Blog No. 185 - Dealing With HCF in July 2022, Part 2: 24 February 2025

Part 2 of my 8 July 2022 letter to Mark Johnson, Chairman of HCF.

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Margaret on the 17th of  March 2015 in Tasmania.

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Another photo of Margaret in Tasmania on 17th of  March 2015

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This is Part 2 of my 8 July 2022 letter to Mark Johnson, Chairman of HCF.

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I was annoyed at the complete bastardry of HCF.  Under extreme pressure, it had finally agreed to obey the law.  Then it decided it did not have to obey the law after all.  I knew by this stage, HCF was run by a bunch of complete s**theads.

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If you and the other Directors of HCF did in fact order the paid executives of HCF to start obeying the law in relation to Lift Cancer Care Services, I must now tell you that your paid executive staff have decided to ignore the orders given to them by the Board.  I am prepared to assume that – under duress – the HCF Board has ordered relevant HCF employees to obey the law in relation to Lift Cancer Care Services.  Unfortunately, although the Directors might wish to obey the law, the paid executive staff of HCF have decided to continue to ignore law and the Board direction.  If they are doing this with the blessings of the Board, all Board members carry legal liability for this action – and will of course pay the appropriate legal price.  If the paid executives are ignoring the law without the knowledge of the Board, then the Board should promptly dismiss all of those concerned. On 24 June 2022, Lift Cancer Care Services advised HCF in writing that it had received payments for outstanding claims for the period September 2021 and November 2021.  Lift Cancer Care Services asked what had happened to the payments for all of the other claims – claims which to the knowledge of HCF date back to 2018. HCF Reverts to Standard Operational Model – Treating “Banned” Health Providers And the Law with Contempt It is from this point that the inherent tendency of HCF to ignore the law and treat with complete contempt, health providers that it has decided to place on its “Banned List”, once again began dominating the HCF dealings with Lift Cancer Care Services.  On the assumption that you and the Board may not know what has been, this is what happened. Later on 24 June 2022, Andrea Caton sent this email to Lift Cancer Care Services. “Dear Ms Whiting HCF do not hold any records related to rejected claims, to facilitate payment LIFT must re-submit claims in paper form by post to the address below. Regards Andrea” On 27 June 2022, Lift Cancer Care Services sent this email to HCF. “Hi Andrea, To avoid any confusion, I would like to confirm that Lift Cancer Care services records currently show that over 630 claims which have been submitted to HCF remain outstanding.  Attached is a spreadsheet with the details of the outstanding claims. These claims are for episodes of care provided between 2018 and 20121.  Lift has not received rejection form HCF for any of these claims. In email communication from Brian Osborne on June 1st 2022, it was confirmed that all claims dating back to 2018 would be paid by HCF. Can you please confirm when these claims will be processed? Regards Lauren” On 27 June 2022, HCF sent this email to Lift Cancer Care Services. “Dear Ms Whiting As explained in my previous emails and correspondence, please note: HCF is willing to pay for care provided by Lift since 2018 HCF rejected claims submitted by Lift during the dispute timeline HCF paid all claims recorded on our claims system, as per remittances received by LIFT last week. If LIFT would like HCF to pay any benefits related to services provided between 2018 and 2021 LIFT must submit a paper claim to the address provided; If LIFT has previously submitted a claim for services rendered between 2018 and 2021 the only way for HCF to pay a benefit is for LIFT to submit a paper claim. From the date of settlement LIFT can submit claims via ECLIPSE Regards Andrea” The underlining is copied from the original HCF email. So here we go again.  HCF is reverting back to type – open bastardry and overt law breaking.  For the record, here are some matters that you should give serious consideration to. The correspondence between HCF and Lift Cancer Care Services makes clear that HCF entered into a contractual agreement which sits on top of its obligations imposed by the health insurance legislation.  Under that contractual agreement, HCF was specifically asked to “confirm HCF will be paying all historical claims lodged by Lift Cancer Care Services (LCCS), dating back to 2018 on the basis of the documentation already provided by LCCS for each of these claims?”  HCF replied saying “Yes confirming HCF will pay historical claims, excluding where we have paid benefits direct to Members.” Contrary to its express written agreement, HCF is now refusing to pay the past claims unless Lift Cancer Care Services resubmits all of the paperwork that HCF already has. Not only is HCF trying to walk away from its obligations imposed under both contract law and health insurance law, it is inventing an additional requirement for all resubmitted claims to be lodged by mail and not electronically. In order to maintain its ludicrous claims that it has not breached the law, HCF has in all previous correspondence – including correspondence to the Commonwealth Ombudsman – that it has NOT rejected claims.  It has claimed an inability to process the claims because of “inadequate” information provided by Lift Cancer Care Services.  It has done this because the law does not provide HCF with any legal basis at all to reject the claims.  HCF’s way to try and get around this awkward legal problem has been to claim that it has NOT broken the law because it has not rejected the claims. Now, because senior executives of HCF – almost certainly including HCF CEO Ms Sheena Jack – feel resentment that they have (apparently) been ordered by the Board to obey the law, but presumably only in relation to Lift Cancer Care Services – HCF has decided to try and “walk around” the orders of the Board.  They will obey Board orders, but do so in such a way that they impose as much punishment as possible on the victim of their lawbreaking – Lift Cancer Care Services. In my letters to you, I itemised details of the scam that HCF has been working.  I pointed out that the scam involves falsification of member claims history records by ensuring that claims for services provided by Lift Cancer Care Services – and presumably by many, many more health providers who are on the HCF “Banned List” - never appear on the member claims history.  It is apparent that HCF is now attempting to use its criminal conduct in falsifying the member claims history records as a means of punishing Lift Cancer Care Services.  Of course, the falsification of the claims history records has been done by HCF so that it can claim to the relevant government agencies that it has not unlawfully rejected any claims.  The argument attempted by HCF here seems to be – “We didn’t unlawfully reject the claim.  Look at the claims history record, no claims was ever made.”  In its latest dealings with Lift Cancer Care Services, HCF is trying to build on and take advantage of its criminal conduct in falsifying the claims history record by saying “The lack of a claims history record means the claims were rejected and supposedly HCF never keeps paper work related to rejected claims”.

Will continue in Blog No. 186.