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.
                  

violations of civil rights page 29: Standing request to Lincare for services

John P. Byrnes CEO
Lincare Holdings, Inc.
19387 U.S. 19 North
Clearwater, Fl. 33764
Dear Sir: the treatment we both have endured at the hands of got officials and their contractors has been unconscionable. However, it got worse when you wouldn't believe what I was trying to tell you. The judges do and on 2/09 said everyone is to ask me for the facts of the case as rumor and gossip is still being strewn  around as facts. I'm approved for life by three health plans: Federal workers compensation, who paid  the company you bought, health connections and the contract with OWCP should be in my files. Then federal blue Cross, Blue Shield who paid you until Illinois Blues took over in OK, TX and NM and posted false info on their computer that owcp was settled and I had retired years earlier. at the same time Affiliated Computer Services, now a Xerox company, took over processing of paper and bills for Federal workers compensation and refused to set up my computer file to this very date. They have 11 years of oxygen invoices that have never been processed because: the computer will pay them and bring them on line with the official US dept of Labor computer that posts my active employment status and permanent medical benefits bi weekly, by contract with Medicare Coordination of benefits, a Group health subsidiary, and The Us dept of Labor. three Medicare judges, including an appellate judge upheld this as accurate on 9/29/2010 case # M09-1406. The 2 ALJ decisions were ignored by MCOB saying: we don't care what a judge says, nor the law nor their contract. There is a 1980's federal workers compensation law that was passed to insure that when life sustaining medical care is in jeopardy, permanent medical could be approved before work issues are resolved. That pertinent info was not shared with my attorney nor I except for a letter received in mid 90's that oxygen tanks they had paid for was to be included in my estate instruction to return them to US Dept of Labor upon my death.
When Cigna Govt services took over  in my area for medicare, they said all your claims and our appeals were thrown away by Palmetto GBA. They have yet to process them. They did approve me for life, paid the claims from the suppler I had for '06-1/08 when you became the monopoly supplier in my area. Rhema said you refused to turn over the contract with US Dept of labor with health Connections that you'd bought out.They  were the only intermediary that sent claims on to Medicare secondary payer recovery to recover from ACS who ignored them and i filed an appeal to try and get enforcement of the laws which medicare has the responsibility to do by law except it was suspended by former Sec of HHS back in the '90's. Illinois blues, has still not processed the co-pays on those claims, although the initial filing was ' dumped onto Medicare.
I have a standing request to your for services. I have tanks and one stop per month should suffice.
Currently, in order to live, my family has had to haul tanks and pay out of pocket. This is truly a ' death panel ' decision and the public should be aware anyone could get injured and have such disparate treatment.
Compounding the problem in '06 was when your manager called ACS and got lied to about my case and told that I'd gotten some big settlement that included your back pay for services. other defamation and slander got spewed around even more. ACS had the appellate judge's orders and files' disappear.'  out of London , Ky where their contract is to post all paper from any source and definitely not be the decider of cases. Nor are they to set up a ' dummy' offline computer file to charge the US dept of labor to process bills and items and respond that some unknown third party is to pay, yet disparately decide the only type of claim not to input is oxygen; knowing full well the ' gig' would be up. it took some ' nice' persons in the Fl call center to tell me the truth claiming the Director of opm 'made  them do it' yet she had no contract with them and was not paying them? This is the entity that  when Arkansas blues was our blues here their manager called me and said OPM asked them to murder me and they paid you. Your local manager seemed unaware of that in 1/06. the terrible thing that was done was that Ill blues took back all payments back to 8/1/00 when I became entitled to part B Medicare when they should have gotten the monies back from ACS. Lying and abuse of power has been rampant.
Compounding the problem was that medicare was not following oxygen guidelines. Sec Tommy Tompkins got them clarified in 2005 and  when i discovered in 2006 that you had never contacted my pulmonologist nor cardiologist to get the medical necessity forms, i had to get them and take them to my doctor who promptly filled them out and said he would have had no problem completing them at the time I first saw him in 1/2004 except each year your employees took the name of my cardiologist and I thought he was completing them. I see that finally Cigna govt services is having training on the guidelines. The are basically no different than in the past except they are more medcially specific. the old ones just said O2 sat rate Or send in medcial records which could be a clerical nightmare in a company as I have witnessed in obtaining doctors records for SSA disability claims. Some have excellent, organized records and others are barely legible which basically required Palmetto GBA to have a doctor on staff to call every doctor that chose to submit records instead of just using a sat rate. In 1/2004 at a cardiopulmonary stress test the technician had me at 70% sat rate before he stopped and then it took the 2 years to get ahold of the tests from the hospital. In this day and age, they didn"t realize that I was not a patient to fear for going too far. Usually doctors stop the tests when the heart starts getting overworked. yes it took a week  to recover, but the results were there that you needed and communications were being thwarted every which way. in TX, technicians are allowed to run the tests.
Palmetto Gba wanted you to leave the diagnosis code off as that triggered owcp paying the bill. when Cigna first try to pay using my secured Medicare number it kicked it out for having primary payers due to the diagnosis code and being oxygen and the official secured records at the US Dept of Labor. This is a very strong and good law that was passed after a scandal of lives lost at the abuse  of power by OPM. now contractors have resumed those ' dirty deeds and lives are in jeopardy.  They used a phony Medicare widow claim number, declaring my husband dead to pay the claims to by pass the security, but did send over to MSPRC who did send out the ignored recovery letter. ( OPM is the entity in charge of all health care plans in USA in 2014.)
My fax number is my phone number. I plan on living a good many more years if medical care is not obstructed.
The new regional office manager at the Dallas  federal workers compensation office is aware  now that she has not had access to my actual records, etc. their phone number is 214-850-2300_. I suggest you call here for clarification as to what to do. Any problems, please keep me informed.No patient should be treated in such a manner. The Sec of Labor has asked for complaints and civil rights to be filed against the contractors when they treat one badly. Its not easy to ' fire' a govt contractor. The state of Mn tried to fire ACS and they counter sued and the state had to pay ACS 7.6 million and they still have the contract. Proof is needed. Ill Blues was 'gotten' by state of Ill medicaid recently for their dumping onto  them for $25 million. Finally the govt is waking up that for profit companies will ' get by' with shenanigans and take more money then is due if they can. Any one harmed needs to file and present evidence so the contractors will either ' straighten up or have their contracts cancelled and get someone else or go back to hiring civil servants to process and pay claims, etc. Linda Joy Adams

Violations of civil rights page 20: explanation of organization of filings

1. the complaint form or filing                                                       9. other related info/proof
2. List of summary of issues , many published                             
3. e-mails
4. dates of violations; (the ins dates of service ,for most)
5. research on who are the parties
6. Retaliations
7. Financial hardships( partial. other related items
8. proof  of protected class/ or valid complainant
There's a cover sheet for each category. Since the total documents are voluminous and can't be sent all at once due to physical disability limitations, and the need to meet filing deadlines; the cover sheet will be placed on top of whatever category is under. This has been growing exponentially since the first filing and  no investigations has only made it worse including obstruction of medical care. Doyle @ Linda Joy Adams+M.

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