The following might be repetitive but it's late, I'm tired and doing this on a cellphone. Hopefully this page will be tidier by next weekend!
This email is being forwarded to several other recipients in the hopes they’ll be able to understand what’s going on, help me cut through red tape, intervene and/or expose how Categorically Needy Individuals are being unjustly treated by Pennsylvania’s Department of Human Services (DHS) system's employees, providers and the judicial system after reading my statements.
After numerous automatic denials for DHS Medicaid covered dental care by the DHS Medicaid Dental Approval and Denial Department which I kept fighting and reporting to Governor Tom Wolf’s office that these DHS employees are forcing “categorically needy individuals” to get teeth extractions instead of surgical procedures, root canals or crowns which Legislators authored and Governor Tom Wolf signed into law for those that are on SSI, collect Supplemental Income or TANF because these state workers think the Legislators and Governor “made a mistake,” according to Ms. McNaughton of DHS, when writing and approving all dental care such as teeth extractions, surgical procedures, root canals and crowns. They assert that the cheapest method must be used and it has to be a direct medical need. That is not what the Pa laws state. Certainly root canals and crowns are more expensive than an extraction. The college educated law makers and Governor intended this law to provide proper dental care and not forced teeth extractions which the DHS Medicaid Insurance has forced an unfathomable amount of people to be assaulted by.
I finally started getting approvals. I got several denials and then approvals after complaining, quoting law and calling Governor Tom Wolf’s office.
Every single dental practice or facility I contacted claimed they’d get denied and expected me to either get my still viable teeth pulled or pay out of pocket for them to do a procedure my insurance is supposed to cover! One can only imagine how many tens of thousands of teeth have been pulled because of these DHS employees that are claiming the Legislators and Governor are basically not as intelligent as these DHS employees!
Next, after a year of dental hell which I’ll write about later, on August 02, 2017, DHS and Rabbittransit denied my application for medical transportation services after they transported me one time to Philadelphia Dental School to see an Endodontic Specialist. I was told to use Transportation Mileage Reimbursement forms.
I told both Daphne Simeonoff (DHS MATP state liaison and Program Monitor for Rabbit) and Mr. Michael Bernhardt (Director of Mobility Services, Central Pennsylvania Transportation Authority rabbittransit) that my antique titled vehicle was not capable of going over 20 to 30mph which is why I asked for an application for Medical Assistance Transportation Program (MATP), Shared Ride and Paratransit services. They absurdly kept insisting that I use mileage reimbursement since I have a car! I told them I needed back surgery and use that car to take my trash to the dumpster and I’m not giving up the registration on it, which people kept suggesting, plus it gets me 2 miles down the street to the post office and grocery store and back as I have no hills to deal with which it has difficulty climbing. I stated I’m not repairing it but saving up for another and the car could not be considered as a reliable vehicle to take me any further than 2 miles distance but they ignored that fact even though I posted videos on a webpage showing my car barely able to make it up Sterrates Gap Mountain which I live on!
I appealed the MATP Denial form stating that PA Code 2070.41 (d) for due process was violated. No statements of key aspects were presented. Such is required in writing in a denial letter. I couldn’t possibly defend myself based on State Codes (which is all they provided) without prior knowledge of what the accusations or key aspects of the reason(s) for denial were based.
Please note, I will be updating my webpage on which this information and evidence are posted on so please check back periodically at:
I will also be using a desktop computer shortly to make this page more presentable than I’m capable of doing through my cell phone. Please click on the page’s center, blue, link for my information. The following and so much more is under that blue link.
Most pressing issue at hand is getting a few more trips through MATP to The Philadelphia Dental School to follow-up with root canal retreatment January 16, 2018 2pm and January 18, 2018 at 1pm (as I have pain and pockets of infection that have been left untreated for far too long with these Department of Human Services (DHS) & Medical Assistance Transportation Program (MATP) denials which seem malicious and personal to me. Yes, I have documentation to substantiate this. I am not blaming Mr. Michael Bernhardt, the Reading based rabbittransit provider, as he seems to be just following orders from others in DHS Dental Department and MATP that are making my life difficult and/or jeopardizing and putting my health at risk.
The original Medical Assistance Transportation Program Denial Form violated Pa Code 2070.41 (b) No reason was given for the denial, just laws!
Medical Assistance Transportation Program Written Form
Dated August 02, 2017
“This is to inform notify you your request has been denied for the following reason: Based upon a review of your file, DHS and rabbittransit do not believe that rabbittransit can effectively meet your needs in the Shared Ride Services. You remain eligible for the MATP mileage reimbursement program, (based upon your MA eligibility), however you will no longer be eligible for paratransit, shared ride services. Rabbittransit may discontinue the service of any client who puts the safe operation of the vehicle in danger, puts another passenger, himself or herself or the rabbittransit driver in danger.
The Regulatory Cite and the Instructions and Requirements sections for the basis of this decision are:
Please see image below to view the frivolous citations that are all over the place. Note how not one mention is made in regard to what I did wrong to warrant denial. The citations actually state I “can” get transportation to providers, even if they “aren’t” within my community boundaries “of my choice” through MATP!
“MA Transportation Access Standards: MA, at a minimum, the Grantee assures that transportation is available only to get consumers to and from qualified MA-enrolled providers “of their choice” who are “generally”* available and used by other residents of the community.
The standard allows the following: Generally requires consumers to receive medical care in their home community when available there, but unavailability of qualified MA-providers requires transportation to providers outside the usual community boundaries.”**
*Note: Generally does not mean only, it means usually but not always.
** “but unavailability of qualified MA-providers requires transportation to providers outside the usual community boundaries.”
To which I responded with an appeal mailed in a timely manner on August 14, 2017.
“I want a hearing because PA Code 2070.41 (d) was violated. No clear statements of key aspects was presented. My right to due process was violated. False claim (stating) I had until the 17th to appeal to continue to receive service which I already received. I had just learned I had 10 days. I hope the postmark of 8 -14-17 will be valid as I have been misled and the 13th was a Sunday. I did not do anything I am vaguely being accused of. I am still waiting for Hbg. Mid Penn legal services to return my call. This form erroneously provided a York County legal aid that can’t represent me instead of a local legal aid.
I only received one copy and no original.
I have a dental appointment in Akron PA to complete dental work already started. I need Transportation on 8-23-17 for a 2:30 p.m. appointment 55 miles away.”
I sent a copy to the Harrisburg Bureau of Appeals and Denials Department and to Reading MATP postmarked 8-14-17. My appeal should have been sent to the Reading Bureau of Hearings and Appeals within 2-3 days of Reading rabbittransit receiving it which I do not believe happened.
I heard nothing back from anyone for months and on October 23, 2017 (82 days after original denial and 70 days after my original appeal, which I think is pretty long to wait to get a hearing date, (due process violation?)) The Reading Bureau of Appeals and Hearings (not Harrisburg (jurisdiction?) sent me a Notice of Hearing Date and Time scheduled for November 13, 2017 (This is over 90 days since the original August 02, 2017 denial form which had no key aspects of what I was being accused of. Is this another violation of due process?).
I responded with the following:
Appellant’s Reply to the Bureau of Hearings and Appeals
✓ I will be available for the hearing on November 13, 2017 02:00PM-04:00PM with ALJ Kristin L. Stockbower
“I am still waiting for a return call from Ms. Fran Chervenak of PHLA to help represent me on 11-13-17. As an accommodation for the hearing I am requesting an audio of the hearing. I am asking for permission to audio record the hearing. I have not received any documentation as to what specifically I did to warrant charges. That makes it impossible to prepare for a case which should be dropped.”
Ms. Fran Chervenak from the Pennyslvania Health Law Project (PHLP) did eventually contact me. After she spoke with Mr. Bernhardt, she claimed that for now they are transporting me and until they deny me transportation she can’t do anything further with my case. I told her that’snot what they’ve been telling me and I sent her a copy of Daphne Simeonoff's email stating otherwise.*****
When I finally got notice of the hearing date I begged Ms. Chervenak for help but she claimed they were under staffed or funded and that she thought I was intelligent enough to handle this hearing on my own. I told her that I have PTSD, panic, anxiety, dissociative disorders and Legal Abuse Syndrome (LAS) and I was too beaten down by these constant mental assaults that I am being forced to keep dealing with just to get healthcare, transportation and stay out of jail over malicious acts being carried out under color of law and the judicial system. She then gave me a little bit of advice and wished me good luck. She let a mentally challenged, due to trauma, individual represent themself at a hearing that should have been dismissed and had legal representation.
Prior to the hearing I did reach out to the Reading rabbittransit Agency Representative, Mr. Michael Bernhardt (as the forms he mailed to me suggested I consult with him) and I requested files and evidence. This message was conveyed to Marilys his assistant several days prior to the email request which I sent to Mr. Bernhardt on November 07, 2017 (5 days before hearing) and was told there was none though Mr. Bernhardt used much of such evidence at the hearing which was another violation of my civil rights ***
At this hearing where my civil rights to due process were violated, there was no mention of me putting the safe operation of the vehicle in danger, or another passenger, myself or the rabbittransit driver in danger yet that was what they eluded to very vaguely in the denial letter but never expounded with key aspects as required by law. I suspect they were going to use an incident that occurred in 2014 in which “I” was severely harmed by the actions of one o the Perry County's drivers, Jim, and his supervisor Stacey Nybeck (read www.pctaPerryCountyTransportationAuthority.weebly.com ) but their legal team probably advised them against opening that can of worms.
I was only made aware of the accusations within a few minutes before the hearing which is a violation of my rights to a fair hearing and due process of law. I had no time to prepare for these accusations or find laws to refute them! The hearing should not have proceeded as it did and I protested to Judge Stockbower that I was proceeding under duress. At least I was permitted to audio record the hearing.
I was accused of going outside the usual community boundaries which MATP “is” required to provide transportation services for since the nearest Medicaid Endodontic Specialist is in Philadelphia which is a 2 hour trip!
I was also accused of seeing a general dentist 68 miles from my residence that wasn’t billing Medicaid. I have already seen about 8 dentists over the past year that were deceitful and just wanted to get paid for an office visit or were deemed incompetent. Dr. Eby is the first “qualified” provider that I’ve seen in a long time. He has fixed other's mistakes and done beautiful work. He charged for 2 crowns but there was an issue with them. Before replacing, he referred me to an endodontic specialist. After seeing the endodontic specialist, Dr. Eby saw me at least 2 times for which he did not bill Medicaid to repair his work or follow up care. I was accused of using Medicaid Transportation to a provider that doesn’t bill Medicaid. That was not true. I had no idea such absurd accusations were going to be made. My dentist sent Mr. Bernhardt an email stating I needed transportation for his service and why he wasn’t billing. My request and the dentist’s for transportation was ignored.
I have had to reschedule a medically necessary endodontic appointment for January 4th because of my DHS Medicaid's unscrupulous actions.
I am in pain and have suffered harm from being repeatedly denied dental medical care, having to reschedule appointments while harboring infections, got a severe bout of vertigo presumably from infection of a back molar that took months to get proper treatment and until I was approved for dental medical care and am now I’m being denied medical transportation.
Lesa L. from Philadelphia Dental School (firstname.lastname@example.org (215) 898-8965) calked Medicaid’s Approval Denial Department to spea with Dr. Miller at (717) 265-7482 to get special codes for my dental care as a Categorically Needy Individual. Apparently he has been replaced by a Dr. Carol Boen (sp) who claims she’s never heard of Categorically Needy Individual’s Dental Laws let alone have codes to give to Lesa to use in the Benefits Limitations Exception (BLE) form which Dr. Miller gave to others before Lesa! I am going to be forced to pay cash to Philadelphia Dental School which I can’t afford to pay for dental care which my insurance covers!
I can’t even get a straight answer from DHS about how to go about getting reimbursed nor about getting transportation! I noticed what I think might be a new law claiming you can only get one procedure every 180 days which sounds absurd and I’d like to know how I’m supposed to be left in dental medical need for endodontic and periodontic work, both of which are urgently needed to be completed and done now! Or moreso 6 months ago!!!
I have rescheduled my medically necessary endodontic retreatment appointment from January 4th to January16th 2pm at Philadelphia Dental School. I have no means of transportation, no dental approvals as they are playing games, taking their time or just ignorant and I am in pain
Judge Stockbower did not give me time to go through my files to respond to this allegation that Philadelphia is not within the community boundaries. She stated she had another hearing and she’ll look up applicable codes, which I did not appreciate. I was not told what I did wrong till a few minutes before the hearing, I was not given adequate time to prepare a defense, I was not allowed to look through my files for legal documents to refute the allegations and by the judge not giving me a few minutes under the circumstances I was not allowed to represent myself because she claimed she had another hearing and would look the laws up herself. I do not believe I was even given the 2 hours my hearing was scheduled for! I’ll have to refer to the audio recording I was permitted to do to check the time frame. I think it took 1 hour with me not being allowed to search for codes or laws. Mr. Bernhardt falsely claimed there were other dentists that accept MA and do endodontic work within 20 miles of my home. This is an easy mistake to make because DHS Medicaid’s Provider's list is so incredibly flawed listing providers that do NOT accept Medicaid or provide services they’re listed as providing!
After close of hearing, I called the 3 providers Mr. Bernhardt alleged were endodontists within 20 minutes of my home, that could perform the “specialist” work I needed. They all denied such and 2 didn’t even accept MA! They allowed me to audio record them and I played the recording on Mr. Bernhardt’s and on the Bureau of Hearings and Appeals voicemail box.
Judge Stockbower ruled 6 days later partially against me citing a law for “exceptional transportation” which was written for people that had to be transported via plane! THAT’S the law the judge looked up for me in my place? Unbelievable!!! That is not how MATP laws are set up and Mr. Bernhardt is on record stating they transport a handful of people outside of the boundaries on a weekly basis!
So what’s the issue here? Why then, am I being singled out, black balled, or whatever and forced to suffer in pain with infection and no means of transportation to the nearest endodontic and periodontic specialists that accept MA? Why am I being traumatized, harassed, denied transportation, exacerbating my PTSD and LAS, putting my life and health in jeopardy with infections left untreated due to transportation denials that OTHERS get with no problems? Why was I not given time to look through my documents to quote codes, statutes or laws and the judge said she’d do so for me because she had another trial to hear? She didn’t even use the laws I would have used! Why was I forced to go through this sham of a hearing? Why am I, as a LAS victim being forced to deal with incredible fear, panic, terror, sleeplessness, nightmares, mental trauma, fatigue, abuse of having to deal with legal matters I shouldn’t be facing let alone handling on my own putting unbelievable hardship in my personal life that affects me adversely in a myriad of ways which I’ve been documenting?
I had to cancel 2 dental appointments because Mr. Bernhardt, DHS and Medicare all blew off my request for transportation to Akron and Philadelphia for medically necessary dental work. I personally spoke with Mr. Bernhardt after receiving the ruling from Judge Stockbower. I requested transportation to Akron and Philadelphia while this is still under an appeals timeframe. He stated he would ask his supervisor if there was a law stating I could get continued transportation while in appeals process. I called and left a voicemail message as a follow-up, which I audio recorded, asking if he spoke to his supervisor about such a law and reiterated that I needed transportation because I had an appointment coming up and was in pain.
Since I suspected I was going to get the typical Medicaid dicking around by those above Mr. Bernhardt, I reached out to Medicare Gateway Assured for an expedited decision and I felt I got dicked around by them too. I will post documents later. I had to cancel my dental appointments and suffer with pain and infections.
I contacted Ms. Fran Chervenak of PHLP when I got judge Stockbower's order and all she could state was that since I represented myself at this hearing that PHLP could not represent me! Wow!
I asked for her supervisor's name and number. His name is Mr. Laval Miller-WilsonMiller-Wilson and he is the executive director of PHLP, (email@example.com
215-625-3990 ext 106), He seemed like a pretty nice gentleman and I’m hoping he'll help. He claimed on December 28, 2017 that he didn’t think he could help me with this case before my deadline to get an appeal to the Commonwealth filled out and postmarked on January 03, 2018 but that even though I’m representing myself, they might still be able to help later after the January 3, 2018.
Nobody told me that all I had to do was write a very simple informal letter addressed to the Commonwealth Court and ask for an In Forma Pauperis form and simply state I wanted to appeal the decision. I paid $9.50 to rabbittransit to transport me to Camp Hill Library to use their WestLaw program and just broke down in tears, bawling in the bathroom after Nancy from the Commonwealth Court stated I just had to write a note, that’s it. I was so horribly overwhelmed and suffering from Legal Abuse Syndrome (LAS) and other PTSD related symptoms that I broke down in public and had to go to the restroom to compose myself. I also had to pay $3.00 for copies and over $5.00 for postage. Nearly $18.00 on an extremely tight budget.
DHS and MATP employees actions are torturing and traumatizing me while making my personal life a living hell. It is very hard to function in this state and the immense guilt I feel from ignoring my pets and myself is sickening me. I know legally the alienation of a spouse due to legal abuse can be used to be compensated for but I’ve not seen this done for pets so I will phrase the abuse as making ME feel incredibly sick over alienating my pets as I suffer from LAS and am diminished to a nervous wreck that’s not there mentally due to trauma as I should be! I’m sick from guilt over this.
It seems like everything was dragged out purposefully to ruin any joy I could have felt over the Christmas holidays. I would not be surprised if the Commonwealth Court holds a hearing on or around my birthday on February.
I was forced to do all this, as a mentally crippled, from trauma and abuse, individual without any legal representation even though Ms. Chervenak handled my case initially and then claimed she thought I was smart enough to do this on my own. She had no regard to my mental disabilities.
A week before the hearing I recorded a voice mail message I left on Mr. Bernhardt’s machine requesting for any files or information he had. When I didn’t hear from him, I sent the following emails:
***On Nov 7, 2017, at 2:52 PM, EO <firstname.lastname@example.org<mailto:email@example.com>> wrote:
Dear Mr. Bernhardt,
To date I have not received any files or information as to what I allegedly did to warrant the denial for MATP transportation as required by law. You only posted the laws but not what I allegedly did on the denial form. I appealed stating the denial didn't state what I allegedly did which is required by law.
I received a hearing date in regard to my appeal which is scheduled this Monday November 13, 2017. According to the law for such a hearing I should have gotten copies of files that you plan on using as evidence at the hearing and names of witnesses should you be using any. I also have a right to request for such. I had asked for Maralice to inform you that I'm requesting such yesterday as I've not received anything except a hearing date from the Bureau of Hearings and Appeals. It is 2:50pm and I am now sending the request via email for the aforementioned files and list, should there be any.
Sent from AOL Mobile Mail
From: Michael Bernhardt <firstname.lastname@example.org>
To: EO <email@example.com>
Sent: Tue, Nov 7, 2017 03:26 PM
Subject: Re: Request for Files Eva Ordo
Marilys did let me know that you had called but I am out of the office dealing with a death in the family. I have no additional information or files to share.
Sent from my iPhone
Re: Request for Files Eva Ordo
Tue, Nov 07, 2017 04:08 pm
Thank you and my condolences.
Sent from AOL Mobile Mail
Mr. Bernhardt was to be my go to guy for addressing hearing questions and procedures according to the hearing paperwork. He was not very knowledgeable about the legalities involved in the denial process and therefore not very helpful in the process. He also clearly did not follow legal protocol set in place for such. Again, I believe Mr. Bernhardt has been stuck in the middle of issues his higher ups have with me and something that Perry County Transportation Authority (PCTA) heinously and criminally did against me and now that MATP took over PCTA I am still being abused and mistreated to my detriment by certain individuals that in my opinion are doing this to make my life as miserable as possible so I won’t be able to sue them using Fraud Upon the Court.
DHS's Dental Approval and Denial Department has been exposed by me for doing something I consider to be highly illegal as an insurance company. They are automatically denying claims for dental care, other than teeth extractions, for Categorically Needy Individuals claiming the Legislators and Governor Tom Wolf “made a mistake” when they passed the Categorically Needy Individual’s Dental Laws according to Ms. McNaughton of DHS. I fought this repeatedly and won. I have much documentation on this.
I am being purposefully denied services I’m eligible for. This reminds me of the racketeering charges a law firm accused an insurance company of in the movie The Rainmaker.
Judge Stockbower should have thrown this case out because I stated it violated my civil rights to due process with no key aspects stated as to what I was being accused of, but she refused to repeatedly and I stated I was proceeding under duress.
This is a memorandum from a former MATP higher up official, Mr. Tyrone E. Williams (whom I do not believe is with MATP anymore) sent to staff of MATP which Daphne Simeonoff and Mr. Bernhardt were aware of as I emailed a copy of it to them.
Below is a memo from Mr. Williams advising MATP how to file denials, properly:
Medical Assistance Transportation
Operations Memorandum Systems
MATP OPS # 01/2008-005
Date: January 18, 2008
Subject: Written Notice Form Requirements
To: All Statewide County MATP Program Offices
From: Tyrone E. Williams, Director, Division of Enrollment and Transportation Programs
The Medical Assistance Transportation Program (MATP) is reminding all counties to provide proper documentation on the standard MATP Written Notice form (Written Notice form) when MATP service is denied, terminated or reduced.
Regulations at 55 Pa Code 2070.41(d) governing the written notice of determination or redetermination of need specify that the notice must include the following:
1) A clear statement of the decision and the effective date of that decision.
2) A full statement of the reason for the decision. <----------------NOT DONE!
3) A citation and brief explanation of the regulations used as the basis for the decision.
4) Pertinent information concerning the Appellant’s right to appeal and to request a fair hearing.
This regulation protects the Medical Assistance (MA) Consumer’s right to appeal a decision relating to denying, terminating, or reducing MATP service.
Many counties are failing to appropriately provide key aspects on the Written Notice Form which in most cases results in the Department inappropriately losing fair hearings, increases reconsideration hearings, and denies a MA consumer’s right to due process and appeals relating to MATP service decisions. As stated above, counties must ensure the following:
Regulatory citation - Counties must provide the appropriate cite from 55 Pa. Code, Chapter 2070. In most cases, the citation will come from the provision 55 Pa. Code, Chapter 2070.38. Reductions and terminations based upon professional judgment. It is appropriate that the county references the whole provision with the cite (2070.38) and et. Seq. (which means “and all that follows”- please see attached form). However, counties should review the entire chapter to ensure that they are using the most relevant citation. In addition, counties must reference the specific section in their policies that was previously shared with clients relevant to the decision to deny, reduce, or terminate service.
Effective dates - Counties must provide the appropriate effective date of a reduction or termination of services. The effective date for all reductions or terminations is the 15th calendar day following the date the written notice is mailed or hand-delivered to the client.
Pertinent Information - In addition to informing MA consumers of the process for filing an appeal (which is explained in the MATP brochures), the written form must provide the name and address of the local County legal services office to assist MA consumers when they need to obtain a lawyer to represent them at a hearing. A list of local legal service providers can be found on the MATP website at: http://www.dpw.state.pa.us/PartnersProviders/MedicalAssistance/AdvocatesStakeholders/MATP/.
MATP County Program Offices should review their internal process for preparing and submitting the Written Notice form.
Effective Immediately, the Department is requesting all MATP County program staff begin using the new written notice form and submit a copy of the Written Notice form to their DPW MATP Advisor when filing with the Bureau of Hearing and Appeals for review.
If you have any questions, please contact your county MATP program advisor or MATP Program manager at 717-705-8220.
DHS/MATP clearly did not follow the above procedures required by law and Judge Stockbower disregarded those blatant errors which I made them aware of in appeals documents!
After the Adjudication and court order ruling against me, I filed an Application for Reconsideration on December 19, 2017. I’ve transcribed it as my usually beautiful penmanship was a mess from the trauma, abuse and stress I’m being subjected to.
Application for Reconsideration
1. Did the Bureau of Hearings and Appeals' (BHA) decision correctly apply state and federal policy, regulations and law?
a. Identity, to the best of your ability, the policy, regulation or law and explain how BHA applied it in error.
I appealed the denial of transportation by DHS/MATP under the grounds it violated Pa code 2070.41 (b) as no clear statement was presented or key aspects for me to be able to use to defend myself. Only statutes were sent.
b. To the best of your ability, give the specific policy, regulation or law that you think should be applied and explain why it should be applied.
2070.41 (b) my civil rights to due process were violated. Judge Stockbower held an impromptu discussion before hearing. I was then made aware of what I was accused of. This gave me NO TIME to research laws.
c. If you cannot identify a policy, regulation or law, you may still be granted reconsideration. Provide in detail why you believe BHA was in error.
I am providing a link to a page that has a copy of an email from Mr. Bernhardt stating he had nothing further to add to the denial prior to the hearing. I could not defend myself w/out knowing the charges I was being accused of.
2. Were important facts and/or materials submitted before the fair hearing that were not used by BHA?
N/A civil rights were violated.
If “Yes”, what were the facts, materials and explain why they were important or how they were overlooked?
I am a “categorically needy individual” and the closest endodontist specialist or etc. isn’t nearby. I use Medicare for closer trips. I am not asking for plane trips etc. Others are given trips to specialists. This is not an extraordinary trip!!! Thank you.
Please correct the address on file.
I forgot to include the website URL on the form but I wrote it on the back of the envelope with a note.
Click on the center blue Link on that page.
Exhibit B: Emails from Dr. Eby’s office to, Mr. Bernhardt and to Gateway Medicare;
From: Jeffrey R. Eby, DMD <firstname.lastname@example.org>
To: mbernhardt <email@example.com>
Sent: Tue, Dec 19, 2017 01:30 PM
Subject: E Ordo Apt 12/21
Dear Mr. Bernhardt,
Eva Ordo is scheduled for an appointment in our office on Thursday, December 21st at 2:00pm. We had previously placed a crown on tooth #30 for Eva and she is still having pain and issues with this tooth, therefore it needs to be re-evaluated. We would like to rule out any new infection with the tooth. We have not been billing Medicaid for Eva's last few visits as we have just been making adjustments to work we have already done.
If you have any questions, please feel free to contact our office by e-mail or at 717-859-4170.
Jeffrey R. Eby, DMD
240 N. Seventh Street
Akron, PA 17501
On 2017-12-20 10:33, EO wrote:
Hi Sam, Thank you for emailing Mr. Bernhardt but I don't think he's able to cut through Medicaid red tape.
Would you please call Gateway Assured Medicare at 800-685-5209. You'll need to press #2 and then enter the MPI# etc. and request that I be approved for one round trip through their MTM Transportation on December 21st for a 2pm appointment and state that a "SPECIAL EXCEPTION" for one 136 mile round trip is medically necessary because the doctor had previously placed a crown on tooth #30 for Eva and she is still having pain and issues with this tooth, therefore it needs to be re-evaluated. We would like to rule out any new infection with the tooth.
You probably should state that I had called them on 12-11-17 to request an expedited decision for transportation but have not heard back from them and the appointment's tomorrow.
I tremendously appreciate your helping me. I am very depressed and not feeling well because my gum hurts at #30 and #24 needs a root canal at Philadelphia and these insurance companies are playing games. :-/
Please call me as soon as you hear anything. Thank you!
Sent from AOL Mobile Mail
From: Jeffrey R. Eby, DMD <firstname.lastname@example.org>
To: EO <email@example.com>
Sent: Wed, Dec 20, 2017 11:54 AM
Subject: Re: E Ordo Apt 12/21
I called and spoke with Gateway Assured Medicare. They stated that the appeal has been filed as expedited, however it can still take up to 14 days to get a decision on it. I explained how you got a crown done here and are having pain and issues with it. They said that there is nothing that we can do on our end as the provider to speed up the process.
Note: I believe Medicare should have responded within 24-48 hours and they dragged it out and I had to cancel a medically necessary appointment!
Dept of Hearings and Appeals continued to send a Mr. David Hetrick, MATP c.c. of the hearings even though I told them I thought the gentleman was deceased! Who is David Hetrick? Why can I not find him on any MATP Google search?
REQUIREMENTS FOR NOTIFICATION OF
APPLICANTS OR CLIENTS
§ 2070.41. General requirements.
(a) Each applicant or client shall be notified of an eligibility determination or redetermination within 10 calendar days of the date of the decision.
(b) The applicant or client may be notified either orally or in writing of an eligibility determination or redetermination which is favorable to the applicant or client.
(c) Each applicant or client shall be notified by means of a Departmentally approved written notice form of a determination or redetermination of need resulting in a denial, reduction, or termination of service; except that the notification may be made orally if the requested service is either provided or continued without interruption through another funding source or if the client agrees with the termination.
(d) If a written notice is required, providers shall complete in triplicate applicable portions of the written notice form, including:
(1) A clear statement of the decision and the effective date.
(2) A full statement of the reasons for the decision.
(3) A citation and brief explanation of the regulations used as the basis for the decision.
(4) Pertinent information concerning the applicant’s or client’s right to appeal and request a Departmental fair hearing.
(e) Following the preparation of a written notice form, the provider shall:
(1) Promptly mail or hand-deliver the original and one copy to the applicant or client.
(2) Retain the final copy in either the client’s file or in a rejected application file, as appropriate.
(f) A county or prime contractor may require its providers to:
(1) Prepare and submit to the county or prime contractor for approval and mailing all written notices to applicants and clients.
(2) Submit an ‘‘information only’’ copy to the county or prime contractor of written notices prepared by the provider.
(g) If a county or prime contractor receives an appeal from an applicant or client, it shall:
(1) When a client is currently receiving services, continue service to the client if the request for appeal and fair hearing is postmarked within 10 days of the date the notice was mailed or hand delivered to the client.
(2) Forward the client’s applicant’s request for fair hearing to the Department’s Office of Hearing and Appeals within 72 hours of its receipt. I do not believe this was done and Judge Stockbower prevented me from questioning this during the hearing.
Email from Simeonoff denying transportation:
The FBI And Defense Department Are Investigating America's Biggest Psychiatric Hospital Chain
At least three federal agencies are investigating whether the psychiatric hospital giant UHS held patients longer than medically necessary to maximize profits.
Universal Health Services directs its hospitals to hold patients for as many days as their insurer agrees to pay for, regardless of actual medical need. The probe has been ongoing since at least 2013, when the Department of Health and Human Services issued subpoenas to 10 UHS psychiatric hospitals.
On 8-14-17 I filed an appeal to the DHS/MATP denial letter in a timely manner. They should have forwarded my appeal to the Bureau of Hearings and Appeals within 3 days of receipt. I do not believe they did as required by law. Judge Stockbower prevented me from asking when they forwarded the appeal. Please refer to the two images at the top of this page to view August 02, 2017 denial form. Below are the forms that are dated October 23, 2017, which is 82 days after original denial and 70 days after my original appeal. Do they have 30, 60 or 90 days to have sent these documents. Hearing was scheduled for November 13, 2017, 103 days after denial letter was sent on August 2, 2017 & 91 days after I filed the following on August 14, 2017. Was timely due process violated?
Red Link explains how they colluded to get me committed. Blue Link is how they're denying me Medical Transportation allegedly because of Red Link crime their employees committed against me! White Link shows more collusion trying to commit me for 2 years. There's a very distinct crazy pattern 9f abuse going on here & THEIR documents PROVE my statements.
Sorry for the unorganized page. Will polish it up once I have access to a desktop computer. This isn:t how this site & it's contents is intended to look like
MORE LINKS AT BOTTOM OF PAGE!
Type your paragraph here.
Type your paragraph here.
Staff Admits Lying to Fill Beds for Cash
“Current and former employees from at least 10 UHS hospitals in nine states said they were under pressure to fill beds by almost any method — which sometimes meant exaggerating people’s symptoms or twisting their words to make them seem suicidal — and to hold them until their insurance payments ran out.
This is my response to the form in which DHS MATP & Rabbittransit are claiming incomprehensible reasons for denial of Shared Ride or Paratransit:
I want a hearing because PA Code 2070.41 (d) was violated. No clear statements of key aspects was presented. My right to due process was violated. False claim I had until the 17th to appeal to continue to receive service which I already received. I had just learned I had 10 days. I hope the postmark of 8 -14-17 will be valid as I have been misled and the 13th was a Sunday. I did not do anything I am vaguely being accused of. I am still waiting for Hbg. Mid Penn legal services to return my call. This form erroneously provided a York County legal aid that can’t represent me instead of a local legal aid.
I only received one copy and no original.
I have a dental appointment in Akron PA to complete dental work already started. I need Transportation on 8-23-17 for a 2:30 p.m. appointment 55 miles away.
c.c. Bureau of Hearings and Appeals, Michael Bernhardt, Governor Tom Wolf, Attorney General Medicaid Fraud, CCHR, Daphne Simeonoff
As a side note, this denial letter was not mailed to a valid mailing address. Mailing address is on the application. Mailing address was not updated even after I left a VM message to Mr. Bernhardt to correct it as of August 24, 2017. Appeal was directed to be sent to York MATP Dba Rabbittransit and not to the Bureau of Appeals in Hbg, Pa which I thought was odd so I sent a copy to them as well.
Next, I spoke with a Ms. Fran Chervenak of Pennsylvania Health Law Project who then spoke on my behalf with Mr. Bernhardt who told her different stories than what he told me earlier. He then told her he was having difficulty finding a driver or contractor. I called Rabbittransit's Transportation Status Dept. (after I got Ms. Chervenak’s email) and was told I was not in the computer system as requiring transport. Lot's of conflicting stories!
I then get notification that I will be transported. I called DHS to report these shenanigans and was told I’d get a call from Daphne Simeonoff's Supervisor but instead I got a very dismissive letter telling me they’re still trying to get transportation and after this I will have to use my car and apply for mileage reimbursement.
I WANT TO MAKE IT VERY CLEAR THAT I AM BEING DENIED SERVICES IM ENTITLED TO BECAUSE OF A CORRUPT/ILLEGAL ACT THAT PCTA SUPERVISOROR DID TO ME IN 2014 (THERE’S NO STATUTE OF LIMITATIONS FOR FRAUD UPON THE COURT) SIMEONOFF & BERNHARDT HAVE BEEN TOLD NUMEROUS TIMES THAT MY VEHICLE IS NOT IN ANY CONDITION TO DRIVE 2 MILES LET ALONE 30-60 MILES! PLEASE WATCH THE VIDEO OF HOW MY VEHICLE DROVE COMING HOME FROM THE LOCAL POST OFFICE WHICH I WAS FORCED TO DRIVE TO, TO DROP OFF THE APPEAL SO I CAN GET MEDICAL TRANSPORTATION AS THESE ABUSIVE, EMPLOYEES TORMENT ME MENTALLY BY PLAYING PYSCHOLOGICALLY ABUSIVE GAMES BY DENYING ME TRANSPORTATION FOR FRAUDULENT REASONS WHICH THEY ARE AWARE OF BUT PERPETUATE TO KEEP THE FOLLOWING CRIME COVERED UP WHICH MAKES THEM JUST AS CULPABLE AS OTHERS INVOLVED IN THE CRIME AND COVER-UP.
Corruption in State Funded Psychiatric Facilities: “Lock them in. Bill their insurer. Kick them out. How scores of employees and patients say America’s largest psychiatric chain turns patients into profits.”
Substantial Settlements with UHS Federal and state officials have intervened in a number of those cases and reached substantial settlements with UHS
From: Simeonoff, Daphne <firstname.lastname@example.org>
To: EO <email@example.com>; Michael Bernhardt <firstname.lastname@example.org>; FChervenak <FChervenak@phlp.org>
Cc: Cvetan, Michael <email@example.com>; Slabonik, Erin <firstname.lastname@example.org>
Sent: Mon, Aug 21, 2017 03:58 PM
Subject: RE: Eva Ordo
I have had communication with Michael Bernhardt at Rabbit Transit. He is looking for a contractor to transport you to your appointment on August 23rd. He will contact you if and when he can schedule a contractor to take you.
I do not work for Rabbit Transit, by the way-I am the DHS MATP state liaison and Program Monitor for Rabbit and I do not supervise Michael Bernhardt. Our office oversees the MATP contract for those counties.
Rabbit Transit provides MATP services and administers the program under the guidelines set by the PA State Code and MATP Standards and Guidelines so they have the option to determine service mode for individual riders within their service area. They are required to get consumers to and from qualified MA-enrolled
providers of their choice who are generally available and used by other members of the community or locality in which the consumer is located.
Despite the fact that your dental provider is outside of your home community, Rabbit Transit will attempt to transport you to this one last appointment with Dr. Eby for the follow-up you need. Since there are general dentists within your home community who accept Medical Assistance, Rabbit Transit will not be able to transport you to Dr. Eby’s office again because his office is not within their usual service area. Since Medical Assistance contracts with providers who provide the same dental treatment that Dr. Eby provides within a closer distance to your home, Rabbit Transit will reimburse you for travel to a dentist within your home community for future dental treatment. An MATP grantee such as Rabbit Transit, on a case-by-case basis, reviews an individual consumer’s situation, and may only authorize the least costly and most appropriate mode of transportation that will meet that individual consumer’s current level of mobility and functional independence. Since you do have a vehicle and have been utilizing mileage reimbursement, this continues to be available to you.
MATP only provides transportation or mileage reimbursement to medical services which are covered by Medical Assistance so we would not be able to assist you to get to the grocery store. MATP can provide transportation to covered pharmacies.
Please feel free to contact me with any questions. My hours are 8:00 am -4:00 pm and you can leave a message for me at that number as well if I am not available.
Program Monitor-Lehigh, Capital, Central Region
NOTE: This is quite different from what Mr. Bernhardt told Me Chervenak just a few hours earlier!