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UAW bad deal with Federal HMO Health Alliance: Dumping Retirees

. UAW bad deal with Federal HMO Health Alliance Detroit : Dumping Retirees . _http://www.freep.com/apps/pbcs.dll/article?AID=/20071005/BUSINESS01/710050425 &theme=AUTOTALKS072007&imw=Y_ (http://www.freep.com/apps/pbcs.dll/article?AID=/20071005/BUSINESS01/710050425&theme=AUTOTALKS072007&imw=Y) . UAW deal with GM offers fewer health plans . 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. . 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. . 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. . 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 . 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 . 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 ) . OPM FEHBP " Hospital Extended Care Benefits " CITE: 42CFR409.33 . 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. . 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) ] . 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 . 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. . 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. . 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. . 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. . 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 . 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'. . 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. . 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 . Mike Cox Attorney General . June 10, 2003 . 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 . 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 . 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. . Sincerely, . 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. . Kimberly Kimball Kenockee Twp MI 48006 ************************************** See what's new at http://www.aol.com