UAW bad deal with Federal HMO Health Alliance: Dumping
Retirees
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UAW bad deal with Federal HMO Health Alliance Detroit : Dumping Retirees
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UAW deal with GM offers fewer health plans
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The Free Press, in calling 13 health care providers with operations in
Michigan, confirmed that three will be retained as GM's health plans in Michigan.
They are Blue Cross Blue Shield of Michigan and Health Alliance Plan, both
based in Detroit, and HealthPlus of Michigan, headquartered in Flint.
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She questioned the selection of Detroit area health plans, saying health
care is a highly Regional issue best served by companies that know their areas.
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What the Public Doesn't Know about HMO's and Health Alliance Plan: Hospital
Insurance Fraud against Elderly Hospitalized Covered Individuals - DUMPING -
to force illegal Region V HCFA State OFIS Medicaid kickback conversions.
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The Region V HCFA [ Chicago ] Office had a record high 940 new MSP cases
filed in 1998. Contributing to this were PARTNERSHIP Arrangements with [
T18CFR371Crime Federal HMO 'illegal agreement' T42CFR417 Hospital Insurance Fraud:
Dumping ] Contractors and U.S. Attorneys in Michigan and Ohio .....Public
Fraud
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1998 -- Illegal Agreement with Region V HCFA - MICHIGAN - Michigan Law
Requires YOU [ Federally Entitled T42CFR409 Hospitalized Individual ] to complete
an internal review with your health plan [ T42CFR417 DHHS Employee 'discharge
procedures': Anti-dumping: Anti-kickback Violation - adverse determination
illegal denial of Existing OPM 'Federal Hospital Insurance T42CFR409.33' & OPM
FEHBP employee: 5CFR890.105 illegal denial of covered claims: Illegal
agreement to induce forfiture: T18CFR371Crime to force illegal HCFA State OFIS
Medicaid T42CFR409.33 kickback conversions: 'grievance procedure' - misprison of
a felony T18CFR286 ] prior to using the external review. The health plan [
Federal HMO ] will give you a final decision within 45 days and will provide an
Office of Financial and Insurance Services ( OFIS: T18CFR371Crime:
T18CFR286Crime ) Health Care Request for external review form. If your health plan
does not provide a decision within the required time frame, you may [ be dead -
by criminal denial and termination of posthospital extended care services,
misprison of a felony T42CFR417 grievance procedure: actual commission of a
felony - used to Force illegal HCFA medicaid kickback conversions ] file for
External Review Without the Notice of final Adverse Determination. [
anti-dumping violation $25,000 FELONY for Each Denial T42CFR417 grievance service =
adverse determination of Medically Necessary Services ]. OFIS misprison of
Federal Hospital Insurance Fraud resulting in death of Michigan Citizens with
Federal HMO policies FELONY
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1999 Federal HMO Hospital Service Contract Provider
Health Alliance Plan Detroit Michigan - Region V HCFA Chicago
OPM FEHB ( Federal Employee Health Benefits Program RI 73-015 .... page 15 )
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OPM FEHBP " Hospital Extended Care Benefits " CITE: 42CFR409.33
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The [ Federal HMO & DHHS Employee ] Plan [ Denies T42sec417 ] PROVIDES a
comprehensive range of benefits when skilled nursing care is necessary &
confinement in a skilled nursing facility is medically appropriate as determined by
a plan doctor.
The [ Federal HMO & DHHS Employee ] Plan [ Denies T42sec417 ] PAYS FOR up to
730 days ( 2 years - value $288,000.oo ) each continuous period of
confinement or for sucessive periods seperated by less than 60 days.
This 730 days period will be reduced by 2 days for every Inpatient
HOSPITAL day Prior to ADMISSION to a Skilled Nursing Facility. ( Hospital
Transfers ) A new period of 730 days will begin after at least 60 days have
elapsed
from the last date of discharge. You [ Covered Individual are Denied
T5CFR890.105 OPM illegal agreement to induce forfiture: OIG 'Health Care Fraud and
Abuse Control T42CFR417 Program' ] Pay Nothing. All Medically Necessary
Services Are [ Denied T42CFR417 Adverse Determination: Anti-dumping violation ]
Covered, including: ::::::: bed, board & general nursing care ::::::: drugs,
biologicals, supplies & equipement ordinarily provided or arranged by the
skilled nursing facility when perscribed by a Plan Doctor.
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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 [ DHHS
T42CFR417 Adverse Determination: Anti-dumping violation to Force, fraud by fright;
illegal State OFIS Medicaid kickback conversions ] or failing to disclose
certain events; felony; penalty. [M.S.A. 16.614(3) ]
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1999 OPM FEHBP - Federal HMO Hospital Service Contract Provider - Health
Alliance Plan Detroit [ Region V HCFA Chicago ] MI HAP PROVIDERS offers 2,596
personal care physicians (PCP) and 4,901 specialists. HAP’s delivery system
includes 45 hospitals [ inducing forfiture: 1998 illegal agreement with Region V
HCFA: T42sec417 DHHS & Federal HMO Employee Service: discharge procedures:
Grievance Procedure illegal denial of Existing OPM Hospital Extended care
Benefits/Services -administrative Fraud by Fright - T18CFR Felony dumping ] in
southeast Michigan and the Flint area, including 23 major hospital networks [
robbing the Elderly of 401k's and savings accounts to Force Medicaid kickback
Conversions - eligibility Poor ], 65 urgent care centers and 765 ancillary
providers: Hospital Affiliate Nursing Homes [ Criminally Billing OPM FEHB for
criminally Denied T42CFR409.33 Posthospital Extended Care Claims 5CFR890.105,
to force HCFA State [ OFIS ] Medicaid T42CFR409.33 kickback conversions
],mental health facilities, optical providers, laboratories, durable medical
equipment providers,ambulance services and Pharmacy Chains
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T42CFR417 Federal HMO Grievance Service: Misprison of Federal Hospital
Insurance Fraud: Anti-dumping & Anti-kickback Violations against Entitled
Individuals in Region V HCFA
[CITE: 42CFR409.33] [Page 187-188]TITLE 42--PUBLIC HEALTH CHAPTER IV--HEALTH
CARE FINANCING ADMINISTRATION ( HCFA ) Administers the Medicaid
Program,DEPARTMENT OF HEALTH AND HUMAN SERVICES ( DHHS ) OIG is supposed to enforce
Anti-dumping violations not conduct it PART 409-- HOSPITAL INSURANCE BENEFITS
--Table of Contents Subpart D-[ Federal ]-Requirements for Coverage of
Posthospital SNF Care Sec. 409.33 Examples of skilled nursing and rehabilitation
services.
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According to the Detroit News, Between 1999 & 2001 Michigan's HCFA Medicaid
clientele ballooned [ DHHS T42sec417 Adverse Determination: 'HMO grievance
service': induced forfiture of existing federal hospital insurance benefits:
$25,000.oo FELONY Each T42CFR417 Anti-dumping Violation: to force illegal HCFA
State OFIS Medicaid kickback conversions ] to 1.25 million from 1 million, at
a cost of approximately $6,000 on each Medicaid Reciepent.
The Detroit News stated according to Paul Rienhart " a Medicaid Expert " in
The State Budget Office of Michigan, says
[ OFIS & HCFA illegal agreement T18CFR371Crime Public Fraud ] Medicaid
consumed 8% of Michigan's General Funds in 1998.
[ OFIS & HCFA illegal agreement T18CFR371Crime Public Fraud ] Medicaid will
consume 32 % of the General Fund budget by 2004.
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Michigan Compiled Laws: Complete through PA ( public act ) 297 of 2000
PUBLIC HEALTH CODE ( EXCERPT ) ACT 368 OF 1978 - 333.5659 Life Insurer, health
insurer, or health care payment or benefits plan;[ Federal HMO ] Prohibited
Acts. ( b ) LIMIT the amount of coverage or benefits available [ T42CFR417 - 1998
DHHS OIG, HCFA and U.S. Attorneys - illegal agreement with Federal HMO's:
Grievance Service: T18CFR1518Crime enacted to induce forfiture of Existing OPM
FEHBP HMO Federal Hospital Insurance Coverage - Anti-dumping Violation: to
force illegal HCFA State OFIS Medicaid kickback conversions ] to a terminally
ill patient within the scope and level of coverage or benefits [ T42CFR409.33
] of an EXISTING [ OPM FEHBP Federal HMO ] policy, certificate, or contract.
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Approximate Value of Existing OPM Federal Hospital 'Extended Care' Benefit
criminally denied T42CFR417: misprison of a felony - DHHS & Federal HMO
employee - 'U.S.Attorney and DHHS OIG & HCFA 'grievance service': T42CFR417
misprison of a felony = $288,000.oo.
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Subj:Skilled Nursing Facility Coverage<-- OPM FEHB 'Hospital Extended Care
Benefits'
Date: 4/23/99 8:19:16 PM !!!First Boot!!!
From:MSWEB1@hapcorp.org (Member Services Web) Federal HMO Region V Chicago
To: _Kstbylite1@AOL.com_ (mailto:Kstbylite1@AOL.com)
Ms. Kimball,
Thank you once again for contacting the <~DHHS T42sec417 Denial of
Posthospital Care
Member Services Web. Upon review of the
referral to Nightengale East Nursing Center, <--deception: Hospital transfer
we have found that Mrs.Rupert will be
referred to Nightengale for a Total of TWO <--Felony to induce forfiture
Intent to harm
WEEKS for family training for maintenance of
her feeding tube. This family training is
considered to be basic care according to <--T42PHC409.32&.33 Federal
requirements
HAP criteria. Although the 'skilled nursing
facility benefit' is for up to 730 days, HAP <--Hospital Extended Care
Benefit 730 days
criteria require that the care must be skilled. <-- Medical records were
concealed & withheld from family members until the OPM FEHBP Dumping Victim was
off hospital property: transfered 20 April 99 - Hospital Medical Records
released for Law Enforcement on 21 april 99.
Because Mrs.Rupert is recieving basic and
NOT skilled care, she does not meet the <---false claim fraud - intent to
harm
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. <~ HMO Employee Mattie Ogburn was
in direct contact with Hospital DHHS Employee Marla Ruhana - concealing OPM
FEHB Patient needs ( terminally ill ) and Existing T42CFR409.33 federal
coverage, to Force HCFA Medicaid kickback conversion for 'Long Term Care'
T42CFR409.33 Medicaid payments.
Ms.Ogburn has spoken with Mr.Rupert and
is handling your Mother's case.
Member Services Web
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1999 Retired OPM FEHBP was killed During the Commission of a Felony: DHHS
T42sec417 Grievance Service: * as threatened * 2 weeks = murder. Fraud by
Fright - white collar crime: Federal Hospital Insurance Fraud - criminal denial of
Existing T42CFR409.33 Federal Hospital Insurance Benefits: Anti-dumping
Violation, to Force illegal HCFA State OFIS Medicaid kickback conversion for
'Long Term Care' Medicaid T42CFR409.33 Payments: Fraudulent Insurance Act:
illegal agreement DHHS OIG 1998 'Health Care Fraud and Abuse Control [ T42CFR417 ]
Program'.
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Subj: question regarding making a police report - State Police - MI Homeland
Security
Date: 12/28/2002 10:36:05 AM Eastern Standard Time
From: Kstbylite1
To: _devlinb1@michigan.gov_ (mailto:devlinb1@michigan.gov)
CC: Kstbylite1
I went to the Michigan State Police Post in Richmond Michigan in January
2002 to file a complaint against State of Michigan Employees [ OFIS ] allowing
Hospital Insurance Fraud [ T18CFR286Crime ] being committed by [ Federal HMO
T42CFR417 Hospital Service Provider ] Health Alliance Plan Detroit. The
Richmond Post refused to allow me to make a police report or submitt my evidence.
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State of Michigan
Department of Attorney General - T18CFR371 illegal agreement with HCFA
Region V Chicago employees, DHHS OIG employees & U.S.Attorney employees.
P.O.Box 30212
Lansing, MI 48909
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Mike Cox
Attorney General
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June 10, 2003
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Dear Mrs. Kimball:
This is to acknowledge your e-mail of April 15,2003, regarding your (
Criminal ) complaint against [ OFIS T18CFR286Crime and ] Health Alliance. [ State
Liscensed DHHS employees T42CFR417 Anti-dumping and Anti-Kickback violations
against Federal HMO Beneficiaries, to force illegal HCFA State OFIS Medicaid
kickback conversions - Felony ]
The Office of Financial and Insurance Services ( OFIS ) is the State Agency
Responsible for regulating insurance companies doing business in the State of
Michigan and investigating matters involving insurance companies and policy
holders. I am, therefore, sending your letter to OFIS [ OFIS employees are
being reported for Aiding and Abetting felony HMO Fraud against Retired OPM
FEHBP Covered Individuals - federal racketeering ] so they can investigate the
matter, and I am requesting them to contact you directly regarding their
findings.
Thank you for bringing this matter [ Public Corruption ] to my attention.
Sincerely yours,
Mike Cox
Attorney General
c: Consumer Services
Office of Financial and Insurance Services - Public Fraud: Intent to Harm
P.O.Box 30220
Lansing, MI 48909
( 517) 373-0220
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Read the October 2006 Health and Human Services (DHHS) Office of Inspector
General report on [ HCFA ] Medicaid payments for [ MI OFIS kickbacks ]
deceased [ Federal ] beneficiaries - for more insite into the ongoing Criminal Abuse
[ U.S. Attorney & DHHS Office of Inspector General - Health Care Fraud and
Abuse Control Program T42CFR417 criminal denial of existing federal insurance
to force illegal State HCFA Medicaid kickback conversions ] Against Elderly
American Citizens with Federal HMO Policies
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HMOs have illegal agreements with States to DENY T42CFR417 existing Hospital
Insurance Services and FORCE Entitled Individuals into State Medicaid
Programs for the POOR. Governor J. Granholm and Attorney General Mike Cox should be
in Federal Prision for Medicaid fraud resulting in death of michigan
citizens who have HMO Policies.
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Sincerely,
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All ENTITLED Federal Employee Health Beneficiaries [ & the General Public
] who are being criminally denied [ DHHS T42CFR417 ] Existing Federal
Health Insurance Coverage, illegally billed for denied covered claims and
forced into HCFA State Mediciaid Programs for the POOR. Title18CFR1001Crime.
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Kimberly Kimball
Kenockee Twp MI 48006
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