imc indymedia

Los Angeles Indymedia : Activist News

white themeblack themered themetheme help
About Us Contact Us Calendar Publish RSS
Features
latest news
best of news
syndication
commentary


KILLRADIO

VozMob

ABCF LA

A-Infos Radio

Indymedia On Air

Dope-X-Resistance-LA List

LAAMN List




IMC Network:

Original Cities

www.indymedia.org africa: ambazonia canarias estrecho / madiaq kenya nigeria south africa canada: hamilton london, ontario maritimes montreal ontario ottawa quebec thunder bay vancouver victoria windsor winnipeg east asia: burma jakarta japan korea manila qc europe: abruzzo alacant andorra antwerpen armenia athens austria barcelona belarus belgium belgrade bristol brussels bulgaria calabria croatia cyprus emilia-romagna estrecho / madiaq euskal herria galiza germany grenoble hungary ireland istanbul italy la plana liege liguria lille linksunten lombardia london madrid malta marseille nantes napoli netherlands nice northern england norway oost-vlaanderen paris/Île-de-france patras piemonte poland portugal roma romania russia saint-petersburg scotland sverige switzerland thessaloniki torun toscana toulouse ukraine united kingdom valencia latin america: argentina bolivia chiapas chile chile sur cmi brasil colombia ecuador mexico peru puerto rico qollasuyu rosario santiago tijuana uruguay valparaiso venezuela venezuela oceania: adelaide aotearoa brisbane burma darwin jakarta manila melbourne perth qc sydney south asia: india mumbai united states: arizona arkansas asheville atlanta austin baltimore big muddy binghamton boston buffalo charlottesville chicago cleveland colorado columbus dc hawaii houston hudson mohawk kansas city la madison maine miami michigan milwaukee minneapolis/st. paul new hampshire new jersey new mexico new orleans north carolina north texas nyc oklahoma philadelphia pittsburgh portland richmond rochester rogue valley saint louis san diego san francisco san francisco bay area santa barbara santa cruz, ca sarasota seattle tampa bay tennessee urbana-champaign vermont western mass worcester west asia: armenia beirut israel palestine process: fbi/legal updates mailing lists process & imc docs tech volunteer projects: print radio satellite tv video regions: oceania united states topics: biotech

Surviving Cities

www.indymedia.org africa: canada: quebec east asia: japan europe: athens barcelona belgium bristol brussels cyprus germany grenoble ireland istanbul lille linksunten nantes netherlands norway portugal united kingdom latin america: argentina cmi brasil rosario oceania: aotearoa united states: austin big muddy binghamton boston chicago columbus la michigan nyc portland rochester saint louis san diego san francisco bay area santa cruz, ca tennessee urbana-champaign worcester west asia: palestine process: fbi/legal updates process & imc docs projects: radio satellite tv
printable version - js reader version - view hidden posts - tags and related articles

Office of Inspector General's in Violation of Patroit Act 1001

by Kimberly Kimball Friday, Dec. 23, 2005 at 9:51 PM
LawISAmootIssue@aol.com Kenokee Twp MI 48006

Office of Inspector general's in Violation of Patroit Act regarding Medicaid kickback fraud conducted against Elderly Hospitalized Federal Employee Health Beneficiaries - Hospital dumping for criminal conversions.

I'm an American Citizen who has been reporting a crime - OPM FEHBP Hospital Insurance Fraud since 1999.....my Criminal Complaint has been placed in the OPM & DHHS HMO Government Grievance Procedures, whereas when Judicial Review was requested, it was denied sua sponte, just as quickly as the OPM FEHBP Hospital Insurance. I've been reporting OPM FEHBP health insurance kickback fraud resulting in death of a Retired Federal Employee - Air National Guard Base Technician.

.

Office of Inspector general's are and have been in violation of the US Patroit Act sect 1001 Civil Rights and Civil liberties Violations against the Public: by allowing and concealing mass OPM FEHBP Hospital Insurance Fraud ( anti dumping / anti kikcback violations ) against Retired Federal Employees forced into Medicaid by criminal termination of OPM FEHBP Hospital Insurance Service Contracts.

.

[CITE: 5CFR890.105] & Medicaid False Claims Act - OPM FEHBP Supersedes Medicaid.

.

The Retired OPM FEHBP Beneficiaries are being automatically denied Hospital Insurance Benefits ( criminal enactment of DHHS HMO grievance / appeals procedures - hospital discharge procedures ) for posthospital care, for criminal conversions into Medicaid. Felony kickback fraud.

.

[CITE: 42CFR409.33] HOSPITAL INSURANCE BENEFITS --Table of Contents Subpart D--Requirements for Coverage of Posthospital SNF Care Sec. 409.33

.

OPM Federal Employee Health Benefits Insurance Policy and Information Division:

.

Subj: RE: more details

Date: 3/3/00 12:23:10 PM Eastern Standard Time

From: FEHB@opm.gov (FEHB Internet Mailbox)

To: Kstbylite1@aol.com ('Kstbylite1@aol.com')

.

I am sorry about what happened to your mother. It's so hard to watch

someone we love suffer, and if we feel the person isn't getting the proper

medical care, it makes it so much worse.

You have a couple options for addressing your concerns.

The first option is to go through the health plan. As you know, benefits

for extended care/skilled nursing facilities are limited. But if you feel

that the care your mother was receiving should have been covered, based on

the description in the plan's brochure, you can file a disputed claim. The

process is spelled out in the brochure. You must first request a

reconsideration from the plan; they may overturn their decision on appeal.

If they uphold their decision, your next level of appeal is OPM.

The second option, if you really believe that fraud is involved, is to file

a complaint with our Inspector General's offi ) for posthospital care, for criminal conversions into Medicaid. Felony kickback fraud.

.

[CITE: 42CFR409.33] HOSPITAL INSURANCE BENEFITS --Table of Contents Subpart D--Requirements for Coverage of Posthospital SNF Care Sec. 409.33

.

OPM Federal Employee Health Benefits Insurance Policy and Information Division:

.

Subj: RE: more details

Date: 3/3/00 12:23:10 PM Eastern Standard Time

From: FEHB@opm.gov (FEHB Internet Mailbox)

To: Kstbylite1@aol.com ('Kstbylite1@aol.com')

.

I am sorry about what happened to your mother. It's so hard to watch

someone we love suffer, and if we feel the person isn't getting the proper

medical care, it makes it so much worse.

You have a couple options for addressing your concerns.

The first option is to go through the health plan. As you know, benefits

for extended care/skilled nursing facilities are limited. But if you feel

that the care your mother was receiving should have been covered, based on

the description in the plan's brochure, you can file a disputed claim. The

process is spelled out in the brochure. You must first request a

reconsideration from the plan; they may overturn their decision on appeal.

If they uphold their decision, your next level of appeal is OPM.

The second option, if you really believe that fraud is involved, is to file

a complaint with our Inspector General's office. They investigate fraud

complaints. You may either call the health care fraud hotline

(202-418-3300) or write to:

U.S. Office of Personnel Management

Office of the Inspector General Fraud Hotline

1900 E Street, NW, Room 6400

Washington, DC 20415

.

Again, I'm sorry to hear about your mother's death.

Karen Leibach

Insurance Policy and Information Division

.

[CITE: 5CFR890.105 ] If the carrier ( OPM FEHBP HMO -Hospital affiliate ) denies a claim (or a portion of a claim - [ posthospital extended care SERVICES ] ), the covered individual may ask the carrier ( FEHBP HMO affiliate ) to reconsider its denial.

A covered individual * must exhaust both * the carrier ( DHHS - HMO- service-grievance procedure ) and OPM review processes specified in this section before seeking judicial review of the denied ( Covered ) claim.

.

Elderly Victims of Hospital Insurance Fraud ( anti dumping / anti kickback violations ) die without posthospital care / SERVICES.

A Hospitalized Elderly Victim of Hospital Insurance Fraud are Not able - mentally or physically - to conduct OPM & DHHS Government Grievance Procedures to Fight for DENIED Covered posthospital services.

Grievance & appeals procedures are used to conduct, conceal and allow fraudulent insurance acts against public programs and american citizens. Denial of Civil and Criminal Rights - Obstruction of Justice.

.

According to the Detroit News, Between 1999 & 2001 Michigan's Medicaid clientele ballooned to 1.25 million from 1 million, at a cost of approximately ,000 on each Medicaid Reciepent. Criminal ( kickback ) Conversions of OPM Retired FEHBP.

,

According to Vernon Smith, " a health care expert " who attended - Previous Attorney General MI, ( now ) Governor Jennifer Granholms Summit, he stated the Biggest Factor responsible for raising Medicaid spending is Enrollment.
.

Section 1001 of the USA Patriot Act, signed into law by the President on October 26, 2001, directs the Inspector General to review information and receive complaints alleging abuses of civil rights and civil liberties by Department of Justice employees.

The OIG has created a special section in its Investigations Division to process these complaints. This section will **** identify the more serious ***** civil rights and civil liberties allegations and assign them to OIG employees for investigation.

The OIG will refer other complaints to Department components for their review and handling.

How to Report a Complaint about Waste, Fraud, Abuse, or Misconduct in the Department of Justice:

The Office of the Inspector General (OIG) investigates allegations of fraud, waste, abuse, and misconduct by Department of Justice employees, contractors, and grantees.

.

The OIG is an independent entity within the Department of Justice that reports to both the Attorney General and Congress on issues that affect the Department's personnel or operations.

.

.

You may report waste, fraud, abuse, or misconduct to the OIG by mail:

.

Office of the Inspector General

U.S. Department of Justice

Investigations Division

950 Pennsylvania Avenue, NW

Room 4706

Washington, DC 20530

e-mail: oig.hotline@usdoj.gov

.

Public Official Criminal Misconduct OIG Fraud - RICO

.

OIG SSA Allegation Management Division Quote: " If we were to provide information pertaining to the subject of the allegation, he or she might then have grounds to seek possible criminal and civil sanctions against OIG and its employees".

.

Title 18 US Code: OIG's violating HIPAA Laws - 1518 - reads - obstruction of criminal investigations of health care offences - Hospital Insurance Fraud -anti dumping, Retired OPM FEHBP- anti kickback, into Medicaid. Obstruction of Justice Region V CMS.

.

IAIP redacted 8Jun04 .indd S.C. Section 552, as amended. Preface The Department of Homeland Security (DHS) Office of Inspector General (OIG) was established by the Homeland Security Act of 2002 (Public Law 107-296) by amendment to the Inspector General Act of 1978.

.

Subj: RE: abuse of civil rights by justice employees

Date: 12/13/2002 8:54:30 AM Eastern Standard Time

From: Inspector.General@usdoj.gov (General, Inspector)

To: Kstbylite1@aol.com ('Kstbylite1@aol.com')

.

Dear Ms. Kimball:

.

The purpose of this letter is to acknowledge receipt of your Internet submission dated October 31, 2002. The matters that you raised have been reviewed by the staff of the Investigations Division, Office of the Inspector General.

.

The primary investigative responsibilities of this office are:

.

· Allegations of criminal, as well as non-criminal, misconduct committed by U.S. Department of Justice employees and contractors; and

· Waste and abuse by high ranking Department officials, or that affects major programs and operations.

.

This Office does not have jurisdiction in the matter you described.

.

Section 1001 of the USA Patriot Act, signed into law October 26, 2001......

.

Therefore, your complaint has been forwarded to:

.

Office of Personnel Management

Office of the Inspector General

1900 E Street NW

Washington, D.C. 20415

.

Allegations of criminal misconduct committed by- OIG OPM J. Frech - U.S. Department of Justice employees and contractors - OPM FEHBP Health Insurance Contracting Divisions.

Stop Health Care Fraud!

.

Office of Inspector General

Office of Personnel Management

Joseph Frech investigator

dtd: 9 may 2002

.

" The matters discribed in your letter are not within the jurisdiction of this office. The OIG had also recieved information regarding your case in September 2000. At that time we determined that the ( OPM FEHBP ) Health Benefits Contracts Division has sole jurisdiction over your complaint. The decision made by the contracts division is final and the OIG will NOT Investigate ( OPM FEHBP Contracting Divisions assisting, allowing & concealing felony federal health care offences against Retired FEHBP ). "

.

I hope this answers any questions regarding this matter.

.

Sincerely,

.

The Office of the Inspector General

Department of Justice

--------------------------------------

.

MASS DUMPING OF RETIRED FEHBP WILL BEGIN IN 2006 - FELONY FRAUD

.

Subj: Re: Health Alliance Insurance Fraud

Date: 2/21/2003 5:07:41 PM Eastern Standard Time

From: senator@stabenow.senate.gov (Senator Debbie Stabenow)

To: kstbylite1@aol.com

February 21, 2003

.

Thank you . . .

. . for contacting me about ( OPM FEHBP ) insurance & Medicaid ( kickback ) fraud committed by Health Alliance Plan. I appreciate that you have taken the time to communicate your views and concerns with me.

I understand your concern about this issue. Should related legislation

come before the U.S. Senate for a vote, I will keep your views in mind,

and share your thoughts on this issue with my colleagues who serve on the

Health, Education, Labor and Pensions Committee.

Thank you again for contacting me. Please feel free to contact me

whenever I can be of assistance to you or your family.

Sincerely,

Debbie Stabenow

United States Senator

.

=============== RELATED LEGISLATION - Medicare Drug Plan

.

Carrier OPM - HCFA - DHHS & OIG counterparts - subject to prosecution under section 1001, title 18, United States Code.

.

1999 RULES & REGULATIONS Part IV DHHS OIG 42 CFR Part 1001 . Federal Health care Programs: ( OPM FEHBP ) . Fraud & Abuse Anti Kickback Statutes Sect 1128B(b) of the Social Security Act provides criminal penalties for individuals or entities that knowingly & willfully offer, pay, solicit, or recieve renumeration to induce ( inducing forfiture OPM FEHBP for criminal Medicaid kickback conversions ) the referral of business reimbursable under a Federal Health Care Program ( including Medicare & HCFA Medicaid ). Section 2 of the Medicare and Medicaid Patient & PROGRAM PROTECTION ACT of 1987 ( MMPPPA )

.

OPM JANUARY 2003
.

[Code of Federal Regulations][Title 5, Volume 2][Revised as of January 1, 2003]From the U.S. Government Printing Office via GPO Access[CITE: 5CFR890.304] [Page 439-441] TITLE 5--ADMINISTRATIVE PERSONNEL CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents Subpart C--Enrollment

.

To Conceal past & Future OPM Hospital DHHS dumping & kickbacks with HCFA/CMS - making the Medicare -Drug- Plan - a criminal kickback solisitation. TARGETING Retired FEHBP.

.

Sec. 890.304 When do enrollments terminate, cancel or suspend ? .

.

(2) An annuitant or survivor annuitant may suspend enrollment in FEHB for the purpose of enrolling in a Medicare-sponsored plan under sections 1833, 1876, or 1851 of the Social Security [[Page 441]] Act , or to enroll in the Medicaid program or a similar State-sponsored program of medical assistance for the needy, or to use CHAMPVA or TRICARE (including coverage provided by the Uniformed Services Family Health Plan) or TRICARE-for-Life instead of FEHB coverage.

To suspend FEHB coverage, documentation of eligibility for coverage under the non- FEHB program must be submitted to THE RETIREMENT SYSTEM.

If the documentation is received within the period beginning 31 days before and ending 31 days after the effective date of the enrollment in the Medicare-sponsored plan, or the Medicaid or similar program, or within 31 days before or after the day designated by the annuitant or survivor annuitant as the day he or she wants to suspend FEHB coverage to use CHAMPVA or TRICARE (including the Uniformed Services Family Health Plan) or TRICARE-for-Life instead of FEHB coverage, then suspension will be effective at the end of the day before the effective date of the enrollment or the end of the day before the day designated. Otherwise, the suspension is effective the first day of the first pay period that begins after the date THE RETIREMENT SYSTEM recieves the documentation.

(3) The enrollee and covered family members are not entitled to the temporary extension of coverage for conversion or to convert to an individual contract for health benefits.

( OPM HOSPITAL DHHS HMO DUMPING - PostHospital Facilities ( Hospital contracted Affiliates ) Bill/SUE Victims for criminally terminated OPM HMO Hospital Insurance - forcing Medicaid Application - kickback fraud ).

(e) Temporary continuation of coverage. Employees and family members are entitled to temporary continuation of coverage only as provided under subpart K of this part.

.

TITLE 5 > PART III > Subpart G > CHAPTER 89

Sec. 8903. - Health benefits plans

.

The Office of Personnel Management may contract for or approve the following health benefits plans:

(1) Service Benefit Plan. - One Government-wide plan, which may be underwritten by participating affiliates licensed in any number of States, offering two levels of benefits, under which payment is made by a carrier under contracts with physicians, hospitals, or other providers of health services for benefits of the types described by section 8904(1) of this title given to employees, annuitants, members of their families, former spouses, or persons having continued coverage under section 8905a of this title, or, under certain conditions, payment is made by a carrier to the employee, annuitant, family member, former spouse, or person having continued coverage under section 8905a of this title.

.

Affiliate: Health Alliance Plan - OPM FEHB HMO Federal Hospital Insurance Service Contractor/Provider.

.

HAP offers 2,596 personal care physicians (PCP) and 4,901 specialists. HAP’s delivery system includes 45 hospitals in southeast Michigan and the Flint area, including 23 major hospital networks, 65 urgent care centers and 765 ancillary providers: nursing homes, mental health facilities, optical providers, laboratories, durable medical equipment providers,ambulance services and pharmacy chains.

.

Public Official Criminal Misconduct by Government Employees. " Color of Law "

Michigan is involved in allowing and concealing Hospital dumping by OPM FEHBP & DHHS into Medicaid.

DHHS made my Governor Vice Chairperson for DHHS National Governor's Committee.

.

The Department of Health & Human Services - Office of Inspector General

( DHHS/OIG ) continues to work with the Administration on Aging ( AOA ), Health Care Finance Administration ( HCFA ), and the American Association of Retired Persons ( AARP ) to develop an outreach campaign to educate beneficiaries and those who work with the elderly to recognize fraud and abuse and to report it appropriately.
This campaign will be fully "launched" in 1999.

The Region V office had a record high 940 new MSP cases filed in 1998. Contributing to this were partnership arrangements with contractors and U.S. Attorneys in Michigan and Ohio..................

.

Title 18 U.S.C. § 4. Misprision of felony. Whoever, having knowledge of the actual commission of a felony cognizable by a court of the United States, conceals and does not as soon as possible make known the same to some judge or other person in civil or military authority under the United States, shall be fined under this title or imprisoned not more than three years, or both.

.

THE MEDICAID FALSE CLAIM ACT (EXCERPT)Act 72 of 1977

400.603 Application for, or determining rights to, medicaid benefits; false statement or false representation of material facts; concealing or failing to disclose certain events; felony; penalty. [M.S.A. 16.614(3) ]

(3) A person, ( Kimberly Kimball ) who having knowledge of the occurrence of an event ( OPM contracted Hospital DHHS Workers inducing forfiture of FEHBP Insurance by criminal enactment of HMO Grievance Procedures ) affecting his initial or continued right to receive a medicaid benefit or the initial or continued right of any other person on whose behalf he has applied for or is receiving a benefit, shall not conceal or fail to disclose that event ( OPM Hospital DHHS conducting anti dumping / anti kickback violations against HMO COVERED Federal Employee Health Beneficiaries ) with intent to obtain a benefit to which the person or any other person is not entitled or in an amount greater than that to which the person or any other person is entitled.

(4) A person who violates this section is guilty of a felony, punishable by imprisonment of not more than 4 years, or a fine of not more than ,000.00, or both.

.

OPM FEHBP Insurance Supersedes Medicaid - OPM FEHBP are Not 'entitled' to Medicaid Services 'Allready covered' by OPM FEHBP ( kickback fraud ).

.

Michigan Consumer & Industry Services-concealing Medicaid kicback fraud for DHHS/HCFA region V now called CMS- Center for Medicaid Services.

.

John Engler, Governor / Attorney General Jennifer Granholm
Department of Consumer & Industry Services

P.O.Box 30664

Lansing MI 48909

.

August 17,1999

.

RE: 990759 BonSecours Hospital

.

Dear Ms Kimball

.

This communication is a follow-up to our letter to you regarding your complaint against BonSecours Hospital.

.

As you are aware, your complaint was forwarded to the Department of Health & Human Services, Health Care Financing Administration ( HCFA ), in Chicago for thier evaluation and direction to the State. HCFA has advised us that they are NOT authorizing an Investigation of the alledged allegation in your letter. Based on HCFA Decision, we have closed our file.

.

If you should have any questions, please call Mary Duncan at ( 517 ) 334-7442, between 8:00 am and 4:30 pm, Monday through Friday.

Sincerely,

signature : Mary Duncan

James L Buchanan, Chief

Detroit Field Services/Special Services Section

.

MI

Attorney General - health care fraud division # 2002-04-0925 .......... Mike Cox / Jennifer Granholm

original Complaint #'s filed with State Law Enforcement Offices & dates filed:

a. Health Care Fraud Division # 99-05-1034

January 2000 ........................ Linda Damer

b. Insurance Bureau # 31302-001

March 2000 .......................................... Cindy Mielock , Kristie Tabor

c. Liscensing Division # 68-99-3073-00

April 1999 ....................Victim still living.................. Cynthia Samuel

d. Bureau of Health Systems # 990759

April 1999 ....................Victim still living ................... Mary Duncan

.

MI

.

From : Jeanette Girty Health Alliance Plan -

DHHS HMO Grievance - Quote in writting on June 20, 2000 -

To Taber,Kristie - Michigan Insurance Bureau -

.

HAP Quote: " After a two week stay, the ( Covered OPM FEHBP ) husband STILL refused to apply for ( HCFA ) Medicaid ".

.

HCFA Health Care Finance Administration - Handles Medicaid

.

Subj: update, letter sent to State Fraud & Insurance Bureaus -Reply

Date: 8/3/00 11:06:34 AM Eastern Daylight Time

From: SHahnReizner@hcfa.gov

To: Kstbylite1@aol.com

CC: DSchmidt@hcfa.gov, JTolian@hcfa.gov, PMiner@hcfa.gov

Ms. Kimball,

While we appreciate your efforts to keep this office informed of your communication with the Michigan Department of Insurance, please note that the matter that Department has taken up in response to your inquiry concerns a coverage decision made by a Federal Employee Health Benefit Plan.

As you know, the Federal agency that handles inquiries about FEHB plan coverage issues is not HCFA, but the Office of Personnel Management, which has already been in communication with you about this matter.

It is therefore not necessary or for you to copy me on your ongoing

communications with the Michigan Department of Insurance.

Susan Hahn Reizner

Medicaid Fraud and Abuse Coordinator

HCFA Region V - Chicago

.

OPM FEHBP

Subj: Alexandra Rupert

Date: 9/6/00 2:45:32 PM Eastern Daylight Time

From: IETHOMAS@opm.gov (Thomas, Imogene E)

To: SpiritDancerMita@aol.com ('SpiritDancerMita@aol.com')

CC: kstbylite1@aol.com ('kstbylite1@aol.com')

Hello Ms. Kimball

I received a response from Jeanette Girty at Health Alliance Plan regarding

your mother Alexandra Rupert's denied claim. Ms. Girty informed me that

they resolved this case long ago. HAP paid the additonal days and sent the

approval letter to you in Marysville, MI on May 21, 1999. You also sent in

a complaint letter to the Michigan Insurance Bureau in March of this year

regarding the same thing as well as some alleged quality issues. They also

investigated the QA issues and responded to you. Ms. Girty said HAP had not

received an itemized bill for the additional three days so they sent you

another letter reminding you of the approval and asked you to forward the

itemized bill to them. As of today, they have not received this

information. HAP need the information (the itemized bill) for proof of

payment. HAP considers this case resolved and closed. Any questions let me

know.

Regards,

Imogene E. Thomas

.

Michigan Insurance Bureau

.

Subj: Health Alliance Plan

Date: 12/21/2000 4:34:13 PM Eastern Standard Time

From: Kristie.Taber@cis.mi.us ( Taber,Kristie @ INSFS@CIS)

To: Kstbylite1@aol.com ( Kstbylite1@aol.com)

Cindy Mielock forwarded to me your recent e-mail. I have reviewed our file

and your concerns. Our previous review consisted of a review of Health

Alliance Plans handling of the submitted claims, and their payment of

benefits pursuant to the terms of the contract. At the time that the

dispute arose, the process to review your concerns was through the plans

grievance procedures. As a result of your grievance, further benefits were

paid on behalf of your mother, Mrs.Rupert. As such, it appears that the

HMO has paid all the claims submitted, and there are no outstanding bills.

Also, pursuent to our previous telephone conversations, we obtained a copy

of the HMO's established guidelines used for making the determination that

your mother's condition 'no longer' required skilled care. This was provided

to you in our October 16th, 2000 corraspondence. Our file was closed at this time.

It appears that the remaining issues concern matters outside of our

authority, such as the quality of care your mother recieved. You have

contacted other governmental agencies regarding these concerns.

Unfortunately, those issues are not issues we are able to address on your

behalf.

I hope this explains the status of your file with our office. If you have

further questions, please feel free to contact me directly at 517-373-2080,

or toll free at 1-877-999-6442.



Center for Regulatory Effectiveness Michigan

Whom to contact: Michigan Office of Financial and Insurance Services (OFIS) ( Taber,Kristie @ INSFS@CIS)

What you can appeal: The availability, delivery, or quality of health care services, including a complaint regarding an adverse determination, as well as issues concerning the contract between you and your health plan.

.

Subj: MI Civil Rights Dept. 285032

Date: 12/2/2003 10:42:57 AM Eastern Standard Time

From: BlairJ@michigan.gov

To: manifestdreams@aol.com

Sent from the Internet (Details)

Dear Ms. Kimball,

Thank you for your e-mail correspondence on November 18, 2003.

As you were notified in April and August 2002, this department is unable

to assist you with your concern. If you have not already done so, I

encourage you to contact the Michigan Insurance Bureau.

Sincerely, Joan Blair, Reconsideration Team Manager 313/456-3827

.

Subject: FBI Response

Date: 5/26/2004 10:26:33 AM Eastern Daylight Time

From: tips11@fbi.gov

Reply To:

To: LawISAmootIssue@aol.com

CC:

BCC:

Sent on:

Sent from the Internet (Details)

.

Dear Ms. Kimball,

.

THIS IS NOT AN AUTOMATED RESPONSE

Thank you for your submission to the FBI Internet

Tip Line. After a careful evaluation of your

information, it is our determination that your

complaint should be reported to your local law

enforcement authorities or District Attorney's

office. If you wish pursue legal matters against

the hospital you should contact an attorney.

Post-Hospital Extended Care Services

.

(i) The term "post-hospital extended care services" means extended care services furnished an individual after transfer from a hospital in which he was an inpatient for not less than 3 consecutive days before his discharge from the hospital in connection with such transfer.

.

........concealing patient skill care needs to criminally terminate OPM FEHBP hospital insurance services for criminal conversion into HCFA Medicaid.

.

Subj: Skilled Nursing Facility Coverage
Date: 4/23/99 8:19:16 PM !!!First Boot!!!

From:MSWEB1@hapcorp.org (Member Services Web)

To: Kstbylite1@AOL.com

.

Ms. Kimball,

Thank you once again for contacting the
Member Services Web. Upon review of the

referral to Nightengale East Nursing Center,
we have found that Mrs.Rupert will be

referred to Nightengale for a total of two
weeks for family training for maintenance of

her feeding tube. This family training is

considered to be basic care according to
HAP criteria. Although the skilled nursing

facility benefit is for up to 730 days, HAP
criteria require that the care must be skilled.
Because Mrs.Rupert is recieving basic and

NOT skilled care, she does not meet the
criteria for the maxium benefit.

If you would like to speak to someone

directly regarding Mrs.Rupert's care, you

are more than welcome to call HAP at

1-800-422-4641 and ask for Mattie Ogburn.
Ms.Ogburn has spoken with Mr.Rupert and

is handling your Mother's case.

Member Services Web

.

18 USC Sec. 24 01/02/01-EXPCITE- TITLE 18 - CRIMES AND CRIMINAL PROCEDURE PART I - CRIMES CHAPTER 1 - GENERAL PROVISIONS-HEAD- Sec. 24. Definitions relating to Federal health care offense-STATUTE-

(a) As used in this title, the term ''Federal health care offense'' means a violation of, or a criminal conspiracy to violate- (1) section 669, 1035 - reads - False statements relating to health care matters, 1347, or 1518 - reads - obstruction of criminal investigations of health care offences, of this title; ( 2) section 287, 371, 664, 666, 1001- anti kickback violations, 1027, 1341, 1343, or 1954 of this title, if the violation or conspiracy relates to a health care benefit program.

(b) As used in this title, the term ''health care benefit program'' means any public or private plan or contract, affecting commerce, under which any medical benefit, item, or service is provided to any individual, and includes any individual or entity who is providing a medical benefit, item, or service ( OPM & DHHS HMO Grievance/appeals Procedures / Judicial Review ) for which payment may be made under the plan or contract.

-SOURCE- (Added Pub. L. 104-191, title II, Sec. 241(a), Aug. 21, 1996, 110 Stat. 2016.)-SECREF- SECTION REFERRED TO IN OTHER SECTIONS This section is referred to in sections 669, 1035 of this title; title 42 section 1395i.

.

Public Official Criminal Misconduct. Felony OPM FEHBP & Medicaid Fraud.

Report this post as:

Local News

GUIDE TO REBEL CITY LOS ANGELES AVAILABLE A12 5:39PM

lausd whistle blower A10 11:58PM

Website Upgrade A10 3:02AM

Help KCET and UCLA identify 60s-70s Chicano images A04 1:02PM

UCLA Luskin: Casting Youth Justice in a Different Light A02 11:58AM

Change Links April 2018 A01 11:27AM

Nuclear Shutdown News March 2018 M31 6:57PM

Join The Protest Rally in Glendale on April 10, 2018! M29 7:00PM

Join The Protest Rally in Glendale on April 10, 2018! M29 6:38PM

Spring 2018 National Immigrant Solidarity Network News Alert! M19 2:02PM

Anti-Eviction Mapping Project Shows Shocking Eviction Trends in L.A. M16 5:40PM

Steve Mnuchin video at UCLA released M15 12:34AM

Actress and Philanthropist Tanna Frederick Hosts Project Save Our Surf Beach Clean Ups M06 12:10PM

After Being Told He's 'Full of Sh*t' at School Event, Mnuchin Demands UCLA Suppress Video M02 11:44AM

Resolution of the Rent Strike in Boyle Heights M01 6:28PM

What Big Brother Knows About You and What You Can Do About It M01 3:30PM

Step Up As LAPD Chief Charlie Beck Steps Down F14 2:44PM

Our House Grief Support Center Hosts 9th Annual Run For Hope, April 29 F13 12:51PM

Don’t let this LA County Probation Department overhaul proposal sit on the shelf F13 11:04AM

Echo Park Residents Sue LA Over Controversial Development F12 8:51AM

Former Signal Hill police officer pleads guilty in road-rage incident in Irvine F09 10:25PM

Calif. Police Accused of 'Collusion' With Neo-Nazis After Release of Court Documents F09 7:14PM

Center for the Study of Political Graphics exhibit on Police Abuse posters F07 9:50AM

City Agrees to Settle Lawsuit Claiming Pasadena Police Officer Had His Sister Falsely Arre F04 3:17PM

Professor's Study Highlights Health Risks of Urban Oil Drilling F04 12:42PM

Claims paid involving Pasadena Police Department 2014 to present F04 10:52AM

Pasadenans - get your license plate reader records from police F03 11:11PM

LA Times Homicide Report F03 1:57PM

More Local News...

Other/Breaking News

What does the Quran Say About Islamic Dress?? A21 4:15PM

Biodiversité ou la nature privatisée A20 11:22AM

The Market is a Universal Totalitarian Religion A20 7:14AM

Book Available about Hispanics and US Civil War by National Park Service A19 5:52PM

The Shortwave Report 04/20/18 Listen Globally! A19 4:01PM

The Republican 'Prolife' Party Is the Party of War, Execution, and Bear Cub Murder A19 11:48AM

Neurogenèse involutive A18 9:21AM

Paraphysique de la dictature étatique A16 10:13AM

Book Review: "The New Bonapartists" A16 3:45AM

The West Must Take the First Steps to Russia A14 12:25PM

Théorie générale de la révolution ou hommage à feu Mikhaïl Bakounine A14 3:30AM

The Shortwave Report 04/13/18 Listen Globally! A12 3:50PM

“Lost in a Dream” Singing Competition Winner to Be Chosen on April 15 for ,000 Prize! A12 3:48PM

The World Dependent on Central Banks A12 4:43AM

Ohio Governor Race: Dennis Kucinich & Richard Cordray Run Against Mike DeWine A11 9:40PM

March 2018 Honduras Coup Again Update A10 10:52PM

Apologie du zadisme insurrectionnel A10 3:33PM

ICE contract with license plate reader company A10 1:14PM

Palimpseste sisyphéen A09 11:23PM

Black Portraiture(S) IV: The Color of Silence...Cuba No...Cambridge Yes A09 5:32AM

Prohibiting Micro-Second Betting on the Exchanges A09 4:18AM

Prosecutors treat Muslims harsher than non-Muslims for the same crimes A08 10:33PM

Amy Goodman interview on cell phone safety A08 10:29PM

Mesa, Arizona police officer kills unarmed white man A08 9:50PM

Israeli leaders should be prosecuted for war crimes A08 9:48PM

Paraphysique de l'autorité A08 12:11AM

Two Podcasts on fbi corruption A06 10:13PM

Fbi assassins assault & try to kill DAVID ATKINS A06 7:29PM

More Breaking News...
© 2000-2018 Los Angeles Independent Media Center. Unless otherwise stated by the author, all content is free for non-commercial reuse, reprint, and rebroadcast, on the net and elsewhere. Opinions are those of the contributors and are not necessarily endorsed by the Los Angeles Independent Media Center. Running sf-active v0.9.4 Disclaimer | Privacy