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.

Blog No. 184 - July 2022 – Dealing With HCF: 23 February 2025

July 2022 was the month I finally bludgeoned HCF into obeying the law.  After reluctantly accepting an order from Chairman Mark Johnson, HCF quickly decided that it had better things to do and made clear it would not pay the hundreds of thousands of dollars it owed Lift.

People dying from cancer did not matter to HCF CEO Sheena Jack.

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Margaret and I, 8th of December 2009.

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Margaret, 8th of December 2009.

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July 2022 – My Final Dealings With HCF

This table summarises my communications with HCF during July 2022. 

Communication	Length	Sent	Response Date	Response Length	Response Sad
Letter to Mark Johnson 8 July 2023	13 pages	Email to mark@markgmjohnson.com at 5:28 pm 8 July 2022	Email 3.36 pm 9 July 2023	1 line	Acknowledgment of receipt of my letter
Letter from Mark Johnson 29 July 2022	1 page	Email from Mjohnson@hcf.com.au 10.29 am on 1 August 2022	I did not bother to reply	Zero

Letter to HCF Dated 8 July 2022

My final HCF letter was dated 8 July 2022.  By then, I had only contempt for HCF.  This is the start of my final letter; I am breaking it into small bits.  

I sent this to Mark Johnson on the same day that I sent my useless letters to the Federal Ministers.  HCF had decided yet again to defecate all over Lift.

Re: Repeated False and Misleading Conduct and Probable Cartel Behaviour by HCF and Other Private Health Insurance Funds Introduction I have consciously refrained from responding to your letter dated 13 May 2022 even though that letter maintained the legally ridiculous assertion that HCF had acted within the law in refusing to process claims received for services provided to cancer patients by Lift Cancer Care Services.  I refrained because I detected a hint in your letter (paragraph 5) that you and the Board of HCF might have directed the senior executives of HCF to comply with the law in future.  I felt it appropriate to wait and see what happened.  If HCF made good its refusal to comply with its legal duties, I was prepared to consider letting the matter be. HCF’S Agreement to Obey the Law Apart from the hint given in your letter, I received an email from Lynette Macks of HCF on 12 May 2022 listing a number of claims lodged with HCF for LCCS services which had been paid on a “discretionary basis”.  Subsequent to 12 May 2022, a number of other claims were paid by HCF on a “discretionary basis”. For the sake of making sure there can be no mistake about the legal status of these “discretionary” payments, I point out that the making of “discretionary payments” does not provide HCF with any legal basis for claiming that it has complied with its legal obligations.  If HCF decides to give me money that it says I have no legal right to receive, that is a bonus for me.  It does not discharge any of HCF’s legal obligations to pay me any money.  I was prepared to overlook this “legal technicality” if HCF simply started doing what it should always have been doing – obeying the law of Australia.  Given recent developments, I think I will have to revisit this “legal technicality”. I was also heartened by being advised by Lift Cancer Care Services that by letter dated 1 June 2022, Julie Andrews from HCF made an “offer” to Lift Cancer Care services.  You might be aware that the making of an “offer” has significant legal status.  It is the prelude to making legally enforceable contracts.  If an “offer” is accepted, an enforceable contract is created.   In this letter, HCF “offered” to start complying with the law.  Ms Whiting of Lift Cancer Care Services sought clarification of this “offer” in an email dated 1 June 2022 and Brian Osborne of HCF provided the requested clarification in an email dated 3:29 pm on 1 June 2022.  I quote verbatim the email from Mr Osborne, complete with the red coloured font that he used in his email. “Dear Lauren,  With respect to your queries: 1     Can you please 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? Yes confirming HCF will pay historical claims, excluding where we have paid benefits direct to Members. 2    With respect to Julie’s second dot point (relating to ex gratia payments), I note that to comply with this, we would just need to be informed by HCF on a case by case basis if (HCF) has made an ex gratia payment to a Lift patient in respect of their episode of care at LCCS.  In the absence of such advice from HCF, LCCS would not know that an ex gratia payment had been made to the member.  I am sure that you will see this is just an operational necessity.  Are you able to confirm HCF will be able to provide us with this information? Yes HCF will provide a list of Members where we have paid ex-gratia benefits and any duplicate claims will be declined. Regards Brian” The HCF “offer” to start complying with the law was accepted by Lift Cancer Care Services under cover of an email sent at 5:09 pm on 2 June 2022 by Ms Whiting.  This is a verbatim copy of that email. “Dear Julie, Thank you for your email letter dated 1 June 2022. Lift agrees to the stated conditions under which HCF will make payments for claims made by Lift arising from services provided to HCF members as set out by the Private Health Insurance (Benefit Requirements) Rules (Rules). Lift will continue to provide a Type C certificate signed by the member’s treating practitioner that includes the medical condition or special circumstances that require hospital treatment. Lift will continue to obtain each HCF member’s informed financial consent before charging them with any out-pocket costs. Lift does not waive its rights in relation to past claims, since it understands that such claims will be paid in accordance with the4 terms of the 1 June letter, as confirmed in Brian Osborne’s email sent on 1 June (attached). Lift understands from your letter that HCF intends in future to accept and honour claims submitted by Lift directly to HCF on behalf of the patients of Lift, subject to Lift complying with the above.  Please confirm that this is the intention of HCF. Regards Lauren Whiting CEO Lift Cancer Care Services” This exchange of correspondence that I have just quoted verbatim seemed to confirm that HCF had finally agreed in writing to start obeying the law.  It also confirmed the making of a legally enforceable contract.  I viewed this as a significant, positive development.  It appeared to me that probably under orders from yourself and the other Directors of HCF, HCF was finally about to abandon its former complete disregard for the law – at least in relation to Lift Cancer Care Services..

Blog No. 183 - Bonnie Pederson, Chief Assistant to Senator Farrell: 22 February 2025

Like her boss, Minister for Trade and Tourism Don Farrell, and Farrell’s colleagues Minister for Health, Mark Butler, Australian Treasurer Jim Chalmers and my local MP Steve Georganas, Bonnie Pederson, the senior assistant to Minister Don Farrell, was completely uninterested in helping me to force the health insurers obey the law.

People dying from cancer did not matter to Bonnie Pederson.

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Signing the paperwork at our wedding on the 30th of July 2009.

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Anne Ryan had an affair with my friend Nes Fernandez and persuaded him to cancel me when Margaret was dying.  This is Anne Ryan with Nes Fernandez on the 13th of December 2010

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Email to Bonnie Pederson 9 July 2022

After writing personal letters to Treasurer Jim Chalmers, Foreign Affairs Minister Penny Wong, Minister for Trade and Tourism Don Farrell and my local Member of Parliament Steve Georganas, I wanted to ensure that my letters were in fact delivered.  Because I had spoken to Bonnie Pederson in Farrell’s office, I sent an email to Pederson asking her to ensure my letters got delivered.  This Table summarises my attempts to communicate with Bonnie Pederson.  I have never heard anything at all – ever – from Bonnie Pederson.

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Communication	Length	Sent	Response Date	Response Length	Response Said
Email to Bonnie Pederson 9 July 2022	2 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero
Letter to Don Farrell 8 July 2022	7 pages	Email sent to dfarrell@aph.gov.au at 4.57 pm on Friday 8 July 2022	No reply	Zero	Zero
Letter to Jim Chalmers 8 July 2022	7 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero
Letter to Penny Wong 8 July 2022	8 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero
Letter to Steve Georganas 8 July 2022	6 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero
Letter 7 July 2022 to Mark Johnson, Chairman of HCF	13 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero
“How the Health Insurance Funds’ Scams Work”	5 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero
Copy of letter 7 July 2022 to Mark Johnson, HCF Chairman	13 pages	Email sent to bonnie.pederson@aph.gov.au at 11.07 am on Saturday 9 July 2022	No reply	Zero	Zero

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My email to Pederson was a personal one.  She had been sympathetic and had promised to help.

Dear Bonnie, …  Things have moved on somewhat since our discussion.  On 11 April 2022 I wrote personal letters to every Director of HCF, NIB and Teachers Health Fund.  In those letters, I gave them details of the workings of the scams that were being perpetrated by the companies of which they are Directors.  I pointed out that because I had now told them in detail what their companies were doing, they carry personal liability for the criminal activities of the companies they are Directors of.  About one week before I sent the letters to the Teachers health Fund Directors, Teachers Health finally decided to obey the law and paid to Lift Cancer Care Services, all of the money that it had refused to pay over the previous four years,  In early June 2022, prompted I am sure by my correspondence to Mark Johnson, Chairman of HCF, HCF in writing told Lift Cancer Care Services that it would pay claims in future and that it would pay the arrears that it should have paid over the previous 4 years.  HCF paid us the money that was owing as a “Discretionary payment”. Sometime in April 2022, the ACCC advised me that it had opened a preliminary investigation file in relation to HCF.  The ACCC conducted a 1 hour telephone interview with me and Margaret on 2 May 2022. At that point, it looked as though my persistence had paid off and that the funds would finally obey the law at least in relation to Lift Cancer Care Services.  They did not and will not obey the law in relation to other health services providers (multiple I think) that they continue to treat in a similar fashion to Lift Cancer Care Services. Unfortunately, my optimism about HCF has now evaporated.  HCF has backtracked on its promise to backpay Lift Cancer Care Services. …  Yesterday 8 July 2022 I wrote personal letters to the new Ministers for Health, Treasury, Trade and Tourism and to my local MP Mr Steve Georganas.  I enclosed with my letters, a copy of a letter that I sent on 8 July 2022 to HCF Chairman Mark Johnson.  In my letters to the Ministers, I asked them to do their best to respectively enforce the law (Mr Butler) and encourage the ACCC (everyone else including Mr Butler) to widen its investigation into the health funds. I sent my letters to the recipients at their @aph.gov.au email addresses.  I am aware that these email addresses are not the most direct route to contacting the intended letter recipients.  I presume that as a staff member of Minister Don Farrell, you have access to more direct ways of communicating with the intended recipients. I am therefore attaching to this email, copies of all the letters that I sent out yesterday, plus an attachment to those letters.  For each Parliamentary addressee, my intention is that they receive (1) my personal letter to them (2) copy of the document setting out how the health fund scams work (3) copy of my letter to Mr Mark Johnson, Chairman of HCF. Will you please use your official position as a staff member to Don Farrell to ensure that the intended recipients receive their letters and attachments as soon as possible. …  … My thinking has also developed somewhat.  Because this vile conduct by the health funds is, I think, endemic and results in the forced closure of many health service providers who have been approved and given provider numbers by the relevant Federal government authorities, this problem is vastly broader than the small sliver of conduct that has encouraged me to act.  I believe a system wide inquiry – perhaps a Royal Commission – should be instituted to uncover the intimate details of the fund behaviour and try and prevent it from turning Australia’s health system into a reflection of the vile “Managed Care” model that operates in the US.  I know we have Medicare, but the funds are doing their utmost to control everything else.  It is vile behaviour.  If it was appropriate to have a Royal Commission into the conduct of trade unions, it is infinitely more appropriate to have a Royal Commission Into the behaviour of the private health insurance funds.  My document headed How the Scam Works provides some insight into how the funds have got away with what they have been doing. Kind Regards   John Hankin