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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
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: http://www.fbi.gov/publications/financial/fcs_report052005/fcs_report052005.htm#c1 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: http://www.fbi.gov/hq/cid/pubcorrupt/pubcorrupt.htm 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.