Posts Tagged ‘Illinois’

Mental Health Care Denied Poor in Illinois

August 31, 2009

The following is A SCHEME TO DENY MENTAL HEALTH CARE IN ILLINOIS TO PERSONS ON MEDICAID.

 Illinois has essentially de facto suspended Dr. Bennett’s Constitutional right to relief from a wrongful conviction by a Habeas petition. Attorney General Lisa Madigan has committed fraud upon the court and the Cook County Circuit Court Judge Lon Schultz has violated Federal and State law, the Constitution, and all morality by convicting her on a charge of Medicaid vendor fraud.

 Please read this carefully and write the Asst. U.S. Attorney General in Chicago, Patrick Fitzgerald – Office of U.S. Attorney General, 219 S. Dearborn, Fifth Floor, Chicago, Illinois, 60604; Director of the Chicago FBI, Robert Grant and the Director of the Task Force on Public Corruption, Special Agent Casanovich, Chicago FBI, 2111 S. Roosevelt Road, Chicago, Illinois 60608, as well as inform the press with letters and phone calls about this gross injustice. Help me disseminate this information far and wide around the world, until agents of the United States government intervene to stop this injustice.

 HABEAS LAW VIOLATED

In March 2009 Dr. Maisha Hamilton Bennett filed a petition for writ of habeas corpus (the grand writ guaranteed by the United States Constitution) in the Illinois Court system. It found its way to the Chancery Court Division of the Cook County Circuit Court before Judge Stuart Palmer. A habeas petition is a last resort step when the court system has failed to free an innocent person or a person whose rights under the Constitution’s Bill of Rights were so violated that they were denied a fair trial.

 Illinois law requires the petition to be heard “promptly” and the warden to bring the prisoner before the court, the court to order the State to produce evidence that the person is being legally held, and allow the prisoner to rebut this evidence and prove he/she has been illegally held because they are actually innocent, the indictment was invalid, no crime was alleged, the court had no jurisdiction, or the Bill of Rights was violated and the person did not receive a fair trial. See: 735 ILCS 5/10‑103, 106, the Illinois Habeas Statute. See: http://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=073500050HArt%2E+X&ActID=2017&ChapAct=735%26nbsp%3BILCS%26nbsp%3B5%2F&ChapterID=56&ChapterName=CIVIL+PROCEDURE&SectionID=62279&SeqStart=73000000&SeqEnd=76800000&ActName=Code+of+Civil+Procedure%2E .

 To date Judge Palmer has refused to hear the habeas petition, recently transferred it to criminal court, where presiding criminal court Judge Biebel is also delaying hearing the petition for weeks to months.  The law actually says that any judge who refuses to hear the petition “promptly” shall be referred to the States Attorney or Attorney General for prosecution of this illegal act and when found guilty should be fined $1000 and the money paid to the prisoner.

 WRONGFUL CONVICTION DR. BENNETT FOR MEDICAID FRAUD WHEN SHE WAS ACTUALLY PROVIDING EXCELLENT MENTAL HEALTH CARE

 Dr. Bennett is innocent because the indictment is legally void – it didn’t adequately state the facts charged so was impermissibly vague, the Federal Medicaid Law allows the conduct that the State says is criminal – thus the Constitutional Supremacy clause was violated – state laws are invalid if they go against federal law, the trial was conducted unfairly, the alleged prosecutor, Attorney General Lisa Madigan violated the law and committed extreme prosecutorial misconduct and the court had NO jurisdiction as a result. For case law and detailed discuss of Code pertaining to Federal Medicaid Code see:

1) Memisovski v. Maram, [Transfer Binder 2004-2] Medicare & Medicaid Guide (CCH) ¶ 301,515, in that it violates 42 U.S.C. 1396a(a)30(A) – Federal Judge Joan Lefkow ruled in 2004 that the Illinois Medicaid Rules violate the Federal Medicaid Code in that they deny access to care to persons on Medicaid for their medical insurance;

2) http://illinoiscorruption.blogspot.com/2008/10/criminal-scheme-of-il-attorney-general.html and;

3) http://illinoiscorruption.blogspot.com/2009/02/judge-jorge-alonso-overturns-federal.html .

 Dr. Bennett was wrongfully convicted of Medicaid vendor fraud in 2003 and is being held in jail without bond. (Now for over 18 months) She is alleged to have ghost-billed for mental health services either not done or done by non-physicians in her practice group practice – she is a Ph.D psychologist and owner of the group, Hamilton Wholistic Healthcare, and alleged to have caused bills to be sent to Medicaid under the name of the practice’s medical director, a physician, who did not see the patients.

 The facts are that Hamilton Wholistic Healthcare was an Illinois Certified Alcohol and Drug Treatment Center run by Trinity Hospital and then when Trinity pulled out, run by Hamilton Wholistic Healthcare. It was an INPATIENT center. Counselors who were M.S. and Ph.D. psychologists as well as physicians when they needed medication treated the patients. The patients’ children were also evaluated and treated with counseling or the parents were counseled. The law allows a service provider to bill the insurer for providing service to the child when the parent is counseled without the child present. The AMA code book for services states this fact. Insurance companies pay these bills with no problems.

 The State put a grandmother on the stand, who was caring for several grandchildren while their mother was in the inpatient drug-treatment center, and she said she was not aware the children were counseled when they visited their mother in the inpatient center. This was the “basis” for the ghost-billing charge. Under federal HIPAA laws the mental health counselors and doctors are NOT ALLOWED to inform the grandmother as she was not the legally guardian. These privacy laws forbid discussions with the grandmother without the mother’s consent. The fact that she didn’t know did not prove anything. It certainly did not prove that the children or the mother were not counseled about how to deal with the drug-addicted mother or parenting.  This was NOT explained to the jury.

 The defense attorney was incompetent in that he failed to put on the stand the counselors so they could introduce the fact the kids and mother were counseled. The law DOES NOT ALLOW the attorney to place into evidence the medical record – only testimony about the medical record, in criminal trials. This is because medical records are considered hearsay and cannot be cross-examined. He failed to put on the stand the children who were then old enough to testify. He failed to put on the stand the mother.

 The billing agent made an error that she admitted she did because the IL Medicaid Provider Service Unit representative told her to do it. This representative told the billing agent, Louise Moore owner of Data Medical Works, that only physicians names could be on bills, so Ms. Moore forged the signature of the medical director on a power of attorney form which allows Ms. Moore to put the doctor’s name on electronic bills, on a Blue Cross/Blue Shield electronic partner trading agreement which allows BC/BS to accept the bills over the wires (computer) on behalf of Medicaid, check them for errors as a service to Medicaid, and forward them to Medicaid. She also forged signatures on an alternate payee agreement so that the checks would be written by Medicaid to Hamilton Wholistic Healthcare instead of to the physician medical director. These checks were immediately deposited in the corporate bank account and not in Dr. Bennett’s bank account. None of this was told to the jury. Dr. Bennett was even charged with this forgery, but the charges of forgery were dropped. I saw the alleged forged documents. They had signatures that appeared to be in the handwriting style of Ms. Moore and many of the alleged invoices’ provider signature presented to the crime lab in the perjury charge appeared to be cut-outs from the handwriting exemplars (handwriting samples) that Ms. Bennett was forced to provide where she was told to write the medical director’s name 30 times or so on a piece of paper. Even my teenage son, at the time, was able to match specific signatures from the handwriting exemplars to specific invoices. The crime lab rejected the invoices for analysis because the man I suspect of fabricating them by cutting out handwriting exemplars, State Police Investigator William Reibel, refused to produce originals. That is why the charges were dropped, to my understanding.

 Community alcohol and drug addiction treatment centers, per Illinois Statute, separate from the Illinois Medicaid Code, are allowed to bill Medicaid under their corporate name and not a doctor’s name and to bill for services of non-physician counselors and psychologists, as long as a physician medical director sets policy – not that she sees patients.

 Hamilton Wholistic Healthcare sent patient encounter forms to Ms. Moore listing the counselor’s name and not the doctor’s name, for each clinic visit when a patient was seen by the counselor in or out of the inpatient center. Without Dr. Bennett’s knowledge (she was the CEO) Ms Moore changed the name of the provider counselor on the electronic bill she generated from these patient encounter forms to the name of the doctor medical director and sent them in to Medicaid electronically. Medicaid then paid Hamilton Wholistic Healthcare. The payments went as salaries to the counselors and to overhead. A small percent went to the CEO. The total amount received from Medicaid for several years was about $400,000.

 Therefore, Dr. Bennett is innocent because she was not involved in putting the medical director’s name on the electronic bills. She did not profit from this error. The federal and state laws allow physicians to bill for their employees. Ms. Moore should have used the name of the corporation and not the name of the medical director on the electronic bills. There was clearly no intent to defraud.  All services were actually provided and addicts received appropriate treatment, as did their children who needed counseling to cope with this situation of an addicted parent.

 There was an administrative error that WAS NOT A CRIME in that the name of a physician medical director instead of the group name was put on the bill, by order of the Medicaid Provider Service Unit representative. All services were provided; only the incorrect provider name was on the electronic invoice, at the direction of Medicaid to Ms. Moore.

As 80 % or more of mental health services are provided by non-physician psychologists, psychiatric nurse counselors, psychiatric social worker counselors, drug-addiction counselors (all licensed in Illinois) and their supervised students, it is bizarre and simply wrong for the State to claim that ONLY physicians can provide mental health services and Medicaid won’t pay for non-physician services (unless provided by a certified and licensed community mental health center.)  This would prevent access to care for Medicaid patients to ALL private psychologists, counselors, etc.  This is simply a fraudulent scheme to deny mental health care to persons on Medicaid to save the Illinois budget. This is also a scheme AG Lisa Madigan uses to claim she is “tough on fraud” and to take advantage of the present climate of hating physicians. These fraudulent indictments of Psychologists and psychiatrist are used as a smoke screen and scapegoat to hide the fact Illinois is violating the Federal Medicaid Code and the Constitution. I was also fraudulently indicted, but found NOT guilty because I had a good attorney. Dr. Bennett did not have a good attorney.

 The Illinois Attorney General’s statement about the conviction that Dr. Bennett is a scumbag who ripped the state off for $400,000 billing for mental health services for children that never were provided is nothing but a bald faced lie.  AG Lisa Madigan should be impeached for fraud upon the court and fraud upon the public.

 This is penny wise and pound foolish, as failure to treat mental health patients increases, suicide, family break-up, and crime, as well as increased cost to the state for welfare, criminal justice, prison, and hospital care.

 Mental Health care in Illinois to poor persons is virtually non-existent. The United States healthcare system is in meltdown and our legislators are acting like children instead of addressing the issues.  I miss Senator “Teddy” Kennedy deeply! God Help Us!

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Cook County Sheriff Staff are Puppets of Corruption

August 9, 2009

THE STORY OF HOW THE DEMOCRATIC MACHINE IN CHICAGO THRIVES AND PERPETUATES GOVERNMENT CORRUPTION, WASTE, INEFFICIENCY, AND FRAUD 

A person asked on line about the fights at the jail this past week where inmates stabbed each other. “With todays riot I think all tax payers should call Sheriff Dart and ask why he refuses to hire more staff as federally mandated, why the E.R.T. (emergency response team) doesn’t search or respond to trouble, why doesnt he fire Director Godinez.”

The answer is not wasting tax-payer dollars on more guards. We need to reduce the jail population to less than 6,000 from its previous high of nearly 11,000. Non-violent offenders should be sentenced to alternatives other than jail that actually benefit society. There are lots of things a sentenced criminal can do as community service other than just picking up garbage, including providing free or reduced services as an employee for the state in almost any job category. Mentally ill convicts, including addicts, should be treated not just jailed so jail does not become a revolving door. There is not even 1/4 the mental health services available to probationers or parolees that are needed. Guards should be required to have a higher level of training, not only in terms of judo, but also in recognizing and de-escalating violence due to mental illness, as well as not treating every refusal to do as told as voluntary and requiring force. Mentally ill are often confused and react better and more compliantly with “herding them gently” or backing-off and giving them space, instead of with brute force, which generally will be irrationally resisted. Women who have been raped or assaulted may go into flashbacks and not even realize where they are, as they are reliving in their mind the brutal attack. Guards need to be taught to control without brutality and foul language. This is not a good example. They should be teaching inmates how to resolve conflicts peacefully and civily not escalate them to violence as the officers often do, because that is what they are trained to do.

Another internet writer stated: “Amen to that, Linda. Why are so many non-violents that could be on house arrest still in jail. And why does the judge get to say “this drug addict is not fit for rehabilitation” without even giving it a try? It baffles me.”

You have to understand Cook Co runs on patronage. You have to have large armies of uneducated workers who vote for you as a candidate, and bring out the vote by acting as poll watchers and bringing people to the polls, especially dead people. Sheriff deputies, Court Clerk staff, DCFS workers, IDOC staff, etc., fullful this role nicely.

To hire such a large army you need to make sure they take long lunches, do only half the job they could so you can hire two for every one employee needed, or campaign on public time. You make your payroll bloated with excess staff. You fire employees who are efficient. You remind employees that if they work to fast they are depriving another person of a job. You promote only those who enforce campaigning and fundraising efforts. You promote incompetents who don’t think for themselves, never questions “authority”, and are loyal to the patronage system. You don’t document anything and you engage in deals behind closed doors.

https://drlindashelton.wordpress.com/2008/12/13/be-a-team-player-corruption-and-patronage-in-illinois/

In order to have lots of guards you need to deny personal recognizance bonds for non-violent (I-Bonds). You need to put people in jail instead of on probation. You need excessive sentences, particularly for drug and non-violent crimes. You need a revolving door of a corrupt parole system and no mental health or drug addiction treatment.

So you need lots of prisoners or you can’t hire lots of guards and keep complaining that you need more guards! That’s the way the machine works to keep the corrupt in office. Guards are used! They are coerced and manipulated and made to think that if they squeal by going to 2111 S. Roosevel FBI office and ask for a duty agent and then provide evidence of corruption, patronage, brutality, medical neglect, excessive force, and fraud, that they will lose their jobs! Guards are fools to cooperate with this corruption. They would have a better job, better working environment, better benefits, if they were trained properly, if they followed the law, and if 10 % of our tax dollars weren’t going into political campaigns, like (”Friends of Madigan) through illegal kickbacks (bribery).

Remember the guards are abused as much as the inmates because they work in crowded unsafe conditions, are improperly trained and encouraged to be sadist, foul-mouthed and vulgar, intolerent, and violent hotheads, and without proper mental health and drug addiction treatment the inmates are dangerous. Guards are simply crazy to keep voting for the same idiots who are USING THEM and demanding 10 % kickbacks (bribes) to their political funds like “Friends of Madigan”. We need a massive grass roots movement, including the guards to vote out of office these criminals including Stroger, Madigan (Lisa & Michael), Dart, the Daleys, Beavers, Burkes, Jones, Steeles, Lipinskys etc., and their puppets. Political office in Illinois needs to stop being an inherited oligarchy. We simply have to help the FBI and U.S. Attorney take down King Richard Thompson, his Lords Madigans, Daleys, Burkes, Beavers, etc., the Sheriff of Nottingham Dart (previously Sheahan), and his high executioner Alvarez (previously Divine).

Anyone who wishes to help me do this – citizens and officers alike – you can even help in anonymous ways – e-mail me at picepil@aol.com.

Gov. Quinn – Please Pardon Debra Gindorf; Post-Partum Psychosis is an Illness NOT a Crime!

April 9, 2009

GOV. QUINN GRANTED DEBRA GINDORF HER CLEMENCY PETITION TODAY MAY 1, 2009 – REDUCING HER SENTENCE FROM LIFE WITHOUT PAROLE TO 48 YEARS. AS THE SENTENCING STATUTES AT THE TIME REQUIRE HER TO SERVE HALF THE SENTENCE, SHE SHORTLY WILL BE RELEASED. THREE PREVIOUS PETITIONS HAD BEEN DENIED BY PREVIOUS GOVERNORS AND HER PRESENT CLEMENCY PETITION WAS SITTING ON GOV. BLAGOJEVIC’S DESK FOR YEARS.

I THANK GOV. QUINN FOR HIS COMPASSION AND MERCY AS DEBRA GINDORF WAS A  POSTER CHILD FOR THE WRONGFULLY CONVICTED AND EXCESSIVELY SENTENCED. I STILL BELIEVE SHE WAS NOT GUILTY BY REASON OF TEMPORARY INSANITY DUE TO POST-PARTUM PSYCHOSIS AND ALL THE PSYCHIATRISTS WHO TESTIFIED AGAINST HER 24 YEARS AGO AGREE. I WISH HER WELL AND I’M SURE SHE WOULD THANK ALL HER SUPPORTERS OVER ALL THESE YEARS.

PLEASE WRITE OR CALL GOV. PAT QUINN IN SUPPORT OF PARDON THANKING HIM FOR FINALLY GRANTING THE CLEMENCY PETITION AT:

Quinn, Pat    217-782-6830
OFFICE OF THE GOVERNOR
CAPITOL BLDG RM 207
SPRINGFIELD IL 62706-1150 
AN E-MAIL I SENT TO GOV. QUINN TODAY:

I am appalled that former Gov. Blagojevic ignored so many clemency petitions [THOUSANDS]. I am writing to bring to your urgent attention one of the most egregious cases where a person was wrongfully convicted. I wrote a letter several years ago to the Prisoner Review Board as an expert on pediatrics and post-partum psychosis, on her behalf urging clemency.

This case is a national and international embarrassment to Illinois. I urge you to make it your FIRST ACT of clemency ASAP.

Ms. Gindorf was a 20ish single mother of two small children/babies 22+ years ago – she had been abandoned by the father and was very poor. In a psychotic act due to post-partum psychosis and due to EGREGIOUS neglect of friends, family, and the state in not providing her the medical/psychiatric/social service help she needed, she apparently heard voices telling her to kill herself and take her children to heaven with her. She was also deeply depressed about her personal situation.

A family member suffered the same after giving birth two times, but I and family were always there to help her through this time. Unfortunately NO ONE WAS THERE TO HELP MS. GINDORF.

As a result she carefully washed and dressed her children/babies and gave them an overdose of over the counter medication (I’m not completely sure about what medication but that doesn’t matter) and also took an overdose herself. However, being young, uneducated and naive, she didn’t give herself a big enough dose and woke up later finding her children dead.

She was charged and convicted of murder and sentenced to life without parole, because those many years ago the disease of post-partum psychosis was not recognized, and the murder of children always gets no sympathy form a jurors who are so overwhelmed with passion against the murderer that they don’t usually think fairly or rationally.

She was clearly innocent due to temporary insanity from the post-partum psychosis. All the psychiatrists and a half dozen others who have examined her since or who are nationally renowned now support clemency. No where else in the world, let alone the U.S. are we so irrational and harsh in treatment of women with post-partum psychosis who commit crimes. It is a national and international disgrace and a stain on Illinois.

PLEASE SHOW THE WORLD, ILLINOIS, AND MS GINDORF THAT YOU RECOGNIZE THE WRONG DONE TO HER AND GRANT HER A FULL PARDON. I BELIEVE SHE IS ONLY REQUESTING CLEMENCY. Please pull out her clemency petition from the pile and review it first.

In Europe, women with this illness who murder their children are sent to a mental hospital for two years and released. High-profile cases where a woman drowned her five children have resulted in not guilty verdicts due to post-partum psychosis. PLEASE SHOW THE WORLD THAT ILLINOIS IS COMPASSIONATE AND BRING IT INTO THE 21ST CENTURY NOW BY IMMEDIATELY GRANTING A FULL PARDON TO MS. GINDORF. I’m sure she will be shocked if you pardon her and not just release her with clemency.

Gov., I believe you are a rational, honest, and hard-working leader. Please reveal this to the world by taking this action!! I do not know Ms. Gindorf, but she deserves your mercy and a chance to recover some small amount of money from the state for wrongful incarceration and the way she has been mistreated by the courts. 22+ years in prison when she is innocent due to a transient mental psychosis is simply barbaric. Within a year of the “crime” she no longer was a danger to society or anyone. She is punished daily with the knowledge that she took the lives of her children, but has received mental health care and now copes with this reality.

This is a treatable illness that even goes away on its own within 6 mo to a year after the child’s birth and only recurs with pregnancy. It is treatable even after subsequent pregnancies. Ms. Gindorf, due to her age, no longer has the option of pregnancy so she is not a risk to anyone.

I am available for discussion at any time about the details of post-partum psychosis.

May the Lord give you the wisdom and strength to act quickly and boldly to reverse this injustice. I know you have a lot on your plate, but his action is sorely needed and will make you and all of us in Illinois feel a little better about admitting our mistakes. Please give Ms. Gindorf justice.

Yours truly,
Linda Lorincz Shelton, Ph.D., M.D.

For more information see: http://www.left-bank.org/FreeDebra/debra-story.htm

Dr Shelton found NOT GUILTY of Medicaid Vendor Fraud – Suit Against IL AG Lisa Madigan, Judge Alonso & Pantle & IL Medicaid Fraud Unit

February 27, 2009

I am now suing the sham Judges Pantle and Alonso, the sham prosecutor IL AG Lisa Madigan and incompetent and corrupt members of the IL Medicaid Fraud Control Unit, Inv. Reibel, Patrick Keenan and others for malicious prosecution, wrongful arrest, wrongful incarceration, and conspiracy to violate civil rights under color of law [in retaliation of me as a whistle blower]. See Federal case in the Northern District of Illinois, Federal District Court, 06 CV 4259, available at the court website called “Pacer”. Anyone can sign up for free, but documents costs 0.08 cents a page to download.

The following is a letter to Special Agent Robert Grant, Director of FBI office in Chicago. Please write him and urge him to follow my suggestions!

Dir. Robert Grant
Chicago Office – FBI
2111 West Roosevelt Road
Chicago, IL 60608-1128
(312) 421-6700

After unconstitutional rulings by Circuit Court of Cook Co Judge Alonso that fixed my trial and made wrongful conviction certain unless there was jury nullification I didn’t show up for my State trial on Medicaid vendor fraud for which I am innocent. The jury made a finding of NOT GUILTY and Judge Alonso quashed the warrant for arrest on the basis of jumping bail and disobeying his orders because he said “what’s the point.” Now why don’t you read what I sent you and get the Cook County State’s attorney to arrest Itadel Shalabi and Nareman Taha for perjury [they are the ones who fabricated bills for Medicaid to get payment for patients they didn’t see] and indict Louise Moore of Data Medical Works for Medicaid fraud [she bills for her billing services for the last ten years by percentage (8 %) which amounts to fraud as you know] and also for forgery as she forged my name on a power of attorney form, blue cross/blue shield electronic partner trading agreement, and alternate payee agreement so that Moore could put my name as a doctor and my Medicaid provider number on the invoices sent to Medicaid for services not done and encounter forms fabricated by Shalabi and Taha, and then Shalabi and Taha who were partners of Vernon Glass the CEO , could sign checks to themselves when the money came into the business Right Frame of Mind & Associates. Why don’t you arrest MFCU Inv. Reibel for falsifying his records and take over all Medicaid Fraud investigations in IL before the dysfunctional MFCU mucks up any more. Vernon Glass is innocent too, yet he must also stand trial? I want to talk to you and give you all the evidence which I now have to prove the above. What’s wrong with you?

Read my blog: http://illinoiscorruption.blogspot.com/ for more details.

As to the Sen. Burris issue what’s wrong with you. Read the following. Why aren’t you going after Lisa Madigan and other members of the real cabal of corruption in Illinois? As I told you, only a “Truth Commission” will really bring the light of day to corruption so it can no longer thrive. Why are you and the U.S. Attorney being so sloppy and ignoring your best witnesses such as Vernon Glass, Maisha Hamilton, me [Dr Linda Shelton] and so many others I can refer you too. The cabal have been destroying us as witnesses by falsely accusing us of crimes or defaming us with false accusation of mental illness. You and the U.S. Attorney are puppets of this cabal by your ignorance and actions ignoring us and feeding these false rumors.

Unbelievably, the jury was a group of well educated individuals who lived primarily in downtown Chicago. They saw through the lies of the prosecutor and the judge’s unconstitutional rulings and came back with a verdict of NOT GUILTY. Then the judge gave up, said “what’s the point” [of the arrest warrant he issued on 2-18-09 when I refused to come to the trial and disappeared”.] He then quashed the arrest warrant. So now I am home and I will pursue a suit for malicious prosecution, wrongful arrest, conspiracy to violate rights under color of law and violation of civil rights against the sham prosecutor IL Atty Gen Lisa Madigan who had no legal authority to usurp the powers of the State’s Attorney and indict or prosecute anyone. The Constitution and laws in Illinois specify that ONLY the State’s Attorney can decide charges, indict and prosecute most crimes. The AG is given authority by law to alone prosecute about 8 crimes such as gambling and environmental crimes. Medicaid vendor fraud is NOT one of them. The SA was never involved int his case. Since the IL AG had no jurisdiction, the court had no jurisdiction. Therefore, the prosecutor and the judge lose absolute immunity. Lack of jurisdiction is the only reason they lose immunity. So I have a suit in federal court now against IL AG Madigan, Judge Pantle, Judge Alonso, and the State Police personal at the IL Medicaid Fraud Control Unit. I wish the US Attorney would get involved as the IL MFCU is so sloppy at investigations that they arrest the wrong people, destroy evidence against the real criminals and allow themselves to be used as a weapon against whistle blowers for political benefit….

I am astonished that you have not interviewed Dr. Maisha Hamilton Bennett, who was wrongfully convicted of [Medicaid fraud, Naomi Jennings who was wrongfully convicted, me [Dr Linda Shelton] or Vernon Glass on the issue of wrongfully alleged Medicaid fraud in Illinois and the illegal and unconstitutional actions of the IL MFCU as well as the scheme by IL Government to deny mental health care to patients on Medicaid. This is a big economic issue as failure to treat mental health care increases crime, welfare costs, and Medicaid costs. You are contributing to economic failure by failing to properly deal with this issue! This is also an act of felony violation of civil rights and ADA violations by IL Government!

Sincerely,

Linda Lorincz Shelton, Ph.D., M.D.
e-mail = picepil@aol.com

Judge Alonso Overturns Federal Medicaid Code – Denies Mental Health Care to Illinoisans on Medicaid

February 12, 2009

Dr Linda Shelton, who has devoted her life to service of others and particularly to providing medical and mental health services to the poor will be completely destroyed in two weeks with a false conviction for Illinois Medicaid Fraud simply for trying to help people on Medicaid obtain mental health care. Please read the following and help any way possible. I thank anyone who will help me.

This is a story epitomizing government corruption and greed, retaliation against whistle blowers, and gross government incompetence brought on by decades of fraud, patronage, and nepotism in Illinois.

Judge Jorge Alonso ruled on my pending criminal case where I am charged with Medicaid fraud that “substitute billing is illegal”. This is where a doctor sends a bill to the insurance company for services performed by his employee such as the service of a nurse administering a vaccine or a psychologist administering a psychological test, or a cast technician applying a cast. In my case the Illinois Attorney General claims that if a doctor bills Medicaid for counseling (for drug addiction, post-traumatic-stress disorder after rape, obsessive-compulsive disorder, depression, dementia, etc.) if the counseling or psychological testing was done by an employee and not directly by the physician then it is a felony crime.

If substitute, also known as incident to, billing is illegal than ALL doctors in Illinois are guilty of a felony crime of fraud! God Help Us! Judge Alonso is so eager to railroad me and convict me that he is violating his oath of office to uphold the laws of the land and the constitution. Due process, guaranteed by the Bill of Rights REQUIRES that he follow the law. He is BLATANTLY violating the law, either maliciously or ignorantly due to his arrogance, incompetence, bias to run and support the alleged prosecutor AG Lisa Madigan, or his ego.

Physicians are NOT trained to do psychological testing for personality disorders or mental illness. Psychologists at the master’s and Ph.D level are trained to do so. These tests are invaluable in helping determine the right diagnosis and the right course of treatment. Judge Alonso has ruled that those on Medicaid are not eligible for this type of evaluation and treatment as a result of his illegal and unconstitutional ruling.

Many non-physicians are licensed in Illinois and all states to provide Psychiatric & Psychological Services:

1. nurses 225 ILCS 65,
2. clinical psychologists 225 ILCS 15,
3. licensed social workers 225 ILCS 20,
4. licensed clinical professional counselor 225 ILCS 107,
5. licensed marriage and family therapist 225 ILCS 55 and 68 ILAC 1283

Judge Alonso’s illegal ruling denies all of these people the RIGHT to practice their profession and denies the citizens of Illinois on Medicaid the Right under the Federal Medicaid Act to access to care equivalent to the care provided in the community.

Federal Judge Joan Lefkow ruled in August 2004, at the end of a 12 year civil rights class action suit that “Illinois Medicaid Policies and Procedures are in Violation of the Federal Medicaid Code because they Deny Access to Care” to children on Medicaid. This ruling is applicable to all Medicaid patients but the ruling only applies to children. It needs to be expanded to cover all Medicaid patients.

The Federal Medicaid Code, 42 U.S.C. 1396A(a)(30)(A), [regarding adults and children covered under Medicaid and the EPSDT program] REQUIRES any State Medicaid program funded by the federal government to provide care equivalent to that obtainable from private insurers in the community to Illinois Medicaid clients.

Therefore, Judge Alonso’s ruling is unconstitutional, unfair, illegal, and amounts to his ruling to overturn the Federal Medicaid Code as well as Illinois Statutes licensing non-physician providers of mental health services. As > 80 % of mental health services are provided by non-physicians this essentially shuts out mental health services to all but a few in Illinois who are poor.

The Federal Court and U.S. Attorney should intervene as this is illegal and also a violation of the Americans with Disabilities Act in terms of discrimination.

As to my case, I am charged with billing for mental health services never done and substitute billing for mental health services between June 2000 and April 2002 while “working” at Right Frame of Mind & Associates (RFOM). Over the last six months when I obtained access to the old business records for RFOM I discovered the fact is that the year before I started working for a group practice called RFOM, part-time providing chart review for quality, consultation about medical and psychiatric policies and procedures, and limited patient care, two woman, who were partners with the CEO and without the knowledge of the CEO, in 2000 fabricated hundreds of patient encounter forms (filled out by doctors or therapists as to what patient they saw, the diagnosis, and what service was provided), that are later translated into bills or invoices by the billing agent, for services they never did. These two women, Itadel Shalabi and Nareman Taha never met me as they were fired before I started working there in 2001.

I had major neurosurgery in July 2000 due to a congenital spinal problem that was crushing my spinal cord and leading progressively towards quadraplegia. I was incapacitated for six months and heavily sedated with narcotics and other drugs for much of that time. I had agreed in early 2000 at the request of the CEO to be one of a dozen or more part-time medical directors to oversee quality of care, screen for medical disorders mimicking psychiatric disorders, help train the counselors to write better notes (many were foreigners with good counseling skills but a little difficulty with English writing), advise the CEO on best medical practices and standard of care, and provide physician services to patients needing medications.

I or my staff while I was in hospital gave the CEO my Medicaid provider number and other necessary documents so that the company’s billing agent Louise Moore of Data Medical Works could sign me up with Medicaid as a provider for the group so that they could bill for my services when I began to work, if I recovered, in 2001.

Ms. Moore I never met at the time was a sweet lady who is ignorant of a lot of things. She held herself out to be a expert at medical billing and she signed a contract with the CEO in early 2000 to set the group up legally to bill Medicaid. Nothing she did was actually proper, but it was not her own fault. She failed to tell the CEO he would be paid more if he had his group certified as a community mental health center. She was totally ignorant of the concept of community mental health centers (or the drug addiction and alcohol treatment centers – another center with its own enabling State Statue).

Under the Community Mental Health Service Act mental health groups that become certified bill Medicaid under the Center’s name and not under the doctor’s name. They also contract with the Illinois prisons, and/or DCFS (Illinois Child Welfare) or other agencies to provide comprehensive mental health services. They must have at least one medical director, but the director is an administrator and doesn’t have to see patients. Ph.D. psychologists or doctors or licensed mental health providers can supervise non-physician mental health service providers and bills can be sent in to Medicaid under the center’s name for all these services.

Ms. Moore ignorantly thinking (falsely) that her contract allowed her to sign the names of Right Frame of Mind employees on to any form signed my name in August and December 2000, without my or the CEO’s knowledge or consent, on a power of attorney form, an alternate payee form, and a blue cross/blue shielf electronic partner trading agreement form, which are all required to allow her to translate the patient encounter form to an electronic invoice and send it over the wire to BC/BS for adjudication, who then sends it to Medicaid, who then pays abut 30-40 cents on the dollar to the Alternate Payee (in this case RFOM).

Ms. Moore had spoken to the Medicaid Provider Service Unit about how to register the non-physician providers to bill Medicaid. She was told that non-physicians cannot bill Medicaid, was NOT told that a better way to bill was as a community mental health center or how to sign the group up as a community mental health center, and told that all bills (invoices) had to have a doctor’s name as the provider.

Then Ms. Moore, without my or the CEO’s knowledge changed the provider name in preparing invoices from Itadel Shalabi’s and Nareman Taha’s fraudulent patient encounter forms to my name so she could bill under my Medicaid Provider Number. I don’t believe that Ms. Moore had ANY knowledge of the fraudulent nature of the Patient Encounter Forms made by these two women.

Therefore the ghost billing charge is a result of ID Theft, resulting from both fraud by these two women and a comedy of errors by incompetent people advising Ms. Moore in the Medicaid Provider Service Unit, as well as her own blundering ignorance. I am totally innocent having not participated in any way in generating these bills or in receiving or using the money paid for them by Medicaid.

Ms Moore unfortunately is also guilty of mass fraud in all the work she has done in the past decade or more. It is illegal for an insurance biller to bill Medicaid based on a contract where they are paid by the percentage of funds received from Medicaid by the provider. Ms. Moore charged around 8% of all billings. This is illegal and considered fraud as it ties the billers service, which has nothing to do with the medical care provided, with the doctor’s service. Therefore, if she billed for a $100,000 procedure by a heart surgeon she would be paid $8,000 for sending in one bill, while when a family doctor bills $100, she would be paid $8. Providers of services to doctors are NOT ALLOWED to tie their services to the income from the actual medical provider. She MUST BILL ONLY by the piece of work such as $8 per bill. However, she has not been indicted for Medicaid Fraud and has not been sued by RFOM for Fraud in holding herself out to be an expert on billing when she was not.

The second aspect of the charge is substitute billing. I signed a Power of Attorney Form and Alternate Payee Agreement in August 2001. I was informed by the CEO sometime in late 2001 or early 2002 that the group was told by Ms. Moore that the counselors’ and psychologists’ services had to be billed under a doctor’s name so that bills on patients I had seen, but for dates of service when they were seen by a non-physician were being billed under my name. I had assumed that the billing agent was competent and doing the billing properly. I had assumed that substitute billing for employees services in mental health care was as legal as billing Medicaid for my nurse giving a patient a vaccine. I had no idea at the time that anyone considered substitute billing illegal. I had no knowledge that Ms. Moore had actually sent in tens of thousands of dollars worth of bills under my name before August 1, 2001 based on documents she forged and the fraudulent patient encounter forms from the above two women. Therefore, I told the CEO that was fine. I was not involved in billing or administration of the group except to fill out patient encounter forms when I saw a patient. I had a good faith belief that all was well.

I had also had an agreement that being part-time the business would limit my patient panel to 200 patients as I did not feel that part-time doctors should supervise the care of any more patients than this number.

Since Judge Alonso has unconstitutionally and illegally ruled that substitute billing is illegal I will be found guilty and likely sentence to prison for 4-15 years, as well as forever lose my medical license and reputation, along with my livelihood, future, friends, health as medical care is inadequate in prison and I am disabled with several serious medical disorders, and will to live. I have informed the U.S. Attorney, FBI, at the time Senator Obama, Senator Durbin, and now Senator Burris along with a lot of Congressmen and other Sentators and State legislators. I am receiving no assistance to solve this problem and restore mental health care in Illinois to those on Medicaid.

In late 2001 Ms. Lovett, Ms. Collins and others from the Office of Inspector General Medicaid contacted the RFOM and claimed that they needed to review some charts as a “standard review of a new practice to help us comply with the rules”. We completely complied and Ms. Lovett came out in 2001. She told the CEO the charts were well done and she would give us a report in 90 days. The CEO was actually very happy about this review because he wanted to make sure that our group practiced with the highest quality and had the best quality charting in the business. They never gave us a report or any feedback and their only response was to initiate a felony prosecution which culminated in the indictment of selectively me (and not one other of the dozen or so medical directors doing the same job – perhaps because only the CEO and I were whistle blowers about Illinois Governement Corruption and mistreatment of children in foster care and on Medicaid by the State) and the CEO.

After a number of months with NO feedback and strange comments from the Illinois State Police Medicaid Fraud Unit (part of the Illinois Attorney General’s Office), where the CEO had gone to inform them that he was concerned abut the integrity of our medical records because he had fired Itadel Shalabi and Nareman Taha for other administrative misconduct and inappropriate behavior with patients and they stole a hundred or so medical records (eventually returning parts of them) I began my own investigation of the rules of Medicaid. The State Police have not arrested them yet.

The CEO, I had learned over about a year was much more naive than I thought about running the business. I had assumed that he was qualified as an administrator and found out he was not. Finding out about the stolen charts and the lack of feedback from the OIG-Medicaid on this “routine review” concerned me. I was also concerned because in April 2002 the CEO told me that Ms. Collins at OIG-Medicaid had informed him to talk to Mr. Brown at Medicaid because there was a problem with the way our group was set up. Mr. Brown told the CEO that RFOM could not be a proper alternate payee under their rules and he apologized for misleading the CEO when the group was originally set up in 2000. He told the CEO that Medicaid could not continue to pay the group unless it was owned by the doctors. The group was the sole proprietorship of the CEO a master degreed psychologist. The CEO said OK, hired an attorney, and asked several of the doctors to be the officers of the group as it changed to corporate status. The corporation was set up so that the doctors would not actually profit from the corporation but were only paid by the hour for their work. The CEO was going to make a profit from managing the corporation. However, no profit was ever made as all the income went to overhead, particularly paying the counselors and doctors their salary and/or hourly rate. The CEO actually put in $100,000 of his own money to meet payroll before he closed the business as no viable financially. My total income from the group was about $5000 over all the time I worked there from 2001 to 2003. I always told the CEO to pay the other employees first and my work was only very limited and part-time.

Beginning in 2002, I researched the Federal and State Medicaid rules, policies, and laws so that I would be able to meet my fiduciary duty to participate in running the corporation at least from an advisory point of view. I discovered the following and this is why I told the CEO in mid 2002 and maintain this belief, that substitute billing is perfectly legal and actually REQUIRED by the Federal Medicaid Code as well as NOT PROHIBITED by Illiniois Statutes or Illinois Adminstrative Rules:

Federal and State Medicaid laws are extensive, complex, and immensely confusing. The State of Illinois is misusing them to indict doctors, psychologists, administrators of psychiatric and psychological practices for “Medicaid Fraud” when they are actually following federal law and providing needy services including counseling, drug treatment, suicide prevention, etc. Attorney General Lisa Madigan and Jim Ryan before her have targeted especially those groups run by whistle blowers, in order to falsely claim they are tough on fraud, to prevent Illinois from paying the bill for mental health services for the poor and needy on Medicaid, and reduce the bottom line.

A claim of “tough on fraud” will help AG Lisa Madigan win election as Governor. Failure to provide mental health care including drug addiction and alcoholism treatment leads to increased crime as drug addicts, alcoholics, and those that are so out of touch and mentally ill find alternatives to legitimate work to feed their habits or survive. Failure to provide adequate mental health care at the front end leads to much higher costs in the long run.

Code of Federal Regulations 42 CFR 414.34 states:
“Payment for services and supplies incident to a physician’s service”
“(b) Services of non[-]physicians that are incident to a physician’s service. Services of non physicians that are covered as incident to a physician’s service are paid as if the physician had personally furnished the service.

United States Code42 U.S.C. § 1396d(a)(5)(A)
requires reimbursement for “physicians’ services furnished by a physician.”

Code of Federal Regulations 42 C.F.R. § 440.50
The HHS rule implementing the Medicaid Act defines “physician services” to include services provided:
“(a) within the scope of practice of medicine or osteopathy as defined by State law; and
(b) by or under the personal supervision of an individual licensed under State law to practice medicine or osteopathy.”

United States Code42 U.S.C. §1396a(a)(32)(C)
Congress further authorized substitute billing under Medicaid for services furnished:
“by, or incident to the services” of another physician

Federal Regulation66 Fed. Reg. 55268
HHS makes clear in its preamble to this rule that it does not restrict the type of auxiliary personnel who may perform a given “incident to” service: “We deliberately used the term any individual so that the physician (or other practitioner), under his or her discretion and license, may use the service of anyone ranging from another physician to a medical assistant.”

Code of Federal Regulations42 CFR 411.15
“Particular services exclude from coverage” specifically states that:
“(m) (3) Exceptions. The following services are not excluded from coverage:

•(iii) Nurse practitioner and clinical nurse specialist services…

•(v) Qualified psychologist services,”

FEDERAL PREEMPTION SUSTAINED BY FEDERAL 2ND CIRCUIT COURT OF APPEAL
•A Federal suit for a psychiatrist against the New York Medicaid Program based on its refusal to approve Medicaid was agreed to for reimbursement for services provided by his employees under his supervision. Yapalater v. Bates, 494 F. Supp. 1349 (S.D.N.Y. 1980), aff’d, 644 F.2d 131 (2d Cir. 1981), cert. denied, 455 U.S. 908, 102 S. Ct. 1255 (1982).
The court determined that the federal Medicaid rule at 42 C.F.R. §440.50 defining “physician services” unquestionably included supervisees other than the physician, just as the same rule must apply here to vacate Plaintiffs’ indictments. Id. at 1363-64.

State Medicaid must Provide Services 42 U.S.C. 1396a(a)30(A)
•Federal Code clearly mandates that State Medicaid plans must provide services to recipients of Medicaid and payment to their service providers equivalent to care and services provided to the general population by private insurers
•Private insurance pays for psychiatric services provided by counselors and psychologists
•RFOM CEO and other employees, besides the physicians were licensed counselors, nurses, psychological therapist, or social workers, per CEO

42 U.S.C. 1396a(a)30(A)
A State plan for medical assistance must
Provide such methods and procedures relating to the utilization of, and the payment for, care and services available under the plan . . . to assure that payments are … sufficient to enlist enough providers so that care and services are available under the plan … at least to the extent that such care and services are available to the general population in the geographic area“,

Ambiguous State Laws Must be Interpreted to Conform to Fed Law
•The Federal 7th Circuit Court of Appeals has also construed ambiguous state regulations to conform to federal Medicaid requirements,
•an approach worth revisiting here with respect to Sections 140.411 and 140.413 of the Illinois Administrative Code.
•See Evanston Hosp. v. Hauck 1 F.3d 540 (7th Cir.1993), cert. denied, 510 U.S. 1091 (1994).

I (SHELTON) CONTINUES HER OWN INVESTIGATION OF BILLING PRACTICES – 2002-2005

•Shelton discovers that Physician Medicaid Manual has inconsistencies, in one place stating bills for employees billed under doctor’s name, and in another place stating that no psychiatric services can be billed for non-physicians, yet in another place stating that non-physicians may provide psychiatric services and Medicaid may be billed. She also discovered the Illinois Community Mental Health Center Code.

Illinois Administrative Code (IAC)
89 IAC 140.12

“Services Not Covered by Physician”
DOES NOT MENTION psychiatric services by non-physicians

Illinois Administrative Code
89 IAC 140.400(a)
“Payment to Practitioners”
“2) A practitioner may bill only for services he or she personally provides or which are provided under his or her direct supervision in his or her office by his or her staff.”

Illinois Administrative Code
89 IAC 140.411

“Covered Services by Physicians”
“The Department shall pay physicians for the provision of services not otherwise excluded which are:
. . .
c) Provided by the physician or by a member of the physician’s staff under the physician’s direct supervision

Illinois Administrative Code
89 IAC 140.413

“Limitations on Physician Services”
that “limitations” on physician’s services include that psychiatric services will be paid for if they are “. . . provided by a physician . . .” [It does not exclude non-physician services and it is a reasonable inference to conclude the definition of “physician” include the services of non-physician employees, under the doctor’s supervision as defined in 89 IAC 140.400 & 411]

How does this negate previous definition of “physician services” which include incident services by his employees?

UNCONSTITUTIONAL STATE CLAIM
State falsely claims use of word “physician” in 89 IAC 140.413 negates definition of
“physician services”, which includes incident services by physician’s employees as defined in 89 IAC 140.400(a), 89 IAC 140.411

State falsely claims that federal law does not apply and statutory construction rules don’t apply
Judge Alonso previously illegally ruled that the Federal Medicaid Code does not apply in this case despite the fact the Illinois Medicaid is a joint federal/state program partially funded by the Federal Medicaid Code!

IAC TOO VAGUE
•Criminal Laws are invalid if too vague to understand (“void for vagueness doctrine”)
•Illinois Administrative Code too vague in sections:
89 IAC 140.12,
89 IAC 140.400,
89 IAC 140.411, and
89 IAC 140.413
Illinois Administrative Code
•Why should 89 IAC 140.413 have more weight than 89 IAC 140.12?
•Why should the definitions of physician services in and 140.411 not apply to the term “physician” in 89 IAC 140.413?

STATUTORY CONSTRUCTION RULES REQUIRE (Regarding interpretation of conflictin State Statutes)
Specific Controls over General
•89 IAC 140.400 & 89 IAC 140.411
more specific “physician services” includes non-physician employee services
•89 IAC 140.413 general word “physician” with no definition of what services this includes cannot by exclusion negate previous more specific definition of services provided by physician

Federal Law Rules
42 CFR 414.34
Services by Physician’s staff are billed as IF the Physician Performed the Services Himself

If State and Federal Law conflicts, Federal Law Rules
Due to the Supremacy Clause of the United States Constitution

FEDERAL LAW REQUIRES PAYMENT FOR EPSDT SERVICES
•The Federal Medicaid Code requires that State Medicaid programs pay for periodic mental health screening and treatment of any defects in mental health for children under 21:
• 42 USC 1396d “Definitions For purposes of this chapter
• (r) Early and periodic screening, diagnostic, and treatment services

•The term ‘early and periodic screening, diagnostic, and treatment services’ means the following items and services:
• (1) Screening services –
• (A) which are provided –
•(ii) at such other intervals, indicated as medically necessary, to determine the existence of certain physical and mental illnesses or conditions;
• . . .
•(5) Such other necessary health care, diagnostic services, treatment, and other measures described in subsection (a) of this section to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not such services are covered under the State plan.”

STATE LAW REQUIRES PAYMENT FOR EPSDT SERVICES
•89 IAC 140.485 states:
•“Healthy Kids Program
•Program Description
–The Healthy Kids Program is the Early and Periodic Screening Diagnostic and Treatment Program [EPSDT] mandated by the Social Security Act (see 42 U.S.C. 1396a(43), 1396d(4)(B)(Supp. 1987)). The goals of the program are to:
•Improve the health status of Medicaid-eligible children ages birth through 20 years through the provision of preventive medical care and early diagnosis and treatment of conditions threatening the child’s health
•…
•8) Treatment. The Department shall pay for necessary medical care (see Section 140.2), diagnostic services [i.e. psychological testing], treatment or other measures medically necessary … to correct or ameliorate defects, physical or mental illnesses….”,
•The Illinois Public Aid Code [AKA Medicaid Act], 305 ILCS 5/19(f) requires that EPSDT screening and mental health treatment be provided to children in the Medicaid program:
•“5/19. Healthy Kids Program
•(f) Covered Medical Services. The Illinois Department shall provide coverage for all necessary health care, diagnostic services, treatment and other measures to correct or ameliorate defects, physical and mental illnesses, and conditions whether discovered by screening services or not for all children eligible for Medical Assistance under Article V of this Code.”

Dr Shelton was a Medicaid Registered EPSTD Provider

Therefore ANY REASONABLE person would conclude that the law permits substitute billing for mental health services whether it be another physician covering for the doctor, or a non-physician supervised by the doctor or her colleagues. If you don’t agree than the void for vagueness doctrine should clearly negate and prevent any criminal charges for substitute billing.

God Help Me! I am innocent and destroyed. This is my reward for devoting my life to service particularly of the poor and needy. If you want to help, contact the Illinois Reform Committee and flood them with letters. Contact the U.S. Attorney and FBI and flood them with letters. Contact your legislators and Congressmen and flood them with letters. Come to the trial on February 17, 2009 which will last two weeks and fill the gallery so that the judge knows your opinion. Contact the press. Donate to my legal fund anything possible. I need tens of thousands of dollars. Shelton Legal Fund, C/O Albukerk & Associates, 3025 W. 26th St. 2nd Floor, Chicago, IL 60623. Thank you if you help.


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