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Sample Letter To Use To Complain to Government Agencies About Kaiser and For Profit Permanente Care:


 The Centers for Medicare and Medicaid (CMS) have stated that they have an ongoing investigation into the practices of Kaiser and the for profit Permanente.   They really need and want to hear from the public.  They need to know what has been going on in this state.  The only way that is going to happen is if you the public let them know about it.

The California Department of Managed Health Care (DMHC) also states that they are overseeing and looking into the practices of Kaiser and the for profit Permanente behavior in this state.  Now is the time to resubmit your complaints for re-evaulation that you believe were not properly looked into.  This includes claims by DMHC that they do not handle senior medical care issues.  Resubmit your complaints no matter what they told you before.  Remind them that you would appreciate a fair and honest re-examination of the situation.

The following is a Sample Letter of Complaint for you the citizen to resubmit to the government agency that oversees your particular situation. At the end of this Sample Letter are the addresses and phone numbers of the applicable government agencies.

Sample Letter of Complaint
[Your Address]
[Your City, State, Zip Code]

[Today's Date]

Name of Contact Person (if available)
Title (if available)
Company Name

Consumer Complaint Division (if there is no contact person)
Street Address
City, State, Zip Code

Re: Kaiser Permanente

Dear [Contact Person]:

The purpose of this letter is to inform you of my problem with ___________
[Explain the
problem you are having]. My policy number is ______________ name
_______________if other than yourself that you are representing for the
complaint.  Date(s) at  location(s).

I too have been appalled at what Kaiser Permanente has done and I am glad
you are investigating the organization and wanted to bring to your attention
my case I have previously brought before you to re-assess your findings as
they relate to your ongoin investigation [describe problem]. I have
already attempted to resolve this problem by [describe attempts and actions
taken]. I have
enclosed copies of my records [include copies of relevant documents].

Unfortunately, the problem remains unresolved and with your ongoing current
investigation of Kaiser Permanente I hope will prompt further investigation
into the overall makeup and patient care portocols (inpatient/outpatient)
Kaiser Permanente so arrogantly ignores as your findings have already shown.
  My case justifies another look and reinvestigation. I am hereby requesting
that you:
1. [List specific actions you want]
2.
3.

I would appreciate it if you would reopen and re-investigate this matter and
take appropriate action to prevent the problem from happening again. You may
contact me at [telephone number] if you would like any additional
information. Please notify me in writing of the results of your
investigation.
Sincerely,

[Your Name]

[Your Signature]
Enclosures: [List copies of attached documents]
C: [Name of anyone you are sending copies of this letter]

Organizations:

California Department of Insurance
Consumers Services Division
300 South Spring Street, 9th Floor, South Tower
Los Angeles, CA 90013
Toll-free number: 1-800-927-4357
TDD: (800) 482-4833
Within Los Angeles: (213) 897-8921




About Medi-Cal
Medi-Cal Public Inquiry & Response:
Toll-free number: 1-800-952-5253

Ombudsman for Medi-Cal Managed Care:
(An ombudsman is a person who investigates
problems and helps you find solutions.)
Toll-free number: 1-888-452-8609

California Department of Health Services (DHS)
1501 Capitol Avenue, Suite 2101
Sacramento, CA 95814
or
P.O. Box 997413
Sacramento, CA 95899-7413
(800) 236-9747
TDD: (916) 440-7399
www.dhs.ca.gov

California Department of Managed Health Care
  • Voice:  (888) HMO-2219
  • FAX:    (916) 229-0465
  • TDD:    (877) 688-9891

  • Mailing Address:
    Department of Managed Health Care
    California HMO Help Center
    980 Ninth Street, Suite 500
    Sacramento, CA 95814-2725

About Medicare

Centers for Medicare and Medicaid Services (CMS)
Mr. Jeff Flick
Regional Office
75 Hawthorne Street, Room 408
San Francisco, CA 94105
Toll-free number: 1-800-MEDICARE (633-4227)
Regional number: (415) 774-3501


Medicare Beneficiary Assistance Lines in California
Northern CA: 1-800-MEDICARE (633-4227)
Southern CA: 1-800-MEDICARE (633-4227)
Medicare NHIC information

For further health care information you may wish to contact any of the
following groups.

HEALTH CONSUMER ADVOCACY GROUPS

General health plan issues:
Consumers Union
1535 Mission Street
San Francisco, CA 94103
(415) 431-6747
FAX: (415) 431-0906

Senior citizen health insurance issues:
Health Insurance Counseling and Advocacy Program (HICAP)
Toll-free number: 1-800-434-0222

Center for Health Care Rights (serves Los Angeles County)
520 S. Lafayette Park Place, Suite 214
Los Angeles, CA 90057
Toll-free number within Los Angeles County: 1-800-824-0780
1-213-383-4519 outside of LA County

Health plan disclosure to patients:
Citizens for the "Right to Know"
925 L Street, Suite 600
Sacramento, CA 95814
(916) 443-7239
Toll-free number: 1-866-785-6285

For those with problems with Government Agencies and Government Employees, Insurance Companies and Medical Entities that have saved their documentation:

At:
 
The FBI has placed it's Financial Crimes Report To The Public from May of 2005 online.  I suggest that everyone read the section on Health Care Fraud.
 
Then over at:
 
Down near the bottom of the page it says - FBI requests the public provide tips for their public corruption investigations. 
 
I am sure that everyone has a tip regarding corruption.  You do have to identify
yourself I was informed however the web page says that you may remain anonymous.
 
Falsely billing Medicare is a Federal Crime.  So if someone falsely claims they provided medical care and you know it isn't true you can report them.  If you know that someone was not terminal, was placed in hospice then report them.  If you know that someone died an un- natural death and Medicare was again billed then turn them in.  I am sure that everyone can think of more reasons to tell the FBI what happened with your loved ones if fraud was involved.

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