Americans Denied Rule of Law T42CFR417 DHHS OIG HMO grievance service
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U.S. ATTORNEYS MAKE ILLEGAL AGREEMENTS WITH STATES:
By: Kimberly Kimball Michigan
Civilian ' General Public ' Oversite
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This is an example of 'Federal Hospital Insurance Fraud' to show the Public How FRAUD & ABUSE Works: ' Fraud by Fright, White Collar Crime ' . The evidence in this witting is very real and American Citizens are being denied due process of law regarding felony HMO Fraud conducted against them.
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TITLE 42--PUBLIC HEALTH CHAPTER IV -[ HCFA ]-HEALTH CARE FINANCING ADMINISTRATION, DEPARTMENT OF [ DHHS ] HEALTH AND HUMAN SERVICES 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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The Anti-Dumping Statute [ Hospital Insurance Fraud DHHS T42CFR417 anti-dumping violation for illegal HCFA Medicaid kickback conversions ] is Enforced Jointly by the Health Care Financing Administration [ HCFA ] and the Office of Inspector General [ OIG ] of the [ DHHS ] U.S. Department of Health and Human Services (HHS).
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DATED: November 24, 1998
_______ / s / ______________________
June Gibbs Brown
[ DHHS ] Inspector General
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DATED: November 24, 1998
_______ / s / _______________________
Nancy-Ann Min DeParle
[ HCFA ] Administrator, Health Care Financing Administration
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1. Separate and apart from the anti-dumping statute, in accordance with sections 1857(g), 1876(i)(6), 1903(m)(5) and 1932(e) of the Social Security Act, the OIG (acting on behalf of the Secretary) has the authority to impose intermediate sanctions against Medicare and Medicaid [ FEDERAL ] contracting managed care Plans that fail to provide [ DHHS & Federal HMO T42CFR417 criminal denial of covered Hospital Insurance Benefits/Services ] Medically Necessary Services, including emergency services, to enrollees where the failure Adversely Affects (or has a substantial likelihood of Adversely Affecting) the Enrollee/Entitled Individual.
[ Criminal Denial T42CFR417 anti-dumping violation, of Hospital T42CFR409.33 Extended Care Services, results in death of Elderly Beneficiaries of the DHHS OIG 'HMO Grievance Service' / misprison of a felony ]
Medicare and Medicaid [ FEDERAL ] managed care Plans that fail to comply with the above provision are subject to civil money penalties of up to $25,000 for Each Denial [ DHHS T42CFR417 & OPM T5CFR890.105 illegal agreement to induce forfiture ] of medically necessary services.
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1999 RULES & REGULATIONS Part IV DHHS OIG 42 CFR Part 1001 . Federal Health care Programs: [ OPM FEHBP,TRICARE,CHAMPVA,Medicaid,Medicare et al ]. Fraud & Abuse Anti Kickback Statutes Sect 1128B(b) of the Social Security Act provides criminal penalties for individuals [ DHHS employees ] or entities [ Federal HMO employees ] that knowingly & willfully [ DHHS & Federal HMO T42CFR417 Anti-dumping Violation/illegal agreement ] offer [ illegal medicaid application ], pay, solicit [ illegal medicaid application ], or recieve renumeration to induce [ DHHS inducing forfiture T42CFR417 of Existing OPM FEHBP Hospital Insurance T42CFR409 for criminal HCFA 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 )
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The Region V HCFA [ CMS / Chicago ] office had a record high 940 new MSP cases filed in 1998. Contributing to this were PARTNERSHIP Arrangements with [ Federal HMO T42CFR417 Hospital Dumping ] Contractors and U.S. Attorneys [ T18CFR1518 - T18CFR286 - T18CFR371 ] in Michigan and Ohio........
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Illegal Agreement -- Michigan Law Requires YOU [ Federally Entitled T42CFR409 Hospitalized Individual ] to complete an internal review with your health plan [ DHHS Employee T42CFR417 Anti-dumping/Anti-kickback Violation - Federal Hospital Insurance Fraud & Abuse - & OPM FEHBP employee: 5CFR890.105 illegal denial of covered claims/ Illegal agreement to induce forfiture T18CFR371 for illegal State HCFA Medicaid 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 ) 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/benefits, 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. FELONY
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1998 -- The ' Health Care Fraud and Abuse Control Account ' would be established as an expenditure [ OFIS / HCFA kickback ] account within the Federal Hospital Insurance (HI) Trust Fund. PUBLIC FRAUD Economic White Collar Crime
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According to the Detroit News, Between 1999 & 2001 Michigan's Medicaid clientele ballooned [ DHHS T42sec417 induced forfiture of existing federal hospital insurance benefits for illegal 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 ] Medicaid consumed 8% of Michigan's General Funds in 1998.
[ OFIS/HCFA ] Medicaid will consume 32 % of the General Fund budget by 2004.
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1998 Health Care Fraud and Abuse Control Program --INDUCED FORFITURE -- Hospital Insurance Fraud - enacted by Hospital DHHS Employees ' discharge procedures/anti-dumping violation/felony fraud/intent to harm- TITLE 42-[ DHHS ]-PUBLIC HEALTH HUMAN SERVICES PART 417-[ Federal HMO ]-HEALTH MAINTENANCE ORGANIZATIONS, [ OIG Special Services / misprison of a felony ] Subpart B-( HMO )- Qualified Health Maintenance Organizations: " Services " (g) Grievance procedures: DENIAL OF Existing OPM FEHBP HMO Hospital Insurance Services [ DHHS Anti-dumping violation for criminal HCFA Medicaid kickback conversions ]. (h) " Special " rules : Enrollees ( Covered Individuals ) under the Federal Employee Health Benefits Program ( FEHBP ). An HMO that accepts enrollees under the ( OPM ) FEHBP (Chapter 89 of title 5 of the U.S.C.) may obtain and retain Federal qualification if....[ 1998 DHHS OIG Volentary Disclousure of Health Care Fraud Program/illegal agreement to Induce Forfiture by Hospital DHHS enactment T42CFR417-criminal denial of OPM FEHBP Hospital Extended Care Benefits w/OPM FEHBP CITE: 5CFR890.105 criminal denial of covered claims - approx Value $288,000 each defrauded individual / ' General Public ' - to force criminal HCFA Medicaid kickback applications/conversions -T42CFR417 DHHS employee and Federal HMO employee Hospital Dumping ]
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1999 OPM FEHBP - Federal HMO Hospital Service Contract Provider - Health Alliance Plan Detroit ( Region V HCFA ) MI HAP PROVIDERS offers 2,596 personal care physicians (PCP) and 4,901 specialists. HAP’s delivery system includes 45 hospitals [ inducing forfiture: T42sec417 w/DHHS Federal HMO Service: discharge procedures: Grievance Procedure/denial of Existing OPM Insurance -administrative fraud Fraud by Fright - 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 Care ) 'COVERED' Claims CITE: 5CFR890.105, for HCFA Medicaid kickback conversions ],mental health facilities, optical providers, laboratories, durable medical equipment providers,ambulance services and Pharmacy Chains
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In the event that an Individual / ' General Public ', e.g., nurse, doctor, other emergency room staff member or patient ( victim of hospital dumping ), believes that a Hospital ( DHHS Social Worker ) may have Violated the Anti-Dumping Statute ( DHHS T42CFR417 FELONY/CRIME ), that Individual [ ' General Public ' / OPM FEHBP ' Hospitalized ' Covered Individual ] should report the alleged Violation [ HCFA Medicaid Kickback Fraud / Hospital Dumping ] to the HCFA office in the Region in which the Hospital is located.
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OFFICE OF FINANCIAL AND INSURANCE SERVICES [OFIS]
STATE OF MICHIGAN - Region V HCFA
Misprison of a felony - Partnership Arrangement 1998 - illegal agreement
T18 Obstruction of Justice/misprison of a felony/T42CFR417/hospital insurance fraud
State of Michigan
John Engler, Governor
Attorney General Jennifer Granholm - Former U.S.Attorney / Current Governor
Department of Consumer & Industry Services
P.O.Box 30664
Lansing MI 48909
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August 17,1999
1st year of the 'U.S.Attorney General and Office of Inspector general' - Health Care Fraud and Abuse Control [ Hospital Insurance Fraud / Volentary Disclosure - SELF-Audit T42CFR417 induced forfiture ] Program for Federal Contractors to conduct felony fraud against 'Entitled' Federal Beneficiaries and Federal Health Care Programs.
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RE: 990759 BonSecours Hospital - Marla Ruhana - DHHS Federal HMO Service: T42sec417 felony: automatic denial of Existing Federal T42CFR409.33 posthospital extended care / services [ DHHS Anti-dumping violation against Retired Federal OPM FEHBP beneficiaries for criminal HCFA Medicaid kickback conversions ]. Conducted during the ' Hospital discharge procedures' by STATE liscensed DHHS Social Workers. Actual commission of a Felony T42CFR417 grievance service/inducing forfiture by criminal denial of covered claims.
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Dear Ms Kimball
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This communication is a follow-up to our letter to you regarding your ( criminal ) complaint against BonSecours Hospital. [ Hospital DHHS workers inducing forfiture of Existing OPM FEHB Insurance to force criminal HCFA Medicaid kickback conversion -discharge procedures, Federal Hospital Insurance Fraud ].
As you are aware, your ( criminal ) complaint was forwarded to the Department of Health & Human Services [ DHHS ], Health Care Financing Administration [ HCFA ], in Chicago [ Region V ] for thier evaluation and direction to the State. [ 1998 HCFA Partnership arrangement T42sec417 'special services' [ OFIS T18CFR286Crime ] grievance procedures, against OPM FEHB Beneficiaries with Federal Contractors and US Attornies in Michigan & Ohio ] HCFA has advised us that they are NOT authorizing an Investigation of the alledged [ criminal Hospital Insurance Fraud and Abuse ] allegation [ Anti-dumping and Anti-kickback Violations ] 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' - T42sec417 -- AG, HCFA & OIG misprison of a felony - illegal Agreement to induce forfiture - Health Care Fraud and Abuse Control Program / Hospital Insurance Fraud - for Illegal HCFA Medicaid Kickback Conversions T18CFR371. Felony
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ABOVE THE LAW - COLOR OF LAW
T42CFR417 Hospital Insurance Fraud resulting in death of a ' Federally Entited Covered Individual ' by criminal denial of Federal Hospital Insurance Benefits T42CFR409.33 Extended Skilled and Basic Care - as threatened ' 2 weeks '/intent to harm/fraud by fright/white collar crime. DHHS Employee MARLA RUHANA, Claimed the OPM FEHBP Hospital Dumping Victim was " LONG TERM CARE ' to induce forfiture to obtain ' Long Term Care ' State HCFA Medicaid Payments for Services Allready Covered under a Federal Health care Program. This was murder and our family has been denied due process of law.
OFIS - MI STATE LISCENSED - Social Worker 6801067035
Name and Address
Name : MARLA KAY RUHANA
Address : Saint Clair Shores, MI 480813719 United States
Profession and License/Registration Information
Profession : Social Workers Type : Certified Social Worker - DHHS T42CFR417 anti-dumping violation for illegal HCFA State Medicaid kickback conversion
Permanent ID # Status Issue Date Expiration Date
6801067035 Active 05/14/1993 04/30/2004
Complaint(s) Open Formal Complaints None - Hospital Insurance Fraud resulting in death of a Federal Beneficiary / murder by criminal denial of OPM FEHBP Hospital Extended Care Benefits Anti-dumping violation.
Disciplinary Action(s) Disciplinary Action Date of Action None
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http://www.raabandassociates.com/services.htm
Marla K. Ruhana, LMSW, INC
Psychotherapist
Marla K. Ruhana LMSW, INC--Psychotherapist & Women's Renewal Retreat Leader
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MI Illegal Agreement - Center for Regulatory Effectiveness Michigan
T42CFR417 misprison of a Felony, Hospital Insurance Fraud against Michigan Citizens / Fraud by Fright / white collar crime:
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Whom to contact: Michigan Office of Financial and Insurance Services (OFIS) ( Taber,Kristie @ INSFS@CIS) What you can appeal [ T42CFR417 'grievance service' illegal agreement to allow T18CFR371Crime - felony Federal Hospital Insurance Fraud Against Michigan Citizens ]: The availability, delivery [ utilization review Discharge procedures Hospital Dumping ], or quality of health care services, including a complaint regarding an ADVERSE determination [ Hospital Insurance Fraud T42CFR417 Anti-dumping violation, resulting in serious bodily injury or death ], as well as issues concerning the contract [ FEDERAL Requirements ] between you and your health plan.
MI OFIS felony - T18CFR286/T18CFR371Crime.
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FEDERAL HMO Region V HCFA Michigan
FEDERAL HOSPITAL INSURANCE SERVICE CONTRACT PROVIDER
[ OFIS origional criminal complaint # 990759 ] Michigan Insurance Bureau
New Criminal Complaint # 31302-001 March 2000
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Federal HMO Employee
Jeanette H. Girty, Manager
Government/Grievance/Inquiry Unit -T42sec417 commission/misprison of a felony
Member Services Department
JHG/ma
Health Alliance Plan - Federal HMO - Region V HCFA Michigan
2850 West Grand Blvd
Detroit Michigan 48202
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Dated June 20, 2000
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[CITE: 42CFR438.704] Federal OPM FEHB beneficiaries are Not 'Entitled' to STATE Medicaid for Services ALLready Covered T42sec409.33 under a Federal Health Care Program - Federal HMO Hospital dumping / HCFA State Medicaid Kickback Fraud - Felony
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To [ OFIS ] State of Michigan Insurance Bureau - PUBLIC Employee: Kristie Tabor:
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Federal HMO Employee - Jeanette H. Girty Quote --- " Prior To ( OPM FEHBP ) Mrs.Ruperts discharge ( Hospital Transfer ) the Social Worker ( DHHS Employee - Marla Ruhana ) Department at Bon Secours Hospital was also Consulted for Discharge Planning ( criminal enactment of T42sec417 DHHS Federal HMO ' OIG 'service: Grievance Procedures: automatic Denial of Existing Federal HMO Hospital Insurance Services - misprison of a felony, defrauding the government [ HCFA Medicaid and OPM FEHB Programs ] With Respect to Federal Hospital Insurance Service Claims - OFIS T18CFR286Crime. ) from the Hospital.
Ms.Rupert's [ OPM FEHBP ] spouce Was [ terrorized ] Provided With Instructions regarding the [ DENIED Covered CLAIM T5CFR890.105 misrepresentation/denial of existing OPM Hospital Extended Care Benefit T42CFR409.33 ] Extended Care [ Medically Necessary Services ] and also information in regards to Applying for MEDICAID for his wife. [ Medicaid False Claims Act - $50,000 Felony to apply for services allready covered T42sec409.33 under a federal health care program - DHHS & HMO Employees - criminal termination of the Federal OPM HMO Policy - in 2 weeks/fraud by fright/white collar crime ]. Marla Ruhana, the ( DHHS Employee ) Social Worker did advise [ Threats and Intimidations ] Mr.Rupert that HAP [ Federal HMO ] does Not Cover 'LONG TERM CARE' ( Retired OPM FEHBP Hospital Dumping Victim is Terminally Ill ) at an Extended Care Facility. " ......" After a two week stay [ in a Medicaid Bed Ward ],the [ Covered OPM FEHBP ] Husband STILL refused to [ illegally ] apply for [ HCFA kickback ] Medicaid ".
The Retired Hospitalized, terminally ill, OPM FEHBP [ 'Long Term Care' ] Dumping Victim, was killed as threatened/murder T42sec417 [ 2 weeks ] for refusing to defraud State HCFA Medicaid - No Law Enforcement to Date.
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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 or failing to disclose certain events; felony; penalty. [M.S.A. 16.614(3) ] ............. DHHS T42CFR417 Hospital Insurance Fraud by Fright /Anti-dumping violation and OPM T5CFR890.105 Criminal DENIAL of COVERED Federal Hospital Insurance Claims to Force illegal HCFA State [ OFIS ] Medicaid Kickback Conversions - misprison of a felony 'grievance procedures' - T18CFR371Crime.
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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; Prohibited Acts. ( b ) LIMIT the amount of coverage or benefits available [ DHHS T42CFR417 Federal Hospital Anti-dumping violation ] to a terminally ill patient within the scope and level [ Federal ] of coverage or benefits [ T42CFR409 Hospital Insurance ] of an EXISTING [ OPM FEHBP HMO ] policy, certificate, or contract.
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Post-Hospital Extended Care Services - OPM FEHBP 'Hospital Extended Care Benefit' T42CFR409.33 (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.
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DHHS T42CFR417 - Criminal Denial of ' Medically Necessary Services ' T42CFR409.33 Intent to Harm:
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1999 Federal HMO Hospital Service Contract Provider
Health Alliance Plan Detroit Michigan - Region V HCFA
OPM FEHB ( Federal Employee Health Benefits Program RI 73-015 .... page 15 )
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DHHS Employee Federal HMO Employee 'OIG Service' T42sec417 grievance procedure - Denial of Existing Federal Hospital Insurance Benefits to force illegal HCFA State Medicaid kickback conversions:
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OPM FEHBP " Hospital Extended Care Benefits " CITE: 42CFR409.33
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The ( Federal HMO & DHHS ) 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 ) 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 illegal agreement to induce forfiture with OIG 'Health Care Fraud and Abuse Control Program' ] Pay Nothing. All necessary Services Are [ Denied ] 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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Approximate Value of Existing Federal HMO Hospital Insurance 'Extended Care' Benefit criminally denied T42CFR417 = $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
To: 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
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 in direct contact with Hospital DHHS Marla Ruhana - concealing OPM Patient needs [ terminally ill ] and existing coverage, to Force HCFA medicaid kickback conversion for 'Long Term Care' Medicaid payments.
Ms.Ogburn has spoken with Mr.Rupert and
is handling your Mother's case.
Member Services Web
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Michigan - DHHS Employee MARLA KAY RUHANA <~ Started the False Claims Process by illegal enactment of T42CFR417 criminal denial of Existing Federal Hospital Insurance Benefits T42CFR409.33, to Force illegal State HCFA Medicaid T42CFR409.33 kickback Conversions/fraud by fright/white collar crime/intent to harm/hospital insurance fraud resulting in death of a Retired OPM FEHBP Beneficiary - ABOVE THE LAW
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CITE- 18 USC Sec. 1518 01/02/01-EXPCITE- TITLE 18 - CRIMES AND CRIMINAL PROCEDURE PART I - CRIMES CHAPTER 73 - OBSTRUCTION OF JUSTICE-HEAD- Sec. 1518. Obstruction of criminal investigations of health care offenses -STATUTE
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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
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 allowing Hospital Insurance Fraud [ T18CFR286Crime ] being committed by Health Alliance Plan Detroit.
The Richmond Post refused to allow me to make a police report or submitt my evidence.
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1998 -- HEALTH CARE FRAUD AND ABUSE CONTROL PROGRAM [ subject to prosecution ], under the Joint Direction [ T18CFR371-illegal agreement to induce forfiture of Federal Hospital Insurance Benefits: DHHS T42CFR417 Anti-dumping violation ] of the ATTORNEY GENERAL and the Secretary of [ DHHS ] the Department of Health and Human Services (HHS)(1), acting through the Department's [ OIG ] Inspector General (HHS/OIG), Designed [ HMO Grievance Procedure T42CFR417 criminal denial of covered Hospital Insurance claims/Volentary Disclousure/SELF-Audit Program ] to coordinate Federal, State and Local Law Enforcement activities [ misprison of a felony / defrauding federal health insurance programs OPM FEHBP CITE: 5CFR890.105 ] With Respect to ( Claims ) Health Care Fraud and Abuse. Misprison of a felony T18CFR24CRIME.
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Subj: FBI Response - Federal Hospital Insurance Fraud
Date: 2/5/2003 3:19:49 AM Eastern Standard Time
From: sioc@fbi.gov (FBI Internet Tips) Reply-to: sioc@fbi.gov <mailto:sioc@fbi.gov> To: Kstbylite1@aol.com
Dear Ms Kimball,
Thank you for taking the time to submit your information to the FBI via the FBI.Gov Web site. It is being evaluated at this time by one of my Agents, and will be forwarded to the appropriate FBI component, as appropriate. If they are not responding to your emails try calling Detroit FBI at 313-965-2323.
Sincerely,
David N. Rushing/rwh
Supervisory Special Agent
FBI Headquarters
Washington, D.C.
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The 1999 DHHS OIG ' Beneficiary Outreach Program ', in part, encourages [ General Public/Entitled/Covered ] Individuals to contact the HHS/OIG Hotline, 1-800-HHS-TIPS, which receives complaints [ victims of Federal Hospital Insurance Fraud T42CFR417 Anti-dumping Violation ] of improprieties in Medicare and other Health and Human Service [ Federal ] programs.
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DHHS OIG 'Health Care Fraud and Abuse Control Program' T18CFR286Crime illegal agreement to induce forfiture of existing federal hospital insurance benefits to force illegal kickback conversions into other federal hospital insurance benefit programs.
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Subj: RE: HHS OIG Hotline Web Submission - 1998 AG & OIG Health Care Fraud and Abuse Control Program - Volentary Disclousure/SELF-Audit Program - misprison of a felony / T18CFR371 / 1999 Beneficiary Outreach Program.
Date: 2/13/2003 10:29:22 AM Eastern Standard Time
From: hhstips@oig.hhs.gov (Tips, HHS)
To: Kstbylite1@aol.com
Ms. Kimball:
This is in response to your email of February 5, 2003, regarding the [ DHHS -employee- Denied T42CFR417 ] health care coverage [ Federal HMO -employee- Denied T42CFR417 Region V HCFA ] for your [ OPM FEHBP Hospital Insurance Fraud/Dumping Victim ] deceased mother.
Although WE ACKNOWLEDGE that you have SERIOUS CONCERNS [ Hospital DHHS Workers conducting HMO Hospital Insurance Fraud - T42CFR417 Anti-dumping and Anti-kickback violations Against Retired FEHBP to Force criminal HCFA Medicaid kickback conversions ], it is our judgment that the issues [ Federal Hospital Insurance Fraud ] do Not fall under the Jurisdiction of the Office of Inspector General.
Since your mother was a federal employee ( Covered Individual ), her FEHB would have been administered by the the Office of Personnel Management (OPM). If you contend that her FEHB [ Federal HMO Contractor ] insurer failed to [ Supply -DHHS and Federal HMO 'Service'-T42sec417 DENIAL of Existing OPM FEHBP Hospital Insurance ] pay for contracted services, OPM would be the proper agency to handle [ SELF-audit CITE: 5CFR890.105 criminal denial of COVERED Claims ] your ( Criminal ) complaint.
Inspector General's Hotline - [ illegal agreement to induce forfiture of existing federal insurance for criminal HCFA Medicaid kickback conversions T18CFR371Crime ].
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1998 -- The Health Care Fraud and Abuse Control Program -- subject to prosecution T18CFR1001 Criminal Denial of posthospital extended care services T42CFR409.33 against the Elderly DHHS T42CFR417 results in death.
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State of Michigan - Health Care Fraud and Abuse Control Program T18CFR371Crime
Department of Attorney General - T18CFR371 w/DHHS OIG & U.S.Attorneys
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, reguarding your ( Criminal ) complaint against ( OFIS T18CFR286Crime ) Health Alliance. [ DHHS Anti-dumping and Anti-Kickback violations against Federal HMO Beneficiaries, to force criminal 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 thier 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
P.O.Box 30220
Lansing, MI 48909
( 517) 373-0220
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Read the October 2006 ( DHHS ) Health and Human Services ( OIG ) Office of Inspector General report on [ HCFA ] Medicaid payments for [ MI OFIS kickbacks ] deceased beneficiaries - for more insite into the ongoing Criminal Abuse [ DHHS OIG illegal agreement T42CFR417 dumping / kickback fraud ] Against Michigan Citizens.
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Criminal Resource Manual 923 18 U.S.C. 371 -- Conspiracy to Defraud the U.S.
http://www.usdoj.gov/usao/eousa/foia_reading_room/usam/title9/crm00923.htm
White Collar Crime, /Section 371. Both offenses require the traditional elements of Section 371 conspiracy, including an illegal agreement, criminal intent, and proof of an overt act.
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The OIG is an 'Independent Entity Within' [ white collar criminals ] the Department of Justice that reports to both the Attorney General and Congress on issues that affect the Department's personnel or operations.
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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-
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The OIG has jurisdiction over all [ criminal ] complaints of misconduct against Department of Justice Employees [ T18CFR371 Misprison of a felony ], including the Federal Bureau of Investigation; Drug Enforcement Administration; Federal Bureau of Prisons; U.S. Marshals Service; Bureau of Alcohol, Tobacco, Firearms, and Explosives; United States Attorneys Offices; and employees who work in other Divisions or Offices in the Department of Justice. The one exception is that allegations of misconduct involving Department ATTORNEYS that arise from their AUTHORITY TO INVESTIGATE, litigate, or provide legal advice are the responsibility of the [ OIGs ] Department's Office of Professional Responsibility T18CFR4Crime misprison of a felony re: Federal Hospital Insurance Fraud against the U.S.Government Federal Health Care Programs and Federally Entitled Covered Individuals with respect to claims T18CFR286Crime/T18CFR371Crime.
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[CITE: 5CFR185.104] PROGRAM FRAUD Sec. 185.104 Investigation. (d) Nothing in this section modifies any Responsibility of an Investigating Official ( OIG ) to Report Violations of Criminal Law [ DHHS Anti-dumping & Anti-Kickback Violations T42CFR417 Against Retired 'Entitled' Federal Beneficiaries w/OPM FEHBP employees CITE: 5CFR890.105 ( criminal denial of covered claims ) forcing criminal HCFA Medicaid kickback conversions ] to the U.S.Attorney General.
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Office of Inspector General - Misprison of a felony T42sec417 Hospital Insurance Fraud
Office of Personnel Management - CITE: 5CFR890.105 criminal Denial of Covered Claims
Dated: 14 May 2003
Joseph Frech Investigator - T18CFR371 illegal agreement w/U.S.Attorney General to defraud Federal Programs T18CFR286 allowing felony Federal HMO Hospital Insurance Fraud against Entitled Individuals to force illegal kickback conversions into other federal programs
C 03-206 Quote:
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" Your only recorse is to file suite against the Office of Personnel Management in Federal Court. "
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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)
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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.
.
LOCAL LAW ENFORCEMENT: Government/Grievance/Inquiry Unit -T42sec417 illegal agreement Misprison of a felony / Hospital Insurance fraud
.
Michigan Attorney General - health care fraud division # 2002-04-0925 - Mike Cox / Jennifer Granholm <~ Former U.S.Attorney / Current Governor
Health Care Fraud Division # 99-05-1034 January 2000 Linda Damer
Insurance Bureau [ OFIS ] #31302-001 March 2000 Cindy Mielock , Kristie Tabor
Liscensing Division #68-99-3073-00 april 1999 Cynthia Samuel - victim still living
Bureau of Health Systems #990759 april 1999 Mary Duncan - victim still living
ACE Eastern District Ellen Christensen USAO refused to investigate 2001 - T18CFR286/T18CFR371.
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Subj: RE: US Attornies conceal Hospital HMO Insurance fraud
Date: 9/22/2005 1:47:54 PM Eastern Daylight Time
From: NewCase.ATR@usdoj.gov
To: LawISAmootIssue@aol.com
Sent from the Internet (Details)
Dear Ms. Kimball:
Thank you for contacting the Antitrust Division of the U.S. Department of Justice. Upon review of your email, we have determined that your complaint does not fall under the purview of the Division.
Thank you for your interest in the enforcement of federal antitrust laws, and we wish you the best in resolving your concerns.
Sincerely,
New Case Unit
Antitrust Division
.
Homeland Security NONE and Governmental Affairs
.
Subj: Re: Your Concerns
Date: 3/26/2007 1:16:37 PM Central Standard Time
From: senator_levin@levin.senate.gov
To: JustmyOpnion@aol.com
Sent from the Internet (Details)
Dear Mrs. Kimball:
Thank you for sharing your thoughts with me regarding HMO [ Hospital ] dumping. I will certainly keep your thoughts in mind should this issue come before the Senate.
Best wishes.
Sincerely,
Carl Levin
.
Americans have a right to Rule of Law, I want Justice not OIG & U.S.Attorney criminal abuse against the General PUBLIC.
Sincerely,
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All Entitled Federal Health Beneficiaries being criminally denied [ DHHS T42CFR417 anti-dumping violation ] Existing Federal Health Insurance Coverage Title18CFR1001Crime.
Kimberly Kimball
.
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