Linda Joy Adams: violations of civil rights page 25: Cigna govt services Redetermination and pending claims and reopen all this is a link to the many follow ups done over the years to get all items answered and to date not even legally filed claims attached to a 1490S have been processed and my primary employer group health plan will pay if there is no oxygen supplier and in order to live 100 lb liquid oxygen tanks are filled at the gas company. BUT SINCE THEIR INFORMATION SOURCE, PRESIDENT BLODGETT OF XEROX MANAGEMENT SERVICES DOES NOT WANT ME TO BE EMPLOYED, and have my permanent medical at FECA,? which he also controls, the bills got illegally dumped onto Medicare and since all the small suppliers were forced out of a side line business of just exchanging filled tanks and paid for life by Medicare also. I did appeal the first years of this but since then Cigna Government Services, now CELERIAN Group with new parent company still refused to process the legally filed invoices. Throughout the appeals I always listed all the oxygen suppliers. on the appeal forms, clear through to M09-1406. which led to passage of HR1063 by Congress so recovery can again be enforced by the government.
I would have had a supplier if the Medicare judges had been obeyed by your predecessor, River Trust who were ordered to get the invoices from Lincare and Rhema who are in my area. And I would not be bankrupted paying to stay alive since all three health plans have me approved for life.
As a result of M09-1406 judge affirming the permanent lifetime approval by Medicare for liquid oxygen 24/7 before ruling that the executive order from the Clinton era could not overturned by an agency judge, and ordered me to file a false claim against CMS contracting companies under one parent umbrella company, and President Blodgett/ who is also the total controller of Fed Blues management and Federal Employees Compensation Act ( workers comp) which this bill is his and he has refused to process any oxygen claims since he took total control of the program in 2002. Recently, a pretense has occurred as .they had done a few pending all these years, filed by me, timely, by using a dummy offline system and using a pseudo code. ALL OF THEIR PEOPLE THAT WORK FOR HIM . side they were ordered never to input the claims to the official system as ALL WOULD BE PAID AND ALL MY MEDICAL WOULD BE PAID as when FECA put me on liquid oxygen over 21 years ago , it locked me in under the 1988 labor law for total and permanent medical but that had no affect on employment status. Since he will not post my file with even judges ordering it done, using my records and asking me for facts and processing all matters still not done since injured 1/10/89 ( yes a few items are still pending legally filed and consistently followed up on and even other judges have mentioned they were pending to no avail) the judges said GOSSIP AND RUMOR HAVE RUN AMOK.
And my issues began with FECA with another illegal rifling of my file not reported to law enforcement and that is two felonies and I HAVE YET TO BE MADE WHOLE FOR CRIMES COMMITTED AGAINST ME AND MY OFFICIAL GOVT RECORDS. With this repeated criminal activity on my files since 1/10/89 when I became of type of precedent case/ I always had the rank and file government employees obey the judges when the file got remanded back to them and reconstructed etc. until the next felony disappearance. ACS GOT THE CONTRACT AND CONTROL AS THE GOVT COULD NOT PROVIDE SECURITY ON THEIR OWN PAPER FILES..
But in the long run , it was more secure than what has gone on since. for me. But with ACS , they ignored all and no one in the government has access to anything any more. The only thing secure is that system that posts to the COMMON WORKING FILE. and Labor's IT people say there has been attempts to hack into it.
And since President Blodgett was said to have ordered , through his company managing FEHB, Blues, the hacking in to of the Common working file at the CMS contracting owner Group Health , now Emblem Health International and deleting the Federal Blues and other info in violation of their CMS contract to alter any posting from ones employer, no one has any idea what is going on and what to do when the system is hacked and info is not reliable to use. You treat as a conditional payment is the simple law to follow.
Bi weekly US Department of Labor official system posts, and a copy of the remand order to River Trust includes it and showed employed as that is the FECA law until he posts my file so my claims examiner at FECA can process a request for schedule award and permanent disability.
He has gone from agency to agency and contractor to contractor stating I got a workers comp settlement and retired and its a lie and he did it after he got the orders from the US Department of labor Judges. that I did return ot work in 1990. that was the created false info that a rifled file look like had occurred and should have not been given wage loss. But that has nothing to do with the permanent medical as that is separate. I did and even ended up with THE EEOC SANCTIONING SEC OF HHS DONNA SHALALA who was my boss at the time in 1994 for refusal to accommodate my severed handicaps after injured. . without the total file, no one can even put the judges remand orders in context and currently appeals are pending they do not even know exist as President Blodgett refused to let them see them to even answer. we communicate better here . At least they have access to read what they cannot officially at work.. But its not the official posting from ACS so they can do nothing. about what has become the REAL DEATH PANEL UNDER THIS CONTRACTOR. who now has more companies to take control of most of the nations injured workers rights to live and livelihood. in the guise of states workers comp reform laws. Medicare for all is becoming the law of the land that has not been passed by Congress nor signed in to law by any President. of the USA.
There is also a third party law suit pending that FECA required me to file that, in itself would make all bills a conditional payment even if I was retired.
So thanks to Cigna Government Services they approved me for life for liquid oxygen and then a regulation got passed that forced my small supplier out of the business as many across this nation were before the unconstitutional competitive bid came in and left only the major companies as only they could afford to hire a respiratory tech if one had liquid oxygen which has never made any medical sense. to even doctors. As most of us are not needed home health care till near end of life and so far, I do not consider my self at that point yet.
Few of the regulations s and rules about home oxygen are being followed by suppliers at all and the confusion and chaos has already cost too many lives. plus the need to raise money to pay all the respiratory techs is causing major medical issues and retesting that is not required at all once one is approved for. is going on. to get that low saturation oxygen rate of 88% means going off of oxygen and inducing a type of heart attack that causes permanent damage. And what is going on is no doctor is going to commit malpractice and do it. what they can do is run the tests when one is in duress already as occurred in 7/13 when my tank gave out and had not learned how to repair it with glue and gorilla tape and I showed up at my cardiologist in distress and he ran the test and got the low sat rate. I signed the waiver for the stress test with oximeter, but due to the EKG already showing duress off of oxygen, it almost did not get run. IT WAS TAKE A MEDICAL RISK IN ORDER TO GET OXYGEN SO AS NOT TO NOT DIE AS A MEDICAL FACT. Then that did not do any good to get a liquid oxygen supplier. The concentrators cause severe lung inflammation with in minutes as one gets small amounts of ozone, and ionization back in to the lungs and its not a therapeutic dose which my doctors have said in similar to kind of hyperbaric situation created in the lungs by the near pure liquid oxygen. ( a lay term way to explain it)
Lincare ( Lindegas of Germany) and Rhema Rotech were blocked from submitting the oxygen claims on me to any of the three health plans. Even , I with years of experience both inside the government and outside as patient was not aware that in order to be paid the claims had to go to FECA first, wait forever m then on to the other primary payer, and then on to Medicare as a conditional payment. The oxygen is on a security lock under the 1988 labor law to save lives and rights and has been turned in to a real DEATH PANEL by this contractor never processing them to avoid them being paid and why m need to be asked by someone in law enforcement? And the recovery letter went out to him sent by THE RECOVERY UNIT WHICH THOUGHT WAS THE US DEPARTMENT OF LABOR, BUT WAS TO PRESIDENT BLODGETT AS THEY SAY THEY ARE AND THAT THEY WORK FOR THEM AND ARE A CONTRACTOR OF THE GOVERNMENT AS YOU ARE. he then ordered the recovery unit to destroy all the recovery letters they had sent him over the years and to even go in and take down my self reporting web site I had spent hours completing in detail with all the ICD-9 codes. leaving only a muscular knee injury as if that was only thing wrong and that is only a tertiary covered medical cost at best and not the original at all.
The concerted effort to hide I have always been on liquid oxygen since FECA put me on it over 21 years ago. has been a well constructed effort and has resulted in a lot of hacking into systems which is called hacking when its an illegal altering of official info that is not to be done. Which taking down my self reporting site at Recovery is considered as I have been blocked by every legal avenue to stay alive. HIS VERBAL WORD WAS THEIR GOSPEL. and they did as they were told by him. in defiance of the law, terms of their government contracts and the rights of me to stay alive and not be overpaid to Medicare. and Lincare's corporate headquarters will not allow delivery and neither will Rhema and is has nothing to do with medical necessity at all. if both get fully paid back based on the protective filings from me, then what is the excuse? I always got along fine with the delivery people. Even now, Lincare's local management wishes they could come. and they would if I was a current patients and should never have not been. they bought out Health Connections who was paid by FECA when we moved here. and discovered a few years ago when claims got posted on line and have a copy, that both Fed Blues and FECA had been paying for the same time up until the sale went through. Blues continued to pay until Ill Blues took over in OK and TX and then their patients with a Medicare card got dumped onto Medicare and they took back the money they had paid Lincare leaving me in the lurch and them very unhappy, and said bill Medicare primary and that is when the real issues began and no one knew of the security lock for oxygen on the labor computer. I was not even on the Internet at the time and could find out very little.
No one in the government saw the recovery letter and no one in the government can even see their own judges remand orders, not any of my records or files unless Pres. Blodgett permits it and he will not on me.
I wrote him and his response was to do the contacting of agencies and telling untruths as I HAVE NOT GOTTEN ANY SETTLEMENT AT ALL ON WORKERS COMP. The judges said to ask me for the facts as no one else seemed to know anything but rumor and gossip. But he will not answer my letters asking what is he referring to and the OIG for OPM says they have suspected an embezzlement ring and have no budget to investigate as I am not the only one of the older cases that got this illegal AND DEADLY DUMP onto MEDICARE DONE ON THEM. CSID intimated that we were the 85000 federal employees and dependents who do not get the first round of OPM HACK letters. We still have not got them in the second round going on now and my name begins with A so we must really been 'disappeared?'
So this proposed reconsideration is not just about an Medicare overpayment. , I cannot and nor even the govt cannot stop until we get through the due process to make Celerian Group which inherited all of this from Cigna Government Services via River Trust. and , has been refusing to do and assist on NOW THAT WE HAVE HR1063 WHERE THE FORCING OF THE TIMELY PROCESSING AND INPUT OF THE OXYGEN CLAIMS to the real system and my file posted IS NOT PRECLUDED BY A PARTNER OF THE GOVT. There is a lost of reimbursements approved and still not processed at FECA with even a few items as far back as 1989. and we need the money badly. Since they are legally and timely filed and repeatedly followed up on they are currently pending there just as all these oxygen claims are pending with Celerian Group. This international cabal of companies has crated such chaos and no one knowing one end form the other , etc. with all kinds of misinformation floating around, that in all of this, the rights and tax dollars have gone missing. and that is my right to life. and livelihood. ITS A PUZZLE AND NONE HAS ALL THE PIECES TO PUT IT TOGETHER
So if what his people say did not occur and the bills was not paid by FECA, then a timely response would than lead to other plans and Medicare paying. conditionally. until all could get and would get sorted out.
This is not just the paid invoices from the gas company since 1/1/08 but the timely filed unpaid invoices from Lincare and Rhema,, which as a supplier who agreed to accept assignments for Medicare and required any way to file the claims DID NOT FILE THE CLAIM S THEY WERE ORDERED NOT TO BY ????? I filed as timely needed. And River Trust had a responsibility to see to it tat the law was obeyed and them contacted to get the rest of the forms in to be paid. CMS contractor Blodgett???? who signs all up for assignment of Medicare, in CONFLICTS OF INTEREST. few know exist and none in the real government seem aware of?
The system , since, 1/1/06 has no coding for a conditional payment, and you will seem that Cigna government services used a phony claim number to by pass the system. The use of a phony Medicare claims number led to massive thefts of Medicare by another company stealing claims and id and in my case 17 pays per claims by Trailblazers whose parent company SC Blues now owns Celerian Group. THERE IS NO SECURITY PROTOCOLS PROGRAMMED ON THE MEDICARE SYSTEM WHEN THIS COULD AND CAN BE DONE.
All CMS could do is not renew their contract in this area as Congress would not permit anything else be done...
Trailblazers had asked for the Common Working File to be hacked every time they paid a claim on me since 2002 and so did all the others. But Cigna did use a phony to get the claim paid, but then was the only one who went on and sent it to Recovery. . and NEVER TREATED IT as a conditional payment as Cigna Government Services LEGALLY did. thus affording me the civil right access to ask for enforcement of the conditional pay law that has been suspended enforcing way back in 1994. The other part of that executive order was to accept the status ones employer gives and is still the rules., and I am officially under FECA for that and nothing will change ON MY STATUS UNTIL MY FECA FILE AND PENDING REQUEST FOR PERMANENT DISABILITY CAN BE PROCESSED BY FECA and they have no access to my files and data to do so as its under the control of ACS, one of President Blodgett.'s over 100 companies. and more that he has controlling interest in plus all the partnership deals to the pint HE IS THE FINAL AND TOTAL AUTHORITY ON HEALTH CARE IN THE USA AND THE CONFLICTS OF INTEREST ARE OVERWHELMING FROM EVERY ANGLE. Now, with more companies, most workers comp in the nation is now under him and his dictatorial reach goes to most other parts govt form local to federal and in other nations . And into private industry where his management firms help them manage their dealings with the government and hide they do not work for ones private employer, too.
.AND CONGRESS FOR OVER 17 YEARS ALLOWS TO MONEY TO DO AN INTERNAL AUDIT OR INVESTIGATE CRIMINAL WRONG DOING. as a govt contractor. But he is not immune under HR1063 which is now enforced by the owner of the hacked in Common Working File which violates the law, terms of their CMS contract, defies judges and told me,WE DO NOT CARE WHAT A JUDGE SAYS AS OUR SECRET DEALS WITH INSURERS OVERRIDES ALL.
Patients rights of life and livelihood get trashed along with a very tattered US Constitution..
Medicare judge asked for River Trust to get those claims from Lincare and Rhema and they did not do so and still have not, and you have inherited that request which is persistently followed up on and my LIFE IN ENDANGERED AND NO OXYGEN SUPPLIER UNTIL IT IS DONE.
I recently refiled all of these again, and I got a response that pretended that this was the first request after all these years and it is but a follow up to ENFORCE HR 1063. Even refusing to process and give me a summary notice on the more recent invoices attached to form 1490S. WHERE ALL WE SENT YOU THAT TOOK HOURS TO SEND?
I invoke the Teri Schiavo law that I CHOOSE TO LIVE. And the right to breathe and have that life means liquid oxygen . With three health plans approved for life,, why can't I have my oxygen delivered like every one else who is and totally paid for and if Medicare has to pay, just treat as a conditional pay as it was before until the government decides they should go get the monies back for the taxpayers from our other plans. HR1063 does not interfere with the merits of a workers comp claim, but it does demand timely processing and 17 years is not timely. nor is 7 years trying to get the Medicare judge obeyed , timely either. This is why no supplier will even take a workers comp case, due to the untimely process they are forced to go through to finally get any pay from Medicare with Pres Blodgett now running things. and Suppliers not aware of all the ins and outs and the 1988 labor law that makes oxygen so vital to start a domino affect on to permanent and total medical coverage at workers comp.
CNA is the insurer for the building and an injured worker has no choice but to find and attorney and file a Law suit and my case, has more wide implications, than just me and all that went on as I have written about. Its how class actions get started, also. That law suit is to reimburse the tax payers and languishes in a court house in Hudson County NJ waiting for workers comp to figure up the total damages and they are the ones blocking it for the taxpayer to get their money back. And a copy has been supplied to all. its also part of the domino affect of approvals of oxygen kept well hidden fact even from me in all of this until more recent times. The government is to be the front runner on this and have, in turn , been more involved in a cover up with too many deaths and the forerunner of 9/11/01.
Injury date WAS 1/10/89 AND THE COMMON WORKING FILE SECURITY PROTOCOLS ARE NOT THERE TO CATCH INJURY CASES and was to have been changed and still uses the date of entitlement to PART A Medicare instead. Which is almost always going to be at least 30 months after the injury date and system will let claims go on through and never get sent to recovery either. the master mind behind this is not in chaos, but has created the chaos.
MEDICARE IS BEING ROBBED BY SOME OF ITS OWN PARTNERS IN COLLUSION WITH OTHERS NOT WISHING TO PAY. And since they cannot be investigated for fraud, without another act of Congress, we have to proceed civilly. And that process is being blocked every possible way in this matter..
I REQUEST THAT CELERIAN GROUP VACATE THE DISMISSAL AND WORK WITH US TO GET THE CLAIMS FROM LINCARE AND RHEMA AND GET THEM PAID AS THEY SHOULD HAVE BEEN YEARS AGO IN A TIMELY MANNER, THEN PROCESS and help document why you cannot pay when one has no supplier , so that law can be over turned so patients do not die. when one option to stay alive is by pass the supplier and go to the manufacturer. which other plans will pay for. then we need enforcing of HR1063 so that timely processing of all workers comp claims for oxygen be done so that other plans can pay and then recover approved monies later. And STOP THE HACKING OF THE COMMON WORKING FILE under HR1063.
And this goes for all my bills you have had to pay and did not treat as a conditional payment also. for my self and those on my FEDERAL BLUE CROSS BLUE SHIELD POLICY WHO HAS THAT PRIMARY TO MEDICARE.
Lives have been reported already as being lost, and one is too many. Medicare has a wonderful safety net to allow payment while disputes go real or not as mine is not, but by those not working for the taxpayer but for what seems to be other interests. that conflict with their contract with CMS,
I do not know what you do or do not still have at Celerian Group. So I am looking forward to supplying what ever is needed. we faxed a lot of items to you form medical necessity forms, to prescriptions from over the years, plus all the invoices, and ALL OF THIS YOU HAVE ALREADY HAD IN THE PAST. SO WHY DO YOU CONSIDER ANY OF THIS UNTIMELY FILING? all has been filed with FECA and Federal Blues timely to no avail
I qualified for home oxygen while I tried to work at times since 1/10/89 and pray that no one else get denied treatment that can prevent destruction of internal organs without it as progressed too much.
In the long run its cheaper and I also get my preservative free steroid and cromilyn sodium in the distilled water cup attached as there is no safe asthma inhalers any more for over 11 million of us... and hundreds of dollars of inhalers are now replaced by compounded drops of less than $25 a month. something else Medicare might consider paying for, also to save rising health care costs. and in medically seem to have less side affects. We do need to let our good doctors be put in charge of health care in this nation again and respect them when they figure out ways to deliver good health care at a lower cost. AT PRESENT WHAT IS PAID FOR IS NOT EVEN KEEPING UP WITH MEDICAL SCIENCE.
Please do help get all of this together so I can get one of these two suppliers to come and get them fully paid in a timely manner.
Please note there is a Form CMS 1696 filed by Doyle Adams to be my non attorney legal representative in this and all Medicare matters. Something else that is to be entered on the COMMON WORKING FILE AND MISSING THAT SECURITY PROTOCOL ALSO.
Linda Joy Adams 10/23/15
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