THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: June 7, 2010 09:32 AM Monday; Rod Welch

Called Cherry at Medicare on work plan Kaiser process Millie's claim.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 19 0000. ref SDS 4 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 2
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy.  The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 2 SJ6N
040910 -  ..
040911 - On 100501 1037 Millie letter to medical team confirms Kaiser's new
040912 - strategy to treat Millie's cancer with "targeted therapy." ref SDS 3
040913 - F25O  Millie requests Kaiser immediately switch from Abraxane
040914 - chemotherapy that has failed, and implement Doctor Rugo's plan at UCSF
040915 - on 090616, to treat Millie with PARP that is "targeted" to Millie's
040916 - rare patient profile of "triple negative" and avoids pain and
040917 - suffering from chemotherapy side effects, and for the purpose of
040918 - recovering from UCSF medical mistakes. ref SDS 3 U47P and ref SDS 3
040919 - U49V
040921 -  ..
040922 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040923 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040924 - of cancer caused by UCSF medical mistakes. ref SDS 4 HH4I
040926 -  ..
040927 - On 100502 2143 Kaiser confirms that some patients respond well to new
040928 - "targeted" therapies. ref SDS 5 YX8L  Kaiser contends that all of the
040929 - strategies for "targeted" therapies have been executed for Millie,
040930 - which seems conflicting with the record in this case. ref SDS 5 MZ4N
040932 -  ..
040933 - On 100503 1522 Millie notifies medical team that time of the essence
040934 - to get the next treatment going. ref SDS 6 TD5W
040936 -  ..
040937 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040938 - with Abraxane chemotherapy that seems to be failing, and then after 3
040939 - more weeks without treatment, following a trip abroad, the doctor will
040940 - discuss "next steps." ref SDS 7 YL5N
040942 -  ..
040943 - On 100503 2338 Millie reports to medical team that she will implement
040944 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040945 - letter on 010503, as assurance that recovery will be equal to changing
040946 - treatment immediately on 100505. ref SDS 8 6X7S
040948 -  ..
040949 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040950 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040951 - communicate with Doctor Johnson, or had already done so, to coordinate
040952 - with Kaiser on planning Millie's next treatment to recover from the
040953 - 11th relapse of cancer. ref SDS 9 NT5N
040955 -  ..
040956 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040957 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040958 - ref SDS 10 KE4K
040960 -  ..
040961 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040962 - seemingly on an accelerating rise, which threatens to cascade out of
040963 - control, because Abraxane chemotherapy is not effective. ref SDS 11
040964 - L54I
040966 -  ..
040967 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040968 - Abraxane. ref SDS 12 KE4K
040970 -  ..
040971 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 13 PK9O
040973 -  ..
040974 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040975 - Department for standard of care to recover from 11th relapse of cancer
040976 - caused by medical mistakes getting radiation treatments at UCSF on
040977 - referral from Kaiser. ref SDS 14 IZ7N
040979 -  ..
040980 - On 100528 0322 Millie requests support from Medicare to separate
040981 - recovery for medical mistakes getting radiation from UCSF, from health
040982 - care benefits limited by Medicare insurance coverage. ref SDS 15 QQ6N
040984 -  ..
040985 - On 100528 1031 called Medicare they have formed a team to review
040986 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040987 - response to Millie's claim. ref SDS 16 4W5F
040989 -  ..
040990 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040991 - collaborate with UCSF on treatment for Millie to recover from UCSF
040992 - medical mistakes.  He discussed treating Millie with MPA, but this was
040993 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040994 - ended the treatment due to fears about blood clot side effects, which
040995 - were believed to cause breathing problems Millie had, though later
040996 - breathing problems were discovered to be caused by defective radiation
040997 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040998 - for Millie, the only way Millie can get relief from pain caused by
040999 - cancer that is progressing without treatment is get treatment in
041000 - Hospice.  Since Hospice is the only choice of care offered today,
041001 - Millie accepted this.
041003 -  ..
041004 - On 100601 1531 Sharon called to schedule starting Hospice medical
041005 - services beginning tomorrow between 0900 - 1000. ref SDS 3 036C
041007 -  ..
041008 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041009 - Sharon's report yesterday, that if Kaiser performs on the insurance
041010 - agreement to provide standard of care for Millie's patient profile,
041011 - than Millie can elect to recover from 11th relapse of cancer, rather
041012 - than continue with Hospice support for dying peacefully. ref SDS 4
041013 - 036C
041015 -  ..
041016 - On 100602 1046 Diane received notice from Medicare to file claim for
041017 - Millie to get treatment for recovering from UCSF medical mistakes; she
041018 - is preparing a statement of claim. ref SDS 19 036C  Advised Diane to
041019 - use Millie's statement of claim submitted to Kaiser on 100527.
041020 - ref SDS 19 MZ5H  Eileen called later and reported that Kaiser denied
041021 - Millie's claim on the grounds that Medicare does not authorize payment
041022 - for treatment to recover from cancer, after a patient starts Hospice.
041023 - ref SDS 19 UN4M  Requested that Eileen read he claim and then make a
041024 - good faith determiantion. ref SDS 19 I33H  Eileen called back after
041025 - reading the claim and advised the denial of claim has been withdrawn,
041026 - and the matter is referred to Claims Resolution Department.
041027 - ref SDS 19 UN5P
041029 -  ..
041030 - On 100603 0449 Millie notified medical team that Kaiser called today
041031 - about moving forward to resolve medical mistakes getting radiation
041032 - treatment at UCSF on referral from Kaiser. ref SDS 20 IX9Q
041034 -  ..
041035 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041036 - has remained fairly stable the past 3 weeks since ending treatment
041037 - with Abraxane on 100512; actually went up less without Abraxane, than
041038 - with it, because Millie's cancer resists chemotherapy. ref SDS 21 036C
041040 -  ..
041041 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041042 - cancer marker CA 15-3 606 much smaller rise than exptected after
041043 - ending treatment for 3 weeks. ref SDS 22 036C; asks if Doctor Rugo ever
041044 - returned Doctor Johnson's call from Kaiser, as planned in Doctor
041045 - Rugo's letter on 100501?
041047 -  ..
041048 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041049 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041050 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041051 - commitment in UCSF letter sent to the medical team on 100501.
041052 - ref SDS 23 036C
041054 -  ..
041055 - On 100607 0932 called Cherry at Medicare about progress on contacting
041056 - Kaiser to process Millie's claim filed on 100527, and planned in the
041057 - call with Medicare (Cherry and Beth) as action item #8, planned the
041058 - next day on 100528 1031, ref SDS 16 PE6P; today, Cherry did not have
041059 - time to return the call. ref SDS 0 036C
041060 -
041061 -
041062 -
041063 -
041065 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Called Cherry following up Medicare work plan on 100528 1031.
041402 - ref SDS 16 IM4F
041404 -                       ..
041405 -                      415 744 3768
041407 -  ..
041408 - Left another message asking about results of Medicare calling Kaiser
041409 - last Tuesday on 100601, as planned in the conference call with Cherry
041410 - and Beth on 100528 1031. ref SDS 16 OZ7N
041411 -
041412 -
041413 -            [On 100607 1021 called Paula at Kaiser to follow up.
041414 -            ref SDS 24 036C
041415 -
041416 -
041417 -
041418 -
041419 -
041420 -
041421 -
041422 -
041423 -
041424 -
0415 -