Medicare Coordination of Benefits: On 9/29/2010, Departmental appeals board ruled that OWCP needs to get Linda's claims first and affirmed the two lower judges ruling that fed Blues is also a primary to Medicare. yesterday, i was able to access mymedcaire.gov for the first time, unknown what claim number all the claims are under) and say only a few muscular skeletal claims listed as conditional under he Medicare secondary payer recovery unit. There are secondary/tertiary claims pending with owcp but until ACS set up my computer file and bring it on line with the official us dept of labor computer, nothing is happening and hasn't for a decade since Ill Blues took over in TX, NM, OK and ACS-Xerox took over for the us dept of labor is a real ' death panel ' decision against me. ( ACS-Xerox has 11 year a of oxygen invoices they won't input as the computer will pay them and bring the file on line as I was approved for life.) Hopefully you know understand that your contract violations with CMS and Us dept of labor in allowing any one and everyone to alter the official bi-weekly posting has almost cost me my life and and extreme physical and financial hardship and reataliations. You still show the wrong date of injury and this has led to mass chaos for billing personnel and obstructs medical care. ALL my claims are for either accepted conditions at owcp or for claims pending, sometimes for years in defiance of 6 appellate Judges and hearing officers who have remanded the case pointing out they have never been reviewed. only to have ACS ' disppear' the judges orders. Even their CEO misled the new Reg office manger when he contacted her over a year ago and led to more hardship. You have had a duty to hold fast to your contract and secure the official bi-weekly posting. Your protestations that you didn't alter them is defied by hundreds of witnesses an has led to claims not getting sent on to MSPRC and both your parent companies stopping in recovery back to Medicare which the US atty called a ricco situation.
Now the same thing is happening with Doyle's and our daughter's claims, one of which ended up dumped onto medicaid her third, payer. For them, Fed blues is primary per the same appellate decision and Medicare secondnary until the 1996 request that is still pending unanswered at federal workers compensation for permanent disability is approved. ( not even been seen)
All this because the 10 year lease needed to be signed on my injury work site in 1998 and I had to ' disappear' along with the 4 years I tried to work in considerably pain and with health declining as promised accommodations not done, yet receiving awards for what I was able to do. You were the first one I sent an appeal to years ago, as crucial to the underpinning integrity of the health care system as the former Sec of HHS set it up in the '90's. My son is hauling tanks and paying our of pocket over this as Lincare is now a monoopy supplier in this area and is refusing service until the ' govt programs' are again in compliance with the law? Congress gave this authority to the govt and it passed this responsibility on to you. Please never alter official records again. For the last 2 years, there has only been @10 min every two weeks that its been accurate before you deelted my Fed Blues. off our records. a decade of such ' death panel' decisions has to stop. This has put my life in jeopardy and obstructed medcial care.Now for my family. Explain to billing personnel who beg you to alter the records how to process a conditional payment which is the legal option. That's what conditional payments were passed by Congress to do: stop these shenanighans. Medical subrogation is something entirely diifferent and doesn't pertain except for those pending medical issues. not yet seen at owcp. Why aren't all the cliams listed until OWCP pays?
Showing posts with label 1985 US Supreme Court decision on mentally ill. Show all posts
Showing posts with label 1985 US Supreme Court decision on mentally ill. Show all posts
Wednesday, March 23, 2011
violations of civil rights page 23: Trailblazers redt and reopen- refuses to acknoweldge owcp and muliptle thefts
Trailblazers, Medicare intermediary for Doyle, Linda and Doyle for M appeals:
PO. Box: 650714; PO Box;660155; PO Bx: 660156 Dallas, TX. 75266
These are redetermination requests and to treat as anything else is a violation of our civil rights. This is also a request to reopen all claims back to 8/1/00 to pay as conditional and get them over to Medicare secondary payer recovery so they can list them for recovery from Federal workers compensation on Linda and Federal Blues for Doyle and Martha. based on the Dept Appeals Board decision of 9/29/2010 case: M09-1406 that makes OWCP primary for Linda and upheld that Fed Blues is also a primary. not one claim has ever been sent to MSPRC and that is considered A ricco theft of medicare. All but one appeal has ever been answered and no hearing have yet been held on any of the issues. Q2 administrators after getting a hearing remand admitted that you had paid these claims 17 times on 17 claim number ( 15 you created) starting 8/08 and retro on all Linda's claims back to 1/1/06. My letters and phone call to your reg. CEO never stopped this. Linda's FEHB dependents status is determined by her OWCP status. And medicare is secondary for them. you have not forwarded one of their claims for recovery from Federal Blues ( Ill Blues of TX and OK) in violation of judges, contracts and the law. No final determination has been made by DAB as yet on your claims, but if you had coded these as conditional payments, no appeals would have been necessary except for the specific claims where the test run or the specific surgery or procedure was miscoded such as the cardiopulmonary stress test on Linda in '05 and the sinus surgery and hospitalization on Linda to save her life and part was inoperable due to so much damage from her work injuries. This got coded like a simple office procedure to down play the severity of her injures which has become an all too common practice. the office manager for the doctor got lied to by every contractor and then ' blamed' Linda for not being able to straighten out the whole health care violations that have been on-going for over a decade. Linda lost a good doctor and this is part of what real ' death panels' are: obstruction of life sustianing medical care. More recently Doyle received a summary notice for our daughter and the ricco situation has ' dumped' an office visit with her family doctor onto the State medicaid which the state of ill had to get stopped in the tune of $25 million. A medicaid fraud report has been filed and this needs to be paid as secondary and Fed Blues as primary. There is also a situation where even though MH is not a participating provider with Fed blues, they need to be paid under the equity provision and then medicare. There have been no medical service dates there were no medically necessary and all should be paid conditionally if Medicare ends up having to pay primary to stop the ' death panel decisions.' On Mymedciare .gov, Linda could not find any claims in the last 15 months yet Part B cliams should have been sent in conditionally on all dates of service to protect the filing dates so when SSA ' finds' the missing part B premiums. Where all govt contractors ( partners) giving out so much false info continuously all medical providers should not be held to any filing dates. Your collusion with Medicare coordination of benefits to alter the official records in violation of their contract with the US dept of labor and CMS is death panel violations of our civil rights and the physical and financial hardships have been overwhelming. If you want to turn each claim in 17 and pay your self and bill for all, then send us each letters of waiver that we are not liable for any overpayments nor our estates. This is not a hardship waiver , this is one against equity and good conscience because of the violations by you. You should never listen to any corrupt or misguided federal official at CMS who tries to stop you from doing your job legally. This has occurred and been docmumented in 9/2010 when a letter was sent from Stephanie Gammon Head of fee for services in Dallas to Ms de-Coq head of the call center for the medical providers with the obvious intent to obstruct the DAB decision that affirmed you had engaged in violations by not treating all claims as conditional when medicare had to use the safety net provision in Medicare when the primary payers were and are still in violations. Then an attempt was done to block any final appeals from DAB on any subsequent appeal decisions. SO far no final ones have been done over it. More civil rights violations. Cigna Govt services has been the only intermediary that has cooperated in any way with the civil rights of allowing appeals and on their own sending the paid oxygen claims on over to MSPRC who sent out a letter to ACS as they had done on their own with claims you had paid since 8/1/00 with recovery letters to ACS in '05 and '07 with no response and their parent company group health, which is the parent company for Medicare coordination of benefits whom you have successfully gotten to facilitate bypassing owcp and fed Blues for years; ordered them not to collect. Now they show only muscular skeletal injuries, which are secondary/tertiary claims on the original accepted diagnoses- as my job injuries. This has intentionally mislead medical providers along with the date of injury being listed as 3/1/97 instead of 1/10/89. Even my pulmonoologist asked questions trying to figure out what was going on. yesterday was the first time I was able to access any pertinent info of of my Medicare .gov but no claims for last 15 months are listed. Now I understand why he asked questions that seemed to not ' correlate' as he knows and seen documents on my original accepted conditions and pulomonolgists, cardiologists, ear,nose and throat; and any other doctor who treats is under owcp. Plus there is a myriad of seocndary and tertiary claims filed and ACS won't let have an initial review as they have not processed 11 years of oxygen invoices because they will be paid as before and bring the offline incorrect file online with the official US Dept of Labor file. Claiming some long - gone federal OPM director official ' made them do it' in violaiton of any legal govt contract to uphold the laws of our soverign nation.
THIS IS A REDETERMINATION ON ALL CLAIMS BACK TO 8/1/00 on Linda and 11/1/08 on our daughter and 11/1/08 on Doyle as well as all processed ones be reopened based on the two ALJ decisions of 08 and 09 and the affirming DAB dicision of 9/29/10 ( only final one so far) which clarified that owcp gets Linda's claims first. ALSO a WIAVER of liabiity against us of any overpayments for your actions and our futile attempts to get your compliance with laws and judges decisions. This is filed timely. Due to hardship other documents will be faxed separately. This filing goes to three different PO BOXES: - more finanical hardship.
PO. Box: 650714; PO Box;660155; PO Bx: 660156 Dallas, TX. 75266
These are redetermination requests and to treat as anything else is a violation of our civil rights. This is also a request to reopen all claims back to 8/1/00 to pay as conditional and get them over to Medicare secondary payer recovery so they can list them for recovery from Federal workers compensation on Linda and Federal Blues for Doyle and Martha. based on the Dept Appeals Board decision of 9/29/2010 case: M09-1406 that makes OWCP primary for Linda and upheld that Fed Blues is also a primary. not one claim has ever been sent to MSPRC and that is considered A ricco theft of medicare. All but one appeal has ever been answered and no hearing have yet been held on any of the issues. Q2 administrators after getting a hearing remand admitted that you had paid these claims 17 times on 17 claim number ( 15 you created) starting 8/08 and retro on all Linda's claims back to 1/1/06. My letters and phone call to your reg. CEO never stopped this. Linda's FEHB dependents status is determined by her OWCP status. And medicare is secondary for them. you have not forwarded one of their claims for recovery from Federal Blues ( Ill Blues of TX and OK) in violation of judges, contracts and the law. No final determination has been made by DAB as yet on your claims, but if you had coded these as conditional payments, no appeals would have been necessary except for the specific claims where the test run or the specific surgery or procedure was miscoded such as the cardiopulmonary stress test on Linda in '05 and the sinus surgery and hospitalization on Linda to save her life and part was inoperable due to so much damage from her work injuries. This got coded like a simple office procedure to down play the severity of her injures which has become an all too common practice. the office manager for the doctor got lied to by every contractor and then ' blamed' Linda for not being able to straighten out the whole health care violations that have been on-going for over a decade. Linda lost a good doctor and this is part of what real ' death panels' are: obstruction of life sustianing medical care. More recently Doyle received a summary notice for our daughter and the ricco situation has ' dumped' an office visit with her family doctor onto the State medicaid which the state of ill had to get stopped in the tune of $25 million. A medicaid fraud report has been filed and this needs to be paid as secondary and Fed Blues as primary. There is also a situation where even though MH is not a participating provider with Fed blues, they need to be paid under the equity provision and then medicare. There have been no medical service dates there were no medically necessary and all should be paid conditionally if Medicare ends up having to pay primary to stop the ' death panel decisions.' On Mymedciare .gov, Linda could not find any claims in the last 15 months yet Part B cliams should have been sent in conditionally on all dates of service to protect the filing dates so when SSA ' finds' the missing part B premiums. Where all govt contractors ( partners) giving out so much false info continuously all medical providers should not be held to any filing dates. Your collusion with Medicare coordination of benefits to alter the official records in violation of their contract with the US dept of labor and CMS is death panel violations of our civil rights and the physical and financial hardships have been overwhelming. If you want to turn each claim in 17 and pay your self and bill for all, then send us each letters of waiver that we are not liable for any overpayments nor our estates. This is not a hardship waiver , this is one against equity and good conscience because of the violations by you. You should never listen to any corrupt or misguided federal official at CMS who tries to stop you from doing your job legally. This has occurred and been docmumented in 9/2010 when a letter was sent from Stephanie Gammon Head of fee for services in Dallas to Ms de-Coq head of the call center for the medical providers with the obvious intent to obstruct the DAB decision that affirmed you had engaged in violations by not treating all claims as conditional when medicare had to use the safety net provision in Medicare when the primary payers were and are still in violations. Then an attempt was done to block any final appeals from DAB on any subsequent appeal decisions. SO far no final ones have been done over it. More civil rights violations. Cigna Govt services has been the only intermediary that has cooperated in any way with the civil rights of allowing appeals and on their own sending the paid oxygen claims on over to MSPRC who sent out a letter to ACS as they had done on their own with claims you had paid since 8/1/00 with recovery letters to ACS in '05 and '07 with no response and their parent company group health, which is the parent company for Medicare coordination of benefits whom you have successfully gotten to facilitate bypassing owcp and fed Blues for years; ordered them not to collect. Now they show only muscular skeletal injuries, which are secondary/tertiary claims on the original accepted diagnoses- as my job injuries. This has intentionally mislead medical providers along with the date of injury being listed as 3/1/97 instead of 1/10/89. Even my pulmonoologist asked questions trying to figure out what was going on. yesterday was the first time I was able to access any pertinent info of of my Medicare .gov but no claims for last 15 months are listed. Now I understand why he asked questions that seemed to not ' correlate' as he knows and seen documents on my original accepted conditions and pulomonolgists, cardiologists, ear,nose and throat; and any other doctor who treats is under owcp. Plus there is a myriad of seocndary and tertiary claims filed and ACS won't let have an initial review as they have not processed 11 years of oxygen invoices because they will be paid as before and bring the offline incorrect file online with the official US Dept of Labor file. Claiming some long - gone federal OPM director official ' made them do it' in violaiton of any legal govt contract to uphold the laws of our soverign nation.
THIS IS A REDETERMINATION ON ALL CLAIMS BACK TO 8/1/00 on Linda and 11/1/08 on our daughter and 11/1/08 on Doyle as well as all processed ones be reopened based on the two ALJ decisions of 08 and 09 and the affirming DAB dicision of 9/29/10 ( only final one so far) which clarified that owcp gets Linda's claims first. ALSO a WIAVER of liabiity against us of any overpayments for your actions and our futile attempts to get your compliance with laws and judges decisions. This is filed timely. Due to hardship other documents will be faxed separately. This filing goes to three different PO BOXES: - more finanical hardship.
Saturday, March 19, 2011
Violations of civil rights page 19: explanation of organization of filings
There are multiple offending parties named. many of these are the same for multiple filings with multiple partners plus they are interlocked with some of the other offending partners. Some call this a " shadow govt." It is the govt's contractors who have been permitted to violate civil and human rights and break laws and in some blatant cases; steal the tax payers monies and creating overpayment liabilities against innocent parties who should be able to get a letter of wavier for being ' against equity and good conscience' and not one based on hardship due to the fact that Congress has blocked anyone from stopping the violations, even forbidding internal audits anymore. When a govt tries to cancel a contract, they can be sued by the violating contractor unless there is strong proof. This recently occurred in Mn and the state lost. So far the only agency that seems to have an office of contract compliance compliant dept for the harmed person to file with is the US dept of Labor. General Counsel for Medicare and officials in the Justice dept have researched this out and we have a unique set of laws in our states and federal govt that allows for a civil rights investigator to do an internal 'audit'. We are in the protected classes we, three, are filing. Doyle @ Linda Joy Adams
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