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Joseph Crussiah

9701 Cottrell Terrace

Silver Spring, MD 20903
Office of The Honorable Senator Benjamin Cardin
To the attention of Mr. Chris Pumphrey:
I am grateful for the assistance is attempting to resolve the problems. I am in receipt of the
letter from DHMH, forwarded by your office. Unfortunately, DHMH has not resolved any of the
problems. My letters noted several problem areas, but the problem that your office was assisting
with, was that with Medicaid. DHMH is in-charge of much more than Marylands Medicaid
program. As a passing note, I suggested that The Board of Physicians, a division of DHMH also
take look at the conduct of several physicians. My issues that I wanted to resolve has to do with
the Medicaid division of DHMH and with even greater specificity, the division that administers
the Managed Care program. My understanding is that, it is the division named Healthchoice.
DHMH contradicts, itself: DHMH states that I did not make any complaint to The Board of
Physicians [no letters and no call to the patient complaint line], but then DHMH states that I filed
bushels of complaints, all which were investigated.
As my letters stated: the etiology or causation of my current medical condition, is a product
of The Board of Physicians poor policing of physicians in Maryland. Then, even without the
help of government, I was making great strides toward getting good medical care. The
individually, licensed physicians, were malleable to my requests. But then, I became enrolled
into Medicaid. CMS website, by clicking Waivers gives access to the documents that
Maryland submitted to get a Section 1115 Waiver. The Waiver allows Maryland to take away my
federal right of fee-for-service Medicaid and replace it with the Managed Care System.
Fee-for-service is a financing only function for DHMH. The medical care issues I could
resolve with the doctor that I chose. Even if the problems became great, who wants the
aggravation of going through a Board of Physicians, that is hostile to the concept of patient
safety. It is much easier to look for greener pastures. But Medicaid Managed Care, also
includes delivery. Delivery is the medical care itself.
The Medicaid MCO does use doctors and it also seeks to achieve the same outcome in patient
care, equal to fee-for-service. But the doctors are only a part of the team. The delivery is much
different from fee-for-service. The physician assigned as my PCP, has stated that many
physicians dont seek contracts from the Medicaid MCOs, because of this different delivery
method, which these other physicians hold, is contrary to their professional code. PCP is
Primary Care Provider and does not have to be a physician. It could be a nurse practitioner. The
Board of Physicians has a different set of rules for physicians and nurse practitioners. Then on
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top of that you get the whole family and extended family; the state government, its
contractor [the MCO, such as Medstar Family Choice], MSFCs parent organization [Medstar]
physicians of MSFCs choosing [even where the enrollee is allowed to pick from a list, that
really isnt choice and furthermore what news articles and complaints by doctors in other states,
show is that, even the so called, list of choices, in practical effect, many of the providers are not
available]. Then MSFC has employees in Wisconsin that are part of the medical care process.
But these employees cannot even pronounce medical terminology, let alone, understand it.
When problems come, I cannot move on to another physician; because my physician is DHMH,
itself. Things are similar to Veterans Administration health care. In the VA System, patients do
get choices of doctors, but these doctors are controlled by the administration and furthermore, the
patient has to deal with all the additional people, that are not part of the standard AMA Code of
Ethics, private physician, delivery method. The AMA Code of Ethics, with particularity; warns
that the physician who has the treatment relationship with the patient, is to be the supervisor of
all the higher powers and institutions; but with the Medicaid MCO MSFC, several nurses, such
as Carol Attia and Lesley Wallace, from a remote site; order the doctors and the patients, around.
A non-exhaustive list of the other order givers are The Secretary of DHMH, whose profession
may be that of a lobbyist and the CEO of Medstar who has some Masters of Arts degree from
somewhere. In the eyes of doctors; a joke. None of these people can be regulated by The Board
of Physicians, because they are not physicians.
In my case DHMH has not only sided with the wrongdoing of its agents; DHMH and several
other Maryland agencies have, directly done some of the wrongful acts. The letter from DHMH
is, in itself, a wrongful act by DHMH. Very clearly, the bulk of my problems were identified to
be that of Medicaid. I requested that Senator Cardins Office ask DHMH to contact me. DHMH
never contacted me. DHMH suggests that way to solve the problems, one of its beneficiaries is
having with DHMHs contractor MSFC is for the Medicaid beneficiary, which is a class of
poorly educated and very sick individuals, to fight out the issues in a closed room with several of
the contractors medical directors and lawyers.
The controlling laws are those related to Medicaid and Medicaid Managed Care, both from
federal law and COMAR. Many of these laws and rules are stated in MSFCs own Enrollee
Handbook and Provider Manual; most notably rights and responsibilities. There is also the
Medicaid definition of abuse. These kind of things are controlling, not action with The Board
of Physicians or the HIPPA Laws.
DHMH seems to be distressed about the existence of The First and Fourth Amendments. I invite
DHMH to visit the YouTube channel under my last name. I dont have any written or oral
commentary, and there is a select set of recordings. Those labeled MRI show the origins of the
medical condition. Those labeled MCO Doctor show, both; the MCOs doctors being dishonest
but also the PCP, admitting to the dire state of my medical condition and the need for immediate
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appropriate medical care [but that it is out of his hands if MSFC and its specialists are sabotaging
the needed medical care]. Those labeled MCO Office show the extra family, that I have to
deal with. The non-physicians of MSFC that I have to go through. Things sound exactly as with
housing or employment discrimination [a lot of polite nonsense, with the effect that of being
deprived of rights. One of the MCOs agents even says that she has never heard of the Enrollee
Handbook]. The one labeled MCO Doctor Government Nexus shows that Medicaid MCO
medical care is different from the regular doctor-patient relationship medical care. The ones
labeled MISC show actions of several state units.
I had never stated that I wanted DHMH to give its version of facts for my letters. I requested
that DHMH talk to me. Then I could present the facts to DHMH, verbally. Now that DHMH
has given a written response, I respectfully request that DHMH submit a revised reply, one based
on DHMH operating the non fee-for-service Medicaid and not a response based on DHMH
regulating physicians.

Respectfully Submitted,
Joseph R. Crussiah
August 12, 2016

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