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U.S. Health-care Crisis
& ERISA Criminal Enforcement
Are All
Consultants Corrupt? (Fast Company)
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Hearing, Senate Committee on Finance,
3-3-04
View Video
or
Transcript
(PDF)
(KaiserNetwork.org)
[Ann
Combs: "No the results are not good.
It’s a tragedy."]
"In one settled case, the district court judge had to order the
US Attorney’s office to open a criminal investigation,
investigation based on evidence he saw in a private civil case
where there was evidence of money laundering, fraud, health care
fraud, wire fraud, also sorts of RICO violations, a federal
judge had to order the justice department to investigate. That’s
a big problem."
Mila Kofman, Georgetown University
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Health-Care 9/11 Report of 2005
Health-care WMD
by Jin Zhou,
02/05/2005
© 2005,
Jin Zhou,
ERISAclaim.com |
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Unanimous US Supreme Court: |
Employer-Sponsored Health-Care Is
Completely Governed by ERISA laws and rules;
Aetna Health Inc. v. Davila, 06/21/04 |
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Congressional Leaders: |
One
Administration = One Voice = ERISA Self Enforcement only, or
No Enforcement? |
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Health-care Terrorists? |
"ERISA Advantage" bogus
plans,
"unlimited and frequent premium increases, and the potential for
rampant fraud with little, if any, regulatory recourse" in 30
years of ERISA self enforcement. |
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Health-care WMD (Weapons of Mass Destruction) |
"Medical
Inflation, WMD" for
"ERISA Advantage" from
ERISA Failure -
"Failure of Imagination" Again
for US Healthcare:
USA:
$1.9 Trillion, 15.7% of GDP
GM:
$5.6 Billion, $1,500 Per Car
Economists: Federal deficit a bigger risk than terrorism (USA
Today) "The survey, taken
between Feb. 28 and March 8, found U.S. businesses had three nearly
equal concerns about longer-term risks: health care, the aging
population and the federal deficit." |
| USA
2005: |
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Personal Bankruptcy
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GM Chapter 11,
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National healthcare expenditure $$1,9 trillion
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One nation under debt
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GAO Report: Tax
Expenditures Represent a Substantial Federal Commitment and Need to
Be Reexamined (PDF) (U.S. Government Accountability Office)
Abstract Highlights-PDF PDF
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| White
House Rx: |
$1,000
HSA personal responsibility +AHP with
More "ERISA advantage" for
"widespread
plan insolvencies and fraud" and
"A
Prescription For Disaster". |
| 2005 for
Michael Moore? |
"John Q. ERISA
Enforcement"??? |
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Congressional conclusion 2008:
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"Failure of Imagination" Again,
with No One's Responsibility and Accountability. |
Title 29 U.S.C. § 1141 states:
"It shall be unlawful for any
person through the use of fraud, force, violence, or threat of
the use of force or violence, to restrain, coerce, intimidate,
or attempt to restrain, coerce, or intimidate any participant or
beneficiary for the purpose of interfering with or preventing
the exercise of any right to which he is or may become entitled
under the plan, this title, section 3001, or the Welfare and
Pension Plans Disclosure Act. Any person who willfully violates
this section shall be fined $10,000 or imprisoned for not more
than one year, or both. The amount of fine is governed by 18
U.S.C. § 3571. The U.S. Sentencing Guidelines address 29 U.S.C.
§ 1141 under the guidelines for "Fraud and Deceit" (U.S.S.G. §
2F1.1) or for "Extortion by Force or Threat of Injury or Serious
Damage (U.S.S.G. § 2B3.2)......"
"For example, Section 1141
would reach the use of deception directed
at misleading a welfare plan beneficiary as to the amount of
health benefits owed to the beneficiary under the terms of the
plan or at misleading a pension plan participant as to
the amount of retirement benefits to which he would become
entitled under the plan upon his retirement."
ERISA in the United States Code
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"Failure of Imagination" Again?
"John Q.
ERISA
Enforcement"
Release Date: 10/21/2004
"EBSA closed 4,399 civil investigations in
FY 2004. Nearly 70% of those investigations resulted in correction
of violations under the Employee Retirement Income Security Act
(ERISA). Criminal investigations led to
the indictment of 121 individuals. In addition, EBSA received a
record 474 applications to participate in its compliance assistance
program to help employers and plan officials to voluntarily correct
specific violations of the law."
EBSA Achieves Record $3.1 Billion in Fiscal Year 2004
Results •
Press Release
Spitzer's Latest Target (yahoo.businessweek.com)
"New York's Attorney General now has employee-benefits
insurers in his sights. A federal probe could be next
... WASHINGTON, TOO? "We found that favoritism,
secrecy, and conflicts rule this market, and not open
competition," said Spitzer in testimony about the insurance ..."
U.S. Senate Committee on
Governmental Affairs:
"Oversight
Hearing on Insurance Brokerage Practices, Including Potential Conflicts of
Interest and the Adequacy of the Current Regulatory Framework."
Date: 11/16/04
From 03-03-2004 to
05-10-2004 to 09-30-2004
Why Bogus Plans Called "ERISA Advantage"???
Because There is An Advantage of None or Little/Late Enforcement of
ERISA
Man Sentenced
to Prison in Nationwide Health Insurance Scheme (Axcess News)
Excerpt: "In pleading guilty, [John B.] Hyde
admitted that he was president of ISI which operated in Novato
[California]. ISI marketed and sold a health plan known as the ERISA
Employee Health Benefit Plan or the ERISA
Advantage. The health plan was marketed and sold to thousands
of people throughout the country who believed that they were covered
by a legitimate health plan."
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Three people arrested for health insurance fraud
(News-Medical.net,
Tuesday, 11-May-2004)
"Three people were arrested
this morning for allegedly orchestrating a scheme to defraud
the customers of Employers Mutual LLC, a company that
purported to provide health care coverage to more than 20,000
people across the United States, but left more than $30
million in unpaid claims for medical services when it was shut
down."
"Deputy Attorney General
James B. Comey stated: “The Department of Justice is committed
to the prosecution of individuals who operate bogus health
insurance schemes. These schemes victimize the employees,
individuals and families who believed they had health care
coverage but are left uninsured with devastating personal
liability for unpaid medical claims.”
"One of the Department of
Labor's highest priorities is to protect the benefits of
workers and their families,” said Ann L. Combs, Assistant
Secretary of Labor for Employee Benefits Security. “These
corrupt individuals took advantage of the trust that small
businesses and their workers placed in them to provide
health benefits. Today's indictments demonstrate our
commitment to vigorously pursue those who prey on people
seeking affordable health coverage for themselves and their
families and ensure that they are prosecuted to the fullest
extent of the law."
Canyon Lake couple arrested after federal indictment
(North County Times)
U.S. Department of Justice
September
30, 2004
FORMER PRESIDENT OF INTERSTATE SERVICES
INCORPORATED PLEADS GUILTY TO HEALTH CARE FRAUD
"ERISA Advantage"
|
ERISAclaim.com - A $1.0 Trillion Nuclear Solution to U.S. Health-care
Crisis & $44 Trillion Budget Deficits
ERISAclaim.com: 50% Savings - Healthcare Crisis Turnaround for
Employers, Insurers & TPA's
ERISAclaim.com - 950,000 MD's Settled With Aetna & Cigna on ERISA
ERISAclaim.com: ERISA Certification Programs
for Cost-Saving & Reimbursement by Compliance
DOL +
DOJ Enforcement of
ERISA
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& |
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HHS Works with
ERISA (+77 Millions/4 Yrs)
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