then the next step is recovery of monies back to Medicare for bills paid for those injuries rather than destruction of files because Affiliated Computer Services did not want to pay....which all of our health plans have as a partner and one CEO has 'misinformed agency after agency as he is over the information they get ..... to enable the theft of Medicare and Medicaid to continue as Medicaid is involved in Part D Medicare for two of us, on the policy, Should be three but that hearing filed by Doyle was also disappeared into the bottom less pit of misinformation and lies at ACS too as judges have given control of their files over to them to deal with before they get to know what they even have, And no one can get a waiver of overpayment either as patients are over paid until they get a waiver okayed, and obviously we can't arrest anyone, nor shut down a criminal enterprise either.
I'm one of the 90 black listed HHS employees from 1/89 who were to be denied the right of life when a toxic cloud enveloped our work site and the cover up began. before we even got to the hospitals in Jersey City and I was the only one that even got through to get tests run to prove toxic fume burning as the admissions clerk put the wrong employer down on the admissions chart and when that was discovered after the diagnosis and me already being prepared for admission to save my life and some treatment started, I was sent home to die as HHS workers were to be sent away with no care on orders of the highest levels of this govt....DEATH PANELS ARE NOT NEW FOR FEDERAL WORKERS WHO HAVE NO REAL PROTECTIONS,
And now no one does as the federalization of all of our health care has turned those rights of life entirely over to this international cabal of HHS and OPM contractors which have not been subject to laws of this land nor any internal audit controls done either to find out if peoples rights are even being upheld which they often are not, let alone if monies properly spent and not stolen.
One of the spiritual gifts according to my Faith Book , the Bible is not politician but Administration. We know those persons that seem to be able to mange things and get things done with out being dictator and it has a humility In the carrying out of the duties of overseeing things,
But the few who are politically appointed to over see HHS and it wide range of agencies seem to never be able to get much done in decades. and if they do start to infringe on criminal operations, soon they are gotten rid of for some created political reason is my perspective on the matter as witnessed firsthand as an insider and on the outside as a patient.
So at the higher level of the agencies are entrenched corruption in too many areas and they are going to have their jobs for decades until they retire and are still there as political appointees come and go and never able to solve the myriad of problems.
And we can find good administrators who are ethical and honest in all parties, even if we my not agree with all of their politics. We basically need the thefts of the public monies stopped and right of life be upheld for at least the ones of us born, even though some of us are concerned by the rights of the unborn , too, One can't be born if the parents are not alive to have an unborn person, are they?
I 'VE BEEN AROUND THESE PROGRAMS SINCE 1968 and I don't know every thing. I do know enough to ask the right questions , most of the time, but even then it may not be enough for those in charge to correct the problems.
HEALTH AND HUMAN SERVICES,
As the title says, this is a crucial cabinet Dept of the govt that affects everyone of us in crucial ways and due to the impact of the USA, it also impacts the lives and health of everyone around the world.
When it has become to big for any one person to over see and even those undersecretaries to oversee in humongous parts of agencies under them, then its become too easy to just contract out the work and my be the work gets done as we the people wish it for "the general welfare of the people" that's the US constitution responsibility, but too often, unethical and down right criminal conspirators are able to come in and get those contracts and away goes our rights life along with our public tax monies which all of us pay in some form directly or indirectly.
Social Security became an independent agency over a decade ago, and that in itself has not solved all the internal corruption over there as contracts got let and one can read other reports on line by me and others
SOCIAL SECURITY ACT
Under that one law has been so many agencies and areas, and Medicare and Medicaid are part of that law. Originally SSA was over Medicare and there was better controls , but few govt contracts were let in those years through out the govt. and the partners of Medicare helped uphold the laws and rights of us against corruption. We also had an on site rep in side the partner, too. Fraud and corruption got stopped early on for the most part' The Medicare split to a separate agency and immediately things started going down hill is how I witnesses it as we at SSA got less and less involved. and laws and regs got passed that allowed more and more levels of red tape and govt contracts to be let with less and less ones doctor being in charge of ones medical care and that went down hill in the mix. No longer were medical peers overseeing what ones doctor did or standards to follow; but govt contractors with profit making pencil pushers.
Many thieves who got caught sooner , than the now later humorous amounts we now see, often did not get prosecuted but chose to pay back the monies, and with some over sight, continued to care for patients and stopped any hint of thievery. CHRIST SAID GO AND SIN NO MORE AND MANY WERE GIVEN THAT CHANCE TO RESIST TEMPTATION OF GREED, ETC,
FEW MEDICAL PERSONNEL ARE CROOKS AND I AM CONCERNED THAT MANY OF THE PUBLIC ARE BEING MADE TO THINK THEIR OWN GOOD AND ETHICAL DOCTORS, ETC ARE. THERE USED TO BE BUMPER STICKERS TO: SUPPORT YOUR LOCAL SHERIFF, MAYBE WE NEED THE PUBLIC TO START ADVERTISING: SUPPORT YOUR LOCAL DOCTOR who is being coerced into social engineering that few of us want or even need done. to live our lives safely and securely and get the best health care in the world, if the system had not corrupted us into a third world system as our monies get stolen by those allowed to continue in charge, instead of prosecuting them, and allowing some ethical parties to get contracts if contracts is what is really needed.
WHEN THINGS GET SO OUT OF CONTROL AND THE ORGANIZATION IS SO HUGE, HOW DOES ONE MANAGE THE CORRUPTED MESS. When no money is allowed to be spent to stop it. COUP D'ETAT HAS OCCURRED.
We have to reinstate a constitutionally correct systems to do so and then Congress has to start real investigative hearings and listen to those actually doing the work in those Govt contractors, incognito if need be... whomever is president can't issue some orders and then not follow up to see if they are being carried out.
BACKLASH!
We the people have had it and as all the political pundits try to figure out why Rep Cantor lost his primary reelection bid, don't forget he was one who sat and plotted what many of us considered down right over throw of this govt, on the day President Obama became president in 1/09 to obstruct any attempt for governance to go forward,
WE WERE TAUGHT TO BE GOOD SPORTS AND THIS BUNCH THAT MET WERE NOT.
They should have been meeting to figure out how to be one step ahead of a new administration of the opposing party and not to sabotage the govt, but to plot how to modify some of the proposals and policies coming that were too extreme on one side for the others to want.
Instead of health care for all where the public monies were to go for direct health care, we got more scams and govt contracts set up and more red tape than any govt bureaucrat could ever have conceived of and all some said was NO and NO ALTERNATIVE AS IF NO ONE HAD THE RIGHT TO LIFE ANY MORE.
I am seeing a back lash, that needs to be a warning to all in office now,, Stand up for your beliefs, but also propose an alternative. ITS CALLED CONSTRUCTIVE CRITICISM. MY DAD WOULD NOT LET US CRITICIZE THE GOVT WITHOUT ASKING WHAT WOULD YOU SUGGEST BE DONE, ITS CALLED CRITICAL THINKING AND ITS SOMETHING WE ARE TAUGHT TO DO AND ALL SHOULD BE GETTING THAT IN SCHOOL. ONE CAN'T EXIST IN THIS WORLD VERY WELL BY JUST SAYING NO TO OTHERS AND NOT COUNTER WITH ALTERNATIVES. One has to not be bought and paid for, for that to occur, also.
PLEASE DO REGISTER AND VOTE AND IF YOUR ELECTED OFFICIALS SEEM TO BE TRYING, SUPPORT THEM AND PRAY THAT THEY WILL SOON BE JOINED BY OTHERS WHO WILL "PLAYS WELL WITH OTHERS" That used to be part of a grade schools report on children to their parents along with their grades and rated how well they could get along,
REP CANTOR decided not to 'play well with others' and my personal observation is that is why he is not being returned to Congress by the people. That does not mean they are not to stand up for their beliefs, but I saw our own Congressman Mullin; in his first term, get lambasted by those who would not "play well with others ," when he tried to get them to do so. and he is not the only one who has tried.
REGISTER AND VOTE AND DO SO IN ALL ELECTIONS AND DO IT FOR 10 YEARS. 95% for 10... and see if our faith in each other and the US Constitution being followed will not turn this nation around into something better than we ever had before. YAHUSHA WHOM WE CHRISTIANS CALL CHRIST JESUS SAID WE WERE MADE GOOD. HAVING FAITH IN HUMANITY ITSELF MEANS WE CAN DO THIS IF WE "PLAY WELL WITH OTHERS." My prayers for the Sec of HHS who has been given a onerous and out of control Cabinet component of our govt. her success is ours and may all of those elected support her good efforts and do offer alternatives if her efforts do not seem the best for all of us, The Pro Choice party won and will be in office until 1/2017, there is still a many things that can be done to promote life for all born and unborn but special agendas of stealing and scamming is not recommended for any one to be promoting as that makes the decision to CHOOSE LIFE HARDER FOR ALL OF US TO HAVE. ESPECIALLY WHEN THOSE LIKE ME DON'T KNOW IF OUR NEXT BREATH IS GOING TO BE ALLOWED TO HAPPEN BY THE CORRUPTED OUT OF CONTROL NOW NEARLY UNMANAGEABLE MESS AT HHS. SO PLAY WELL WITH OTHERS THOSE HIRED TO TAKE CARE OF THINGS FOR US, OR YOU MIGHT GET 'DECANTORED.' ( You made a bad choice of 'friends.')
Linda Joy Adams 6/12/14
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