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    Friday, February 27, 2009

    Dr Shelton NOT GUILTY - IL Attorney General Corrupt, Judicial Corruption, Denial Mental Health Care to Persons on Medicaid

    Linda Lorincz Shelton, Ph.D, M.D.
    STOP ILLINOIS CORRUPTION
    Founder and Director
    picepil@aol.com

    February 27, 2009
    Special Agent Robert Grant
    Director Chicago – FBI
    2111 West Roosevelt Road
    Chicago, IL 60608-1128

    Dear Dir. Grant:

    I am writing to further inform you about the dysfunctional status and unconstitutional conduct of the Illinois Medicaid Fraud Control Unit, as well as to inform you about the facts pertaining to evidence I have of a crime of Medicaid Fraud including violation of 18 U.S.C. 371 mail fraud, 18 U.S.C. 1341 filing false claims, and 18 U.S.C. 287 fraudulent claims, a violation of 18 U.S.C. 1347 health care fraud. I strongly suggest that your office take over all Medicaid fraud prosecutions and investigations being done by the IL MFCU and the IL Attorney General immediately, as well as review the wrongful convictions of Dr. Maisha Hamilton Bennett and Naomi Jennings by these incompetent corrupt officials.

    As you know, I was under indictment for the falsely alleged state crime of Medicaid vendor fraud. Please be informed that I was found NOT GUILTY by a jury. After unconstitutional rulings by Circuit Court of Cook Co Judge Alonso that fixed my trial and made wrongful conviction certain unless there was jury nullification I didn't show up for my State trial on Medicaid vendor fraud for which I am innocent. The jury made a finding of NOT GUILTY and Judge Alonso quashed the warrant for arrest on the basis of jumping bail and disobeying his orders because he said "what's the point." Your office has engaged in defamation against me including claiming that I have a mental health problem and that I am psychotic about corrupt officials being after me. Maybe you should change your tune and take me more seriously as if you don’t eventually your incompetence will be revealed and much evidence I and others have will have been ignored.

    Now why don't you read what I sent you and get the Cook County State's attorney to arrest Itadel Shalabi and Nareman Taha for perjury [they are the ones who fabricated bills for Medicaid to get payment for patients they didn't see] and indict Louise Moore of Data Medical Works for Medicaid fraud [she bills for her billing services for the last ten years by percentage (8 %) which amounts to fraud as you know] and also for forgery as she forged my name on a power of attorney form, blue cross/blue shield electronic partner trading agreement, and alternate payee agreement so that Moore could put my name as a doctor and my Medicaid provider number on the invoices sent to Medicaid for services not done and encounter forms fabricated by Shalabi and Taha, and then Shalabi and Taha who were partners of Vernon Glass the CEO , could sign checks to themselves when the money came into the business Right Frame of Mind & Associates.

    Why don't you arrest MFCU Inv. Reibel for falsifying his records and take over all Medicaid Fraud investigations in IL before the dysfunctional MFCU mucks up any more? Vernon Glass is innocent too, yet he must also stand trial? I want to talk to you and give you all the evidence which I now have to prove the above. What's wrong with you?

    Read my blog: http://illinoiscorruption.blogspot.com/ for more details, as well as all the documents I have sent you in the past five years or so.

    Why aren't you going after Lisa Madigan and other members of the real cabal of corruption in Illinois? As I told you, only a "Truth Commission" will really bring the light of day to corruption so it can no longer thrive. Why are you and the U.S. Attorney being so sloppy and ignoring your best witnesses such as Vernon Glass, Maisha Hamilton, me [Dr Linda Shelton] and so many others I can refer you too. The cabal has been destroying us as witnesses by falsely accusing us of crimes or defaming us with false accusation of mental illness. You and the U.S. Attorney are puppets of this cabal by your ignorance and actions ignoring us and feeding these false rumors.

    Unbelievably, the jury was a group of well educated individuals who lived primarily in downtown Chicago. They saw through the lies of the prosecutor and the judge's unconstitutional rulings and came back with a verdict of NOT GUILTY. Then the judge gave up, said "what's the point" [of the arrest warrant he issued on 2-18-09 when I refused to come to the trial and disappeared".] He then quashed the arrest warrant.

    So now I am home and I will pursue a suit for malicious prosecution, wrongful arrest, conspiracy to violate rights under color of law and violation of civil rights against the sham prosecutor IL Atty Gen Lisa Madigan who had no legal authority to usurp the powers of the State's Attorney and indict or prosecute anyone. The Constitution and laws in Illinois specify that ONLY the State's Attorney can decide charges, indict and prosecute most crimes. The AG is given authority by law to alone prosecute about 8 crimes such as gambling and environmental crimes. Medicaid vendor fraud is NOT one of them.

    The SA was never involved in this case. Since the IL AG had no jurisdiction, the court had no jurisdiction. Therefore, the prosecutor and the judge lose absolute immunity. Lack of jurisdiction is the only reason they lose immunity. So I have a suit in federal court now against IL AG Madigan, Judge Pantle, Judge Alonso, and the State Police personal at the IL Medicaid Fraud Control Unit. I wish the US Attorney would get involved as the IL MFCU is so sloppy at investigations that they arrest the wrong people, destroy evidence against the real criminals and allow themselves to be used as a weapon against whistle blowers for political benefit.

    I am astonished that you have not interviewed Dr. Maisha Hamilton Bennett, who was wrongfully convicted of Medicaid fraud, Naomi Jennings who was wrongfully convicted, me (Dr Linda Shelton) or Vernon Glass on the issue of wrongfully alleged Medicaid fraud in Illinois and the illegal and unconstitutional actions of the IL MFCU as well as the scheme by IL Government to deny mental health care to patients on Medicaid.

    Denial of mental health care to those on Medicaid violates federal Medicaid law. This is a big economic issue as failure to treat mental health care increases crime, welfare costs, and Medicaid costs. You are contributing to economic failure by failing to properly deal with this issue! This is also an act of felony violation of civil rights and ADA violations by IL Government! Why aren’t you acting?

    As you know, I am always available and ready to talk with you and discuss the evidence I mention above. Why don’t you do your job? Please share this with U.S. Attorney Patrick Fitzgerald.

    Thank you for your time in consideration of this matter.
    Sincerely,

    Linda Lorincz Shelton, Ph.D., M.D.

    Thursday, February 12, 2009

    Judge Jorge Alonso Overturns Federal Medicaid Code - Denies Medicaid Patients Mental Health Care!

    Dr Linda Shelton, who has devoted her life to service of others and particularly to providing medical and mental health services to the poor will be completely destroyed in two weeks with a false conviction for Illinois Medicaid Fraud simply for trying to help people on Medicaid obtain mental health care. Please read the following and help any way possible. I thank anyone who will help me.

    This is a story epitomizing government corruption and greed, retaliation against whistle blowers, and gross government incompetence brought on by decades of fraud, patronage, and nepotism in Illinois.

    Judge Alonso along with Judge Pantle before him have made rulings that are pervasively unconstitutional in denying due process, denying speedy trial, denying defense the ability to present defenses, allowing the alleged prosecutor to withhold key exculpatory evidence, in defiance extensively of U.S. Supreme Court decisions, in defiance of federal and state law for nearly a five year period that I have been deprived of any possibility whatsoever of a fair trial, which by law should not even be held because neither the alleged prosecutor nor the court have jurisdiction to prosecute acts that are legal. They should both be impeached.

    Shelton has appealed to the 7th Circuit Court of Appeals to intervene, but the 7th Circuit does not always follow the law. You can read my appeal to them at: http://www.scribd.com/doc/12284277/SheltonFederal-Motion-for-Certificate-of-Appealability7th-Circuit-Court-of-Appealshabeas2009

    Judge Jorge Alonso ruled on my pending criminal case where Shelton is charged with Medicaid fraud that “substitute billing is illegal”. This is where a doctor sends a bill to the insurance company for services performed by his employee such as the service of a nurse administering a vaccine, removing stiches or counseling a mother how to breast feed, a psychologist administering a psychological test, a drug addiction counselor counseling an addict, or a cast technician applying a cast. In my case the Illinois Attorney General claims that if a doctor bills Medicaid for counseling (for drug addiction, post-traumatic-stress disorder after rape, obsessive-compulsive disorder, depression, dementia, etc.) if the counseling or psychological testing was done by an employee and not directly by the physician then it is a felony crime.

    If substitute, also known as incident to, billing is illegal than ALL doctors in Illinois are guilty of a felony crime of fraud! God Help Us! Judge Alonso is so eager to railroad me and convict me that he is violating his oath of office to uphold the laws of the land and the constitution. Due process, guaranteed by the Bill of Rights REQUIRES that he follow the law. He is BLATANTLY violating the law, either maliciously or ignorantly due to his arrogance, incompetence, bias to run and support the alleged prosecutor AG Lisa Madigan, or his ego.


    Physicians are NOT trained to do psychological testing for personality disorders or mental illness. Psychologists at the master’s and Ph.D level are trained to do so. These tests are invaluable in helping determine the right diagnosis and the right course of treatment. Judge Alonso has ruled that those on Medicaid are not eligible for this type of evaluation and treatment as a result of his illegal and unconstitutional ruling.

    Many non-physicians are licensed in Illinois and all states to provide Psychiatric & Psychological Services:

    1. nurses 225 ILCS 65,
    2. clinical psychologists 225 ILCS 15,
    3. licensed social workers 225 ILCS 20,
    4. licensed clinical professional counselor 225 ILCS 107,
    5. licensed marriage and family therapist 225 ILCS 55 and 68 ILAC 1283

    Judge Alonso’s illegal ruling denies all of these people the RIGHT to practice their profession and denies the citizens of Illinois on Medicaid the Right under the Federal Medicaid Act to access to care equivalent to the care provided in the community.

    Federal Judge Joan Lefkow ruled in August 2004, at the end of a 12 year civil rights class action suit that “Illinois Medicaid Policies and Procedures are in Violation of the Federal Medicaid Code because they Deny Access to Care” to children on Medicaid. This ruling is applicable to all Medicaid patients but the ruling only applies to children. It needs to be expanded to cover all Medicaid patients.

    The Federal Medicaid Code, 42 U.S.C. 1396A(a)(30)(A), [regarding adults and children covered under Medicaid and the EPSDT program] REQUIRES any State Medicaid program funded by the federal government to provide care equivalent to that obtainable from private insurers in the community to Illinois Medicaid clients.

    Therefore, Judge Alonso’s ruling is unconstitutional, unfair, illegal, and amounts to his ruling to overturn the Federal Medicaid Code as well as Illinois Statutes licensing non-physician providers of mental health services. As > 80 % of mental health services are provided by non-physicians this essentially shuts out mental health services to all but a few in Illinois who are poor, because Judge Alonso has declared this service to be illegal.

    The Federal Court and U.S. Attorney should intervene as this is illegal and also a violation of the Americans with Disabilities Act in terms of discrimination. This is a felony civil rights violation called Conspiracy to Violate Civil Rights under Color of Law. It is an impeachable offense as the judge is willfully and blatantly violating the law and the Constitution.

    As to my case, I am charged with billing for mental health services never done and substitute billing for mental health services between June 2000 and April 2002 while "working" at Right Frame of Mind & Associates (RFOM). Over the last six months when I obtained access to the old business records for RFOM I discovered the fact is that the year before I started working for a group practice called RFOM, part-time providing chart review for quality, consultation about medical and psychiatric policies and procedures, and limited patient care, two woman, who were partners with the CEO and without the knowledge of the CEO, in 2000 fabricated hundreds of patient encounter forms (filled out by the provider - a doctors or a therapists as to what patient they saw, the diagnosis, and what service was provided), that are later translated into bills or invoices by the billing agent, for services they never did. These two women, Itadel Shalabi and Nareman Taha never met me as they were fired before I started working there in 2001.

    I had major neurosurgery in July 2000 due to a congenital spinal problem that was crushing my spinal cord and leading progressively towards quadraplegia. I was incapacitated for six months and heavily sedated with narcotics and other drugs for much of that time. I had agreed in early 2000 at the request of the CEO to be one of a dozen or more part-time medical directors to oversee quality of care, screen for medical disorders mimicking psychiatric disorders, help train the counselors to write better notes (many were foreigners with good counseling skills but a little difficulty with English writing), advise the CEO on best medical practices and standard of care, and provide physician services to patients needing medications. I specifically told the CEO I would be unable to participate in the group until after I went through major surgery and a prolonged recover, if I survived and recovered.

    I or my staff while I was in hospital gave the CEO my Medicaid provider number and other necessary documents so that the company's billing agent Louise Moore of Data Medical Works could sign me up with Medicaid as a provider for the group so that they could bill for my services when I began to work, if I recovered, in 2001.

    Ms. Moore I never met at the time was a sweet lady who is ignorant of a lot of things. She held herself out to be a expert at medical billing and she signed a contract with the CEO in early 2000 to set the group up legally to bill Medicaid. Nothing she did was actually proper, but it was not her own fault. She failed to tell the CEO he would be paid more if he had his group certified as a community mental health center. She was totally ignorant of the concept of community mental health centers (or the drug addiction and alcohol treatment centers - another center with its own enabling State Statue). Payment received from Medicaid and the State for the same services would actually have been greater as Community Mental Health Services are paid an additional amount by contracting with agencies in the State such as the Department of Children and Family Services, the Department of Corrections, or other agencies for missed visits, training of employees, etc., that usually are not paid by Medicaid.

    Under the Community Mental Health Service Act mental health groups that become certified bill Medicaid under the Center's name and not under the doctor's, psychologist's or therapist's name. They also contract with the Illinois prisons, and/or DCFS (Illinois Child Welfare) or other agencies to provide comprehensive mental health services. They must have at least one medical director, but the director is an administrator and doesn't have to see patients. Ph.D. psychologists or doctors or licensed mental health providers can supervise non-physician mental health service providers and bills can be sent in to Medicaid under the center's name for all these services.

    Ms. Moore ignorantly thinking (falsely) that her contract allowed her to sign the names of Right Frame of Mind employees on to any form signed my name in August and December 2000, without my or the CEO's knowledge or consent, on a power of attorney form, an alternate payee form, and a blue cross/blue shielf electronic partner trading agreement form, which are all required to allow her to translate the patient encounter form to an electronic invoice and send it over the wire to BC/BS for adjudication, who then sends it to Medicaid, who then pays abut 30-40 cents on the dollar to the Alternate Payee (in this case RFOM).

    Ms. Moore had spoken to the Medicaid Provider Service Unit about how to register the non-physician providers to bill Medicaid. She was told that non-physicians cannot bill Medicaid, was NOT told that a better way to bill was as a community mental health center or how to sign the group up as a community mental health center, and told that all bills (invoices) had to have a doctor's name as the provider.

    Then Ms. Moore, without my or the CEO's knowledge changed the provider name in preparing invoices from Itadel Shalabi's and Nareman Taha's fraudulent patient encounter forms to my name so she could bill under my Medicaid Provider Number. I don't believe that Ms. Moore had ANY knowledge of the fraudulent nature of the Patient Encounter Forms made by these two women.

    Therefore the ghost billing charge is a result of ID Theft, resulting from both fraud by these two women and a comedy of errors by incompetent people advising Ms. Moore in the Medicaid Provider Service Unit, as well as her own blundering ignorance. I am totally innocent having not participated in any way in generating these bills or in receiving or using the money paid for them by Medicaid.

    Ms Moore unfortunately is also guilty of mass fraud in all the work she has done in the past decade or more. It is illegal for an insurance biller to bill Medicaid based on a contract where they are paid by the percentage of funds received form Medicaid by the provider. Ms. Moore charged around 8% of all billings. This is illegal and considered fraud as it ties the billers service, which has nothing to do with the medical care provided, with the doctor's service. Therefore, if she billed for a $100,000 procedure by a heart surgeon she would be paid $8,000 for sending in one bill, while when a family doctor bills $100, she would be paid $8. Providers of services to doctors are NOT ALLOWED to tie their services to the income from the actual medical provider. She MUST BILL ONLY by the piece of work such as $8 per bill. However, she has not been indicted for Medicaid Fraud and has not been sued by RFOM for Fraud in holding herself out to be an expert on billing when she was not.

    The second aspect of the charge is substitute billing. I signed a Power of Attorney Form and Alternate Payee Agreement in August 2001. I was informed by the CEO sometime in late 2001 or early 2002 that the group was told by Ms. Moore that the counselors' and psychologists' services had to be billed under a doctor's name so that bills on patients I had seen, but for dates of service when they were seen by a non-physician were being billed under my name. I had assumed that the billing agent was competent and doing the billing properly. I had assumed that substitute billing for employees services in mental health care was as legal as billing Medicaid for my nurse giving a patient a vaccine. I had no idea at the time that anyone considered substitute billing illegal. I had no knowledge that Ms. Moore had actually sent in tens of thousands of dollars worth of bills under my name before August 1, 2001 based on documents she forged and the fraudulent patient encounter forms from the above two women. Therefore, I told the CEO that was fine. I was not involved in billing or administration of the group except to fill out patient encounter forms when I saw a patient. I had a good faith belief that all was well.

    I had also had an agreement that being part-time the business would limit my patient panel to 200 patients as I did not feel that part-time doctors should supervise the care of any more patients than this number.

    Since Judge Alonso has unconstitutionally and illegally ruled that substitute billing is illegal I will be found guilty and likely sentence to prison for 4-15 years, as well as forever lose my medical license and reputation, along with my livelihood, future, friends, health as medical care is inadequate in prison and I am disabled with several serious medical disorders, and will to live. I have informed the U.S. Attorney, FBI, at the time Senator Obama, Senator Durbin, and now Senator Burris along with a lot of Congressmen and other Senators and State legislators. I am receiving no assistance to solve this problem and restore mental health care in Illinois to those on Medicaid. The public should be outraged, but I do not have time to try to mobilize them.

    In late 2001 Ms. Lovett, Ms. Collins and others from the Office of Inspector General Medicaid contacted the RFOM and claimed that they needed to review some charts as a "standard review of a new practice to help us comply with the rules". We completely complied and Ms. Lovett came out in 2001. She told the CEO the charts were well done and she would give us a report in 90 days. She lied. The CEO was actually very happy about this review because he wanted to make sure that our group practiced with the highest quality and had the best quality charting in the business. They never gave us a report or any feedback and their only response was to initiate a felony prosecution which culminated in the indictment of selectively me (and not one other of the dozen or so medical directors doing the same job - perhaps because only the CEO and I were whistle blowers about Illinois Governement Corruption and mistreatment of children in foster care and on Medicaid by the State) and the CEO.

    After a number of months with NO feedback and strange comments from the Illinois State Police Medicaid Fraud Unit to the CEO (part of the Illinois Attorney General's Office), when the CEO had gone to inform them that he was concerned abut the integrity of our medical records because he had fired Itadel Shalabi and Nareman Taha for other administrative misconduct and inappropriate behavior with patients and they stole a hundred or so medical records (eventually returning parts of them) I began my own investigation of the rules of Medicaid. The State Police have not arrested them yet.

    The CEO, I had learned over about a year was much more naive than I thought about running the business. I had assumed that he was qualified as an administrator and found out he was not. Finding out about the stolen charts and the lack of feedback from the OIG-Medicaid on this "routine review" concerned me. I was also concerned because in April 2002 the CEO told me that Ms. Collins at OIG-Medicaid had informed him to talk to Mr. Brown at Medicaid because there was a problem with the way our group was set up. Mr. Brown told the CEO that RFOM could not be a proper alternate payee under their rules and he apologized for misleading the CEO when the group was originally set up in 2000. He told the CEO that Medicaid could not continue to pay the group unless it was owned by the doctors. The group was the sole proprietorship of the CEO a master's degreed psychologist. The CEO said OK, hired an attorney, and asked several of the doctors to be the officers of the group as it changed to corporate status.

    The corporation was set up so that the doctors would not actually profit from the corporation but were only paid by the hour for their work. The CEO was going to make a profit from managing the corporation. However, no profit was ever made as all the income went to overhead, particularly paying the counselors and doctors their salary and/or hourly rate. The CEO actually put in $100,000 of his own money to meet payroll before he closed the business as no viable financially. My total income from the group was about $5000 over all the time I worked there from 2001 to 2003. I always told the CEO to pay the other employees first and my work was only very limited and part-time.

    Beginning in 2002, I researched the Federal and State Medicaid rules, policies, and laws so that I would be able to meet my fiduciary duty to participate in running the corporation at least from an advisory point of view. I discovered the following and this is why I told the CEO in mid 2002 and maintain this belief, that substitute billing is perfectly legal and actually REQUIRED by the Federal Medicaid Code as well as NOT PROHIBITED by Illiniois Statutes or Illinois Adminstrative Rules:

    Federal and State Medicaid laws are extensive, complex, and immensely confusing. The State of Illinois is misusing them to indict doctors, psychologists, administrators of psychiatric and psychological practices for “Medicaid Fraud” when they are actually following federal law and providing needy services including counseling, drug treatment, suicide prevention, etc. Attorney General Lisa Madigan and Jim Ryan before her have targeted especially those groups run by whistle blowers, in order to falsely claim they are tough on fraud, to prevent Illinois from paying the bill for mental health services for the poor and needy on Medicaid, and reduce the bottom line.

    A claim of “tough on fraud” will help AG Lisa Madigan win election as Governor. Failure to provide mental health care including drug addiction and alcoholism treatment leads to increased crime as drug addicts, alcoholics, and those that are so out of touch and mentally ill find alternatives to legitimate work to feed their habits or survive. Failure to provide adequate mental health care at the front end leads to much higher costs in the long run.

    Code of Federal Regulations 42 CFR 414.34 states:
    “Payment for services and supplies incident to a physician’s service”“(b) Services of non[-]physicians that are incident to a physician’s service. Services of non physicians that are covered as incident to a physician’s service are paid as if the physician had personally furnished the service. "

    Clearly Judge Alonso's statement is FALSE.

    United States Code42 U.S.C. § 1396d(a)(5)(A)
    requires reimbursement for “physicians’ services furnished by a physician.”

    Code of Federal Regulations 42 C.F.R. § 440.50
    The HHS rule implementing the Medicaid Act defines “physician services” to include services provided:“(a) within the scope of practice of medicine or osteopathy as defined by State law; and(b) by or under the personal supervision of an individual licensed under State law to practice medicine or osteopathy.”

    Congress further authorized substitute billing under Medicaid for services furnished:“by, or incident to the services” of another physician. Physicians also routinely bill for services of another physician who is covering for them when they are unavailable.

    Federal Regulation66 Fed. Reg. 55268
    HHS makes clear in its preamble to this rule that it does not restrict the type of auxiliary personnel who may perform a given “incident to” service: “We deliberately used the term any individual so that the physician (or other practitioner), under his or her discretion and license, may use the service of anyone ranging from another physician to a medical assistant.”

    Code of Federal Regulations42 CFR 411.15
    “Particular services exclude from coverage” specifically states that:
    “(m) (3) Exceptions. The following services are not excluded from coverage:…
    •(iii) Nurse practitioner and clinical nurse specialist services……
    •(v) Qualified psychologist services,”

    FEDERAL PREEMPTION SUSTAINED BY FEDERAL 2ND CIRCUIT COURT OF APPEAL
    •A Federal suit for a psychiatrist against the New York Medicaid Program based on its refusal to approve Medicaid was agreed to for reimbursement for services provided by his employees under his supervision. Yapalater v. Bates, 494 F. Supp. 1349 (S.D.N.Y. 1980), aff’d, 644 F.2d 131 (2d Cir. 1981), cert. denied, 455 U.S. 908, 102 S. Ct. 1255 (1982).
    The court determined that the federal Medicaid rule at 42 C.F.R. §440.50 defining “physician services” unquestionably included supervisees other than the physician, just as the same rule must apply here to vacate Plaintiffs’ indictments. Id. at 1363-64.

    State Medicaid must Provide Services 42 U.S.C. 1396a(a)30(A)
    •Federal Code clearly mandates that State Medicaid plans must provide services to recipients of Medicaid and payment to their service providers equivalent to care and services provided to the general population by private insurers
    •Private insurance pays for psychiatric services provided by counselors and psychologists
    •RFOM CEO and other employees, besides the physicians were licensed counselors, nurses, psychological therapist, or social workers, per CEO

    42 U.S.C. 1396a(a)30(A)
    “A State plan for medical assistance must –Provide such methods and procedures relating to the utilization of, and the payment for, care and services available under the plan . . . to assure that payments are ... sufficient to enlist enough providers so that care and services are available under the plan … at least to the extent that such care and services are available to the general population in the geographic area",

    Ambiguous State Laws Must be Interpreted to Conform to Fed Law
    •The Federal 7th Circuit Court of Appeals has also construed ambiguous state regulations to conform to federal Medicaid requirements,
    •an approach worth revisiting here with respect to Sections 140.411 and 140.413 of the Illinois Administrative Code.
    •See Evanston Hosp. v. Hauck 1 F.3d 540 (7th Cir.1993), cert. denied, 510 U.S. 1091 (1994).

    I (SHELTON) CONTINUES HER OWN INVESTIGATION OF BILLING PRACTICES – 2002-2005
    Shelton discovers that Physician Medicaid Manual has inconsistencies, in one place stating bills for employees billed under doctor’s name, and in another place stating that no psychiatric services can be billed for non-physicians, yet in another place stating that non-physicians may provide psychiatric services and Medicaid may be billed. In another section it states that mental health services in hospital by non-physicians should be billed by the hospital or the physician.
    I also discovered the Illinois Community Mental Health Center Code.

    Illinois Administrative Code (IAC)89 IAC 140.12
    “Services Not Covered by Physician”DOES NOT MENTION psychiatric services by non-physicians

    Illinois Administrative Code89 IAC 140.400
    (a)“Payment to Practitioners”“2) A practitioner may bill only for services he or she personally provides or which are provided under his or her direct supervision in his or her office by his or her staff.”

    Illinois Administrative Code89 IAC 140.411
    “Covered Services by Physicians”“The Department shall pay physicians for the provision of services not otherwise excluded which are:. . .c) Provided by the physician or by a member of the physician’s staff under the physician’s direct supervision

    Illinois Administrative Code89 IAC 140.413
    “Limitations on Physician Services”that “limitations” on physician’s services include that psychiatric services will be paid for if they are “. . . provided by a physician . . .” [It does not exclude non-physician services and it is a reasonable inference to conclude the definition of "physician" include the services of non-physician employees, under the doctor's supervision as defined in 89 IAC 140.400 & 411]

    How does this negate previous definition of “physician services” which include incident services by his employees?

    UNCONSTITUTIONAL STATE CLAIM
    State falsely claims use of word “physician” in 89 IAC 140.413 negates definition of“physician services”, which includes incident services by physician’s employees as defined in 89 IAC
    140.400(a), 89 IAC 140.411

    State falsely claims that federal law does not apply and statutory construction rules don’t applyJudge Alonso previously illegally ruled that the Federal Medicaid Code does not apply in this case despite the fact the Illinois Medicaid is a joint federal/state program partially funded by the Federal Medicaid Code!

    IAC TOO VAGUE
    •Criminal Laws are invalid if too vague to understand ("void for vagueness doctrine")
    •Illinois Administrative Code too vague in sections:89 IAC 140.12,89 IAC 140.400,89 IAC 140.411, and89 IAC 140.413Illinois Administrative Code
    •Why should 89 IAC 140.413 have more weight than 89 IAC 140.12?
    •Why should the definitions of physician services in and 140.411 not apply to the term “physician” in 89 IAC 140.413?

    STATUTORY CONSTRUCTION RULES REQUIRE (Regarding interpretation of conflictin State Statutes)Specific Controls over General
    •89 IAC 140.400 & 89 IAC 140.411more specific “physician services” includes non-physician employee services
    •89 IAC 140.413 general word “physician” with no definition of what services this includes cannot by exclusion negate previous more specific definition of services provided by physician

    Federal Law Rules
    42 CFR 414.34
    Services by Physician’s staff are billed as IF the Physician Performed the Services Himself
    If State and Federal Law conflicts, Federal Law RulesDue to the Supremacy Clause of the United States Constitution

    FEDERAL LAW REQUIRES PAYMENT FOR EPSDT SERVICES
    •The Federal Medicaid Code requires that State Medicaid programs pay for periodic mental health screening and treatment of any defects in mental health for children under 21:
    42 USC 1396d “Definitions For purposes of this chapter
    • (r) Early and periodic screening, diagnostic, and treatment services
    ••The term ‘early and periodic screening, diagnostic, and treatment services’ means the following items and services:
    • (1) Screening services –
    • (A) which are provided –
    •(ii) at such other intervals, indicated as medically necessary, to determine the existence of certain physical and mental illnesses or conditions;
    • . . .
    •(5) Such other necessary health care, diagnostic services, treatment, and other measures described in subsection (a) of this section to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not such services are covered under the State plan.”

    STATE LAW REQUIRES PAYMENT FOR EPSDT SERVICES
    •89 IAC 140.485 states:
    •“Healthy Kids Program
    •Program Description–The Healthy Kids Program is the Early and Periodic Screening Diagnostic and Treatment Program [EPSDT] mandated by the Social Security Act (see 42 U.S.C. 1396a(43), 1396d(4)(B)(Supp. 1987)). The goals of the program are to:
    •Improve the health status of Medicaid-eligible children ages birth through 20 years through the provision of preventive medical care and early diagnosis and treatment of conditions threatening the child’s health
    •…
    •8) Treatment. The Department shall pay for necessary medical care (see Section 140.2), diagnostic services [i.e. psychological testing], treatment or other measures medically necessary … to correct or ameliorate defects, physical or mental illnesses….”,
    •The Illinois Public Aid Code [AKA Medicaid Act], 305 ILCS 5/19(f) requires that EPSDT screening and mental health treatment be provided to children in the Medicaid program:
    •“5/19. Healthy Kids Program
    •(f) Covered Medical Services. The Illinois Department shall provide coverage for all necessary health care, diagnostic services, treatment and other measures to correct or ameliorate defects, physical and mental illnesses, and conditions whether discovered by screening services or not for all children eligible for Medical Assistance under Article V of this Code.”

    Dr Shelton was a Medicaid Registered EPSTD Provider

    Therefore ANY REASONABLE person would conclude that the law permits substitute billing for mental health services whether it be another physician covering for the doctor, or a non-physician supervised by the doctor or her colleagues. If you don't agree than the void for vagueness doctrine should clearly negate and prevent any criminal charges for substitute billing.
    God Help Me! I am innocent and destroyed. This is my reward for devoting my life to service particularly of the poor and needy. If you want to help, contact the Illinois Reform Committee and flood them with letters. Contact the U.S. Attorney and FBI and flood them with letters. Contact your legislators and Congressmen and flood them with letters. Come to the trial on February 17, 2009 which will last two weeks and fill the gallery so that the judge knows your opinion. Contact the press. Donate to my legal fund anything possible. I need tens of thousands of dollars. Shelton Legal Fund, C/O Albukerk & Associates, 3025 W. 26th St. 2nd Floor, Chicago, IL 60623. 773 847-2600 He is doing the best he can defending me under the complete lawlessness of the Circuit Court of Cook County.
    Thank you if you help.

    Will Blagojevic Sing?

    IF Blago sings Democrats and Republicans will fall. How do you think his father-in-law Alderman Mell keeps getting re-elected after his district has turned so Republican? Why do you think Blago appointed the King of all corruption, Jim Thompson, as Chief of his transition team when he took office?

    When there's corruption the difference between Republicans and Democrats disappears. They are a cabal of corruption that crosses party lines. Vrdolyak and Burke are the Kingpins of the older generation and Orlando Jones was the Kingpin of the younger generation. When they sing everything will be exposed. Vrdolyak will not sing as he knows how the mob deals with that. After indictment a bullet walked into Jone's head. I don't believe he killed himself. Sooo he won't sing.

    Blago is small potatoes, just a pawn in the chess game, taught by the older generation and doing things the way that EVERY politician in Springfield, Cook County, and Chicago have been doing for decades.

    Corruption will ONLY be vastly reduced when it sees the light of day. When Illinois has a "truth commission" where amnesty is given to those who fully confess, it will be exposed, the fear of retaliation for confessing will disappear, people from all over from the secretaries at IL Secr. of State office and the Cook County Sheriff will confess that they were forced to sell tickets to fund raisers on public time,the Cook County Sheriff's staff will confess to campaigning by polling places on public time, almost every vendor in Illinois will confess to paying a 10% kickback into political funds to keep the machine going including the guy who sells baloney to the prisons, etc.

    Until the fear is reduced which is pervasive in Illinois we can indict thousands of people and they will be replaced by thousands more and corruption will continue. Back room deals, nepotism, kickbacks, patronage, etc will continue until corruption sees the light of day. "Truth Commissions" worked in South Africa and they can work in Illinois. It will be a LOT LESS COSTLY to have a truth commission and move on than to endlessly indict and prosecute literally hundreds of people, which is a drop in the bucket considering the tentacles and spider web of corruption in Illinois.

    I don't believe Blagojevic is a kingpin, but I believe he knows a lot and can take down many if he sings. The risks for singing however are great. Ask Orlando Jones, John Stroger Sr's godson, who carried out the orders for patronage hiring, fraud, and corruption.

    Tuesday, February 10, 2009

    Illinois Appellate Judge Sheila O'Brien Brings Court into Disrepute

    My case is a conviction for aggravated battery of a correctional officer.

    In fact, I had been assaulted and battered by Cook County Department of Corrections Sergeant Anthony Salemi on May 16, 2005. He falsified his records, and he knowingly wrongfully filed a criminal complaint against Plaintiff falsely alleging I attacked him, in retaliation for me complaining about the Cook County Department of Corrections violating my civil rights. (Denying Constitutional and statutory rights to medical care, access to courts, free brief phone call to family and attorney)

    I was in jail for a 30 day sentence for criminal contempt because I told Judge Kathleen Pantle that she was violating the law in the pending fraudulent case involving a fraudulent charge of Medicaid vendor fraud (trial scheduled for February 17, 2009 rm 207 criminal court building 26th and California - all are invited) and had no jurisdiction and then said I was leaving to preserve the issue for appeal and she found me in contempt when I turned around and attempted to leave the courtroom quietly.

    Sgt. Salemi stated that when he entered my cell, after sending away the female unit officer (in violation of rules that male officers may not enter female cells alone except in emergency), I attacked him while in a wheelchair and forcing my way through the door by ramming him with my wheelchair “skinning his shins” and then after this knocked him down and he stood up, “kicking him in the chest with my RIGHT leg.” This is despite the fact that I have a partial right hemiparesis with impairment of my RIGHT leg so that I can not kick it with force above the waist, the wheelchair was broken and difficult to move, I have congenital injury to the spine causing life-long weak arms and shoulders making it difficult to move the wheelchair forcefully, and I was on the sixth day of a dry hunger strike (protesting denial of access to courts and denial of medical care), intensely dehydrated and unable to stand for more than a few moments due to weakness from the dehydration. My physicians gave unrebutted testimony affirming these facts. The state had no expert witnesses or physician witnesses.

    Sgt. Salemi lunged in, grabbed my neck choking me, then flung me out of the wheel chair while pulling the wheelchair from under me causing large contusions to the back and inner thighs (3 X 5 and 4 X 6 inches) as well as bruises on my arm in the form of his fingers, contused knee upon which I landed, and a severely contused toe that got caught in the wheelchair. All of this was documented and the jury ignored it.

    I was wrongfully convicted because of a biased jury. The jury became biased because of extreme Nifong-like prosecutorial misconduct by Assistant States Attorneys Andrew Dalkin and John Maher, and by outrageous denial of due process and abuse of judicial discretion by Judge Joseph Kazmierski, all of which grossly denied me a fair trial.

    I was illegally sentenced to prison instead of probation, in violation of Cunningham v. California, 127 S. Ct. 856 (2007), and the Statutes of the State of Illinois.

    At CCDOC and IDOC I was illegally abused and punished for refusing to walk (IDOC staff falsely claiming I was faking my multiple medical conditions and physical handicap) during the reception process, including a life-threatening assault on me with an ammonia inhalant (purportedly given to prove I was faking a collapse and asthma attack, but which was NOT documented in records at IDOC), but which exacerbated the attack, caused brief unconsciousness and is contraindicated in asthma, as well as denial of medical care. The IDOC staff are attempting to conceal the documents about Plaintiff’s reception events at IDOC in order to cover-up their official misconduct and ADA violations, in refusing to release the reception summary to me.

    The habeas petition contains all the details of the perjured testimony by Sgt. Salemi and other Sheriff officers as well as the proof of my innocence and their falsification of records. My habeas petition contains all pertinent references to the transcripts and record on appeal and all issues on appeal.

    http://www.scribd.com/doc/10325794/Shelton-Federal-Petition-for-Writ-of-Habeas-Corpus-Aggravated-Battery-2009

    The Illinois Appellate Court 1st District has now four times denied my motions to compel the court reporters to prepare a free set of transcripts and file them with the court so that my appeal can move forward. The court reporters have refused this direct order of both the trial court and appellate courts. Judge Sheila O’Brien denied another such motion on 2-5-09. This is unconstitutional and a violation of her oath of office that amounts to felony theft of honest services and conspiracy to violate my civil rights under color of law.

    Judge O’Brien is OBLIGATED by U.S. Supreme Court previous rulings (stare decisis) to ensure that I am NOT prevented from filing transcripts for my appeal. Her rulings denying my motions to compel the court reporters are void as unconstitutional. Failure to enforce her court’s and the trial court's orders is a dereliction of duty and her oath of office that amounts to the federal crime of theft of honest services. It also is a deliberate attempt to impede my appeal which is a Constitutional right. This amounts to the federal felony crime of violation of civil rights under color of law and conspiracy to violate civil rights under color of law.

    Judge O’Brien has brought the court into disrepute because of her incompetent, and/or purposeful, and/or malicious in violation of the Constitution’s mandate that convicted persons have a right to an appeal. She should be impeached.

    Federal Judge Coar agrees with this in general because he has ruled that the actions of the Illinois Appellate Court amount to a State willful waiver of their right to insist that I exhaust state remedies (appeals) before proceeding with a Federal Petition for Writ of Habeas Corpus to overturn this wrongful conviction based on actual innocence, as well as grotesque prosecutorial and judicial misconduct.

    Please consider assisting me with donations to my legal fund and showing up for trial on 2-17-09 on the last charge I am defending. 26th and California in Chicago Criminal Courthouse. The trial will last 5-8 days. Judges tend to follow the law more and make less unconstitutional rulings when they have an audience. That is why I promote the concept of court watchers. Juries tend to have less bias against the Defendant when they see family and others showing the defendant support by filling the gallery.

    Unfortunately my family is small, ill, and distant and no one can come to court. Any support in any fashion in my legal, political, and personal health struggles is appreciated.