Showing posts with label Medicare coordination of benefits. Show all posts
Showing posts with label Medicare coordination of benefits. Show all posts
Wednesday, July 20, 2011
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.
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.
Tuesday, April 5, 2011
What's New | Office of Inspector General
What's New Office of Inspector General see the testimony of deputy oig praising the biggest thieves!
Monday, March 28, 2011
violations of civil rights page 30: DOL,HHS,DOJ,OPM new documents not mailed or faxed
Various filings against named parties are the same parties in multiple agencies. It seem no agency has any oversight control of their contractors and a handful of abusive high level officials. In some cases, wrong information left behind by prior officials seems to still be passed around as factual information. The appellate judges at the US dept of labor said it best in 2/09: ask me for the facts of the case. So many files are ' missing' and no one seems to have a clue as tho what is occurring. What is happening is my life and livelihood have been and are at constant risk because terms of contracts, the laws and judges are blatantly ignored. And the more time that passes, the bigger the back log of items to be processed so that all my bills are paid by the proper party in the proper amount. ACS won't input 11 years of oxygen claims because they will be paid as they used to be. Politicians are made fun of for mentioning ' death panels.' Isn't this one? When my id and claims info were stolen by a contractor, why wasn't this shut down, or at least some official send me a letter that no liability against me or my estate would exist because the govt itself can't stop thefts by their own contractors , facilitated by Medicare coordination of benefits violating their contracts with CMS, and US Dept of Labor and altering the official filings, which the prior general counsel of OPM and US Dept of Labor officials said was accurate and not to be altered, yet ' everyone' could have it altered to cause harm and theft.
Why has no medical provider/supplier been allowed to know whom to bill for payment in a decade as when they try to find out , the very party that give out the wrong info are stealing, and having the official records altered so they can do so; when there is a legal option that give HHS the authority to straighten this out in a very short time by collections form the primary payers. Instead, HHS officials, ' disappear civil rights complaints, and make fun of me that I want medicare to enforce its own laws and go get the monies back from the responsible parties. How does one 'collect' from another agency's contractor who refuses to carry out the law. Why can't OPM control their own contractors, either?
Where is the protection of my official govt files, and information in the custody of various officials and their contractors? They say, Congress won't let us! But no warnings are given to the contractors to shape up or you lose your contract.
Why the retaliation when I beg and plead for discrimination and disparate treatment to stop so that life and livelihood are in jeopardy.
For 22+ years, since injured, there has been no security on any got file. As soon as the law, judges, hearing officers orders get started to be carried out on a non- controverted, established case; the files disappear. Even EEOC sanctions against HHS were ignored. Now the retaliations are even worse as i beg for justice.
The worse was then trying to wipe out 4 years of my life, when i tried over and over to work at great physical peril to my life which resulted in the EEOC sanctions; so that a billions landlord could renew his lucrative lease on a work site that didn't meet federal firs safety codes from the first day we reported to work in 7/88 and although our life-taking injuries weren't from fire, ho knows what would have happened if locked doors could have been open to provide ventilation? In recent years, more employees have been injured as those responsibility for safety precautions seemed to ignore their duties to oversee those govt contractors. and land lords.
The intentional disappearance of four years of work and medical documentation resulted in loss of wage loss as officials could claims: you never returned to work in 1990, and you shouldn't have any benefits. This has been corrected in appeals numerous times only to have the reviewed documentation- ' disappears ' in the custody of ACS. ACS was given the contract to assure the security of files that wasn't available in the Federal offices. The appellate judges decision of 2/09 affirming that I did return to work in 1990 and setting aside the erroneous decision again, and again made no sense to the dallas regional office who had no idea that was the reason wage loss stopped. Yet the medical benefits never ceased due to a strong law passed in the '90's to prevent this kind of abuse of power putting injured federal workers lives in danger.
over 2 years later, no one has contacted me, except for the new regional office manager, to say her office computer file hadn't been updated since 1998. Why? when ACS is hired to treat everyone equally before the law and post all files, even on the ' older' ones. Others with 'older files' are getting their benefits,aren't they?
ACS , however, could spend OK taxpayers monies to set up $0 balance ATM cards for us when no monthly checks were obviously not due based on an all purpose form filed with our County in order to get a denial letter to prove I couldn't get help to pay part B medicare premiums. and a HIPPAA reaeust to prive that federal official s and contractors had used state monies to cause ' harrassment' based on false reports. As far as I know, they are still getting paid for the last 2 years to maintain them and state monies are still being spent under false pretenses at the behest of the offending parties when the state claims they can do nothing agiastt the fed govt' officials and their contractors.
The same parties, show up in discriminatory and disparate treatment in multiple places. Group Health has the subsidiaries of Medicare coordination of benefits, Medicare secondary payer recovery unit ( they ordered them to not collect after letters were sent to OWCP in '05, 07,08. and none to Fed Blues the other primary for myself and family who are caught up in this in trying to get medical care since qualifying for Medicare. And the fraudulent National Health insurance data base created by offending parties altering what the doctors sent in on claims and used too often for medical histories costing obstruction of even emergency medcial care and placing life in jeopardy more than once as it should be reliable if not for offenses by the parries in charge.
I have gone ' public' and several summaries of events are attached. Every medical service date starts a new round of violations.
My files are as complex and convoluted as the international conglomerates that we have named as offenders.
It appears only Sec of Labor Solis has addressed the issue and publicly encourgaged complaints of civil rights to be filed against their contractors. Medicare's is part of HHS and they don't know where one can file a complaints, although their general counsel has said contractors can be investigated for civil rights violations, then why won't they do so in the Dallas region- which resulted in some high level regional officials being named in the complaints.
No one has gotten back to me and my family is still hauling oxygen tanks to the mfg and we are paying out of pocket so I can live, because of the direct lies and misinformation that has been spewed about and the discriminatory regulations that have created monopoly suppliers. ACS has continually lied to medical providers and inferred that I got some humongous settlement monies to pay everyone and Lincare believed them over me and has created endangerment of life and horrible financiial hardship. Other medcial care is continually thwarted as payment is expected for services supplied within a resonable time.
I have no monies to pay to copy and mail. I've written and met every filing date on time. Only to have files and filings disappear, over and over. I am paying a flat rate for long distance and have a higher speed fax machine. You can't blame me for choosing to live and filing papers everywhere possible for enforcements of laws and jduges' rulings that they can't enforce. If govt contractors are going to run this country then all our elected officials might as well go home along with the civil service and big business will run things for profits and no civil rights will exist for any one of us that find themselves disabled, elderly, or a member of minority group. Only those able to be slaves for profit for the few who amass more and more power and wealth will be allowed to eke out a meager existence at the whim of a few. That's not the Constitutional. rights our forefathers fought so hard to have for all of us. The inalienable right to live has been my foremost goal and that means having the best health care not obstructed and monies awarded paid to provide for myself and family not be constantly interfered with. I tried to work at great peril with promised accommodations ignored and no right to work with the regional disability person to make sure i wasn't at physical risk. The missing medical records how 4 years of one continuous asthma attack with constant derision and ridicule by superiors who only got worse as each co-worker lost their battle for life. In 6/68 I chose to become a civil servant and expected the dignity of the right of life and wages paid as agreed to by law and Congress. This has not occurred.
Why has no medical provider/supplier been allowed to know whom to bill for payment in a decade as when they try to find out , the very party that give out the wrong info are stealing, and having the official records altered so they can do so; when there is a legal option that give HHS the authority to straighten this out in a very short time by collections form the primary payers. Instead, HHS officials, ' disappear civil rights complaints, and make fun of me that I want medicare to enforce its own laws and go get the monies back from the responsible parties. How does one 'collect' from another agency's contractor who refuses to carry out the law. Why can't OPM control their own contractors, either?
Where is the protection of my official govt files, and information in the custody of various officials and their contractors? They say, Congress won't let us! But no warnings are given to the contractors to shape up or you lose your contract.
Why the retaliation when I beg and plead for discrimination and disparate treatment to stop so that life and livelihood are in jeopardy.
For 22+ years, since injured, there has been no security on any got file. As soon as the law, judges, hearing officers orders get started to be carried out on a non- controverted, established case; the files disappear. Even EEOC sanctions against HHS were ignored. Now the retaliations are even worse as i beg for justice.
The worse was then trying to wipe out 4 years of my life, when i tried over and over to work at great physical peril to my life which resulted in the EEOC sanctions; so that a billions landlord could renew his lucrative lease on a work site that didn't meet federal firs safety codes from the first day we reported to work in 7/88 and although our life-taking injuries weren't from fire, ho knows what would have happened if locked doors could have been open to provide ventilation? In recent years, more employees have been injured as those responsibility for safety precautions seemed to ignore their duties to oversee those govt contractors. and land lords.
The intentional disappearance of four years of work and medical documentation resulted in loss of wage loss as officials could claims: you never returned to work in 1990, and you shouldn't have any benefits. This has been corrected in appeals numerous times only to have the reviewed documentation- ' disappears ' in the custody of ACS. ACS was given the contract to assure the security of files that wasn't available in the Federal offices. The appellate judges decision of 2/09 affirming that I did return to work in 1990 and setting aside the erroneous decision again, and again made no sense to the dallas regional office who had no idea that was the reason wage loss stopped. Yet the medical benefits never ceased due to a strong law passed in the '90's to prevent this kind of abuse of power putting injured federal workers lives in danger.
over 2 years later, no one has contacted me, except for the new regional office manager, to say her office computer file hadn't been updated since 1998. Why? when ACS is hired to treat everyone equally before the law and post all files, even on the ' older' ones. Others with 'older files' are getting their benefits,aren't they?
ACS , however, could spend OK taxpayers monies to set up $0 balance ATM cards for us when no monthly checks were obviously not due based on an all purpose form filed with our County in order to get a denial letter to prove I couldn't get help to pay part B medicare premiums. and a HIPPAA reaeust to prive that federal official s and contractors had used state monies to cause ' harrassment' based on false reports. As far as I know, they are still getting paid for the last 2 years to maintain them and state monies are still being spent under false pretenses at the behest of the offending parties when the state claims they can do nothing agiastt the fed govt' officials and their contractors.
The same parties, show up in discriminatory and disparate treatment in multiple places. Group Health has the subsidiaries of Medicare coordination of benefits, Medicare secondary payer recovery unit ( they ordered them to not collect after letters were sent to OWCP in '05, 07,08. and none to Fed Blues the other primary for myself and family who are caught up in this in trying to get medical care since qualifying for Medicare. And the fraudulent National Health insurance data base created by offending parties altering what the doctors sent in on claims and used too often for medical histories costing obstruction of even emergency medcial care and placing life in jeopardy more than once as it should be reliable if not for offenses by the parries in charge.
I have gone ' public' and several summaries of events are attached. Every medical service date starts a new round of violations.
My files are as complex and convoluted as the international conglomerates that we have named as offenders.
It appears only Sec of Labor Solis has addressed the issue and publicly encourgaged complaints of civil rights to be filed against their contractors. Medicare's is part of HHS and they don't know where one can file a complaints, although their general counsel has said contractors can be investigated for civil rights violations, then why won't they do so in the Dallas region- which resulted in some high level regional officials being named in the complaints.
No one has gotten back to me and my family is still hauling oxygen tanks to the mfg and we are paying out of pocket so I can live, because of the direct lies and misinformation that has been spewed about and the discriminatory regulations that have created monopoly suppliers. ACS has continually lied to medical providers and inferred that I got some humongous settlement monies to pay everyone and Lincare believed them over me and has created endangerment of life and horrible financiial hardship. Other medcial care is continually thwarted as payment is expected for services supplied within a resonable time.
I have no monies to pay to copy and mail. I've written and met every filing date on time. Only to have files and filings disappear, over and over. I am paying a flat rate for long distance and have a higher speed fax machine. You can't blame me for choosing to live and filing papers everywhere possible for enforcements of laws and jduges' rulings that they can't enforce. If govt contractors are going to run this country then all our elected officials might as well go home along with the civil service and big business will run things for profits and no civil rights will exist for any one of us that find themselves disabled, elderly, or a member of minority group. Only those able to be slaves for profit for the few who amass more and more power and wealth will be allowed to eke out a meager existence at the whim of a few. That's not the Constitutional. rights our forefathers fought so hard to have for all of us. The inalienable right to live has been my foremost goal and that means having the best health care not obstructed and monies awarded paid to provide for myself and family not be constantly interfered with. I tried to work at great peril with promised accommodations ignored and no right to work with the regional disability person to make sure i wasn't at physical risk. The missing medical records how 4 years of one continuous asthma attack with constant derision and ridicule by superiors who only got worse as each co-worker lost their battle for life. In 6/68 I chose to become a civil servant and expected the dignity of the right of life and wages paid as agreed to by law and Congress. This has not occurred.
Wednesday, March 23, 2011
violations of civil rights page 27: medicare coordination of benefits. damages
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?
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?
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 12, 2011
violations of civil rights page 16 Appeal to Federal Blue Cross/Blue Shield of ILLINOIS,TX,OK, NM
Attached are a recap summary of all claims back to 8/1/00 which are currently appealed or are new items received not paid correctly. All claims need to be referred first to federal workers compensation and your contact should be the regional office manager in Dallas, TX, not the non- compliantcontractor as to how this can be facilitated. New actions since your last, inaccurate decisions based on false and incomplete information. Remember you are alleging OPM' past director gave you one set of ' facts' and ACS, the paper controller and claims processor for US dept of labor, claims they were told an opposite set of 'facts' by that same director. Trailblazers has been non cooperative with judges, etc. but Cigna Govt services did cooperate and the only Final decision was issued by Medicare's appellate judge on 9/29/2010 was based on the internal documents that were withheld from you, even from the officials at OPM? , by that director. Federal workers comp gets claims first. Then you and last would be Medicare for any co- pays or deductibles on medical issues not yet reviewed or accepted yet. All conditions accepted or filed on 1/10/89 injury . HIPPAA reqeust for written recap of who said what, when to solve. not yet answered.
Tuesday, February 15, 2011
Violations of civil rights page 6: husband's supplier blocked from payment
My spouse has a medical problem that has had delays in treatment. Federal blue Cross. Bles Shield is primary insurer due to my status as not placed on permanent disability with OWCP. $ Federal judges have ruled on this at Medicare and U.S> dept of Labor yet The govt contractors keep altering the official records saying: we don;t care what a Federal judge says. Healthline was asking for Doyle as to when he will be seeing his doctor so they can get paperwork in to get paid by Medicare. I said Medicare is not primary and we're all overpaid according to judges if they pay first. Doyle's treatment is being determined by the wrong insurer's rules. She said that Fed Blues refused to pay first yet no official denial EOB has yet arrived from them. So much is ' verbal' and civil rights seems to elude everyone. I said this part of the trillion dollar theft Medicare and that Medicare Coordination of Benefits is a govt contractor and subsidiary of Group Health now an international conglomerate. Fed Blues and they defy the judges' ruling that reflect the official posting from the US dept of Labor's official computer and I've never received any official notice of any change even though MCOB alters the official record in violation of their US Dept of Labor contract. I said if you get paid my medicare first, I'll have to fie appeals and cooperation is needed. She hung up on me. The defamation is overwhelming and yet the law and judges and I are in agreement. This is horrific! I'm shaking! Lives at stake!
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