Nine days later, I wake up to the realization that neither Greg Allen nor Notchaca has followed up, so I call Notchaca. She tells me that she called Heidi at DOH and Heidi said she would take care of it; she would mail me the authorizing document. Well, she didn’t, I say, and then get Heidi’s phone number. I call Heidi, identify myself, and she immediately puts me on hold. Shortly thereafter Tim picks up the call.
Tim Perry-Coon is the Medicaid transportation specialist for Central New York in the NYS Department of Health. We have had many occasions to exchange words in the past decade. Not one of them has been satisfactory to me. So I tell Tim what the problem is. He asks some clarifying questions, then says “That’s totally inappropriate” and my jaw drops. Will wonders never cease? So Tim and I decide that he will email a notification to Wayne Freeman that he’s to stop doing this, and I will get a copy of the email.
From: Timothy J. Perry-Coon [mailto:firstname.lastname@example.org]
Sent: Thursday, November 17, 2011 11:57 AM
To: Wayne Freeman
Cc: Anne Woodlen
Subject: Policy and Procedure Regarding Inquiry of Purpose of Travel to a Medical Site
Good morning Wayne,
Anne Woodlen telephoned me and asked about the level of questioning a Medical Answering Services (MAS) call taker can ask, without violating an enrollee’s health care confidentiality. While it is understood that MAS staff are bound by HIPAA confidentiality, you indicated that the call taker should have expected only the destination of the trip when speaking with Ms. Woodlen, in order to verify that the destination was a medical health care site. The follow-up question as to the reason Ms. Woodlen was going to this medical site was inappropriate and the call taker has since been re-trained.
Please continue to educate your call representatives about this circumstance. Additionally, please ensure that the call is immediately referred to an available supervisor when a caller is hesitant about responding to the various DOH-approved questions asked during the trip reservation process.
MAS dispatches rides for nearly two hundred thousand poor people in New York State, and MAS employees have regularly and consistently degraded every one of those people by forcing them reveal private information in order to get transportation. The primary question here is does a poor American have to accept humiliation that is not applied to any other American? Does poverty eliminate an American’s right to being treated with respect? Does the fact that you, the taxpayer, are giving me money also give you the right to demean me? My self-respect is not for sale. You do not get to drug-screen Welfare recipients just because you are giving them money. How about we drug-screen everybody who applies for a driver’s license?
Wayne Freeman is a private businessman who has a contract with Onondaga County. The NYS Dept. of Health has official guidelines about what can and cannot be asked of a Medicaid recipient. Freeman created new policy. There is no indication that he ever informed the county or the state that he was doing so. So the first problem here is that Onondaga County contracted with a guy who doesn’t do right. They did it knowingly; they gave a no-bid contract to a couple of ambulance drivers, Freeman being one of them.
The second problem is that there has never been any complaint process. Medicaid Answering Services would do whatever Freeman, a known deviant from proper behavior, decided to do. [In re known deviancy: the NYS Office of the Medicaid Inspector General fined Freeman $80,000 and forced him to sign a Corporate Integrity Agreement. Thereafter, Onondaga County continued his contract.] Freeman was under no supervision and there was no complaint process for the two hundred thousand clients Freeman was supposed to be serving. If a Medicaid recipient objected to anything Freeman directed his staff to do, then the recipient couldn’t get to the doctor; it was simple. You keep the lower class in line—your line—by denying them services if they don’t kiss your butt. Butt-kissing is illegal in this country (see also: Penn State).
The Inspector General’s actions changed that—but nobody has told the two hundred thousand. No notification has gone out to Medicaid recipients about their right to file a complaint, and how to do it. MAS call-takers are supposed to be trained in how to take a complaint. They aren’t. Under the Corporate Integrity Agreement, MAS had to hire an Independent Review Organization that could monitor their complaints. The Inspector General’s Office won’t give out the identity or contact information for the Independent Review Organization.
Keep in mind that when I complained to the supervisor at MAS about the question being asked, she told me it was a DOH regulation. She lied to me! It is totally and completely wrong to have to file a complaint with the agency against which you are complaining. The only way you can keep a government agency—or subcontractor—honest is by having access to someone outside said agency.
The only way government can work is if “the people” have open access to oversight agencies. There has to be a feedback loop. The government has effectively separated itself from the people. This is one of the ways they do it. In 2011, the government of the United States of America is not of the people, by the people and for the people. Those people who are employed by the government do not see themselves as “the people”; they see themselves as “the government.” They understand that to mean they have unchecked authority to abuse the people who have business with the government.
Government administrators must institute feedback loops whereby citizens are supported in filing complaints against government employees. Failure to do so will result, ultimately, in “the people” overthrowing the government. [See also: Occupy Everywhere.]
I still believe it is my government and I will not tolerate abuse.