CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 25 0000. ref SDS 20 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 3
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 3 SJ6N
040910 -  ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 4 F25O
040915 -  ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 5 HH4I
040920 -  ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 6 YX8L  Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 6 MZ4N
040926 -  ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 7 TD5W
040930 -  ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 8 YL5N
040936 -  ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 9 6X7S
040942 -  ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 10 NT5N
040949 -  ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 11 KE4K
040954 -  ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 12
040958 - L54I
040960 -  ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 13 KE4K
040964 -  ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 14 PK9O
040967 -  ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS 15 IZ7N
040973 -  ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS 16 QQ6N
040978 -  ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS 17 4W5F
040983 -  ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes.  He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice.  Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 -  ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS 4 036C
041001 -  ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS 5
041007 - 036C
041009 -  ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS 20 036C  Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 20 MZ5H  Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS 20 UN4M  Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 20 I33H  Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS 20 UN5P
041023 -  ..
041024 - On 100603 0449 Millie notified medical team that Kaiser called today
041025 - about moving forward to resolve medical mistakes getting radiation
041026 - treatment at UCSF on referral from Kaiser. ref SDS 21 IX9Q
041028 -  ..
041029 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041030 - has remained fairly stable the past 3 weeks since ending treatment
041031 - with Abraxane on 100512; actually went up less without Abraxane, than
041032 - with it, because Millie's cancer resists chemotherapy. ref SDS 22 036C
041034 -  ..
041035 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041036 - cancer marker CA 15-3 606 much smaller rise than exptected after
041037 - ending treatment for 3 weeks. ref SDS 23 036C; asks if Doctor Rugo ever
041038 - returned Doctor Johnson's call from Kaiser, as planned in Doctor
041039 - Rugo's letter on 100501?
041041 -  ..
041042 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041043 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041044 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041045 - commitment in UCSF letter sent to the medical team on 100501.
041046 - ref SDS 24 036C
041048 -  ..
041049 - On 100607 0932 called Cherry at Medicare about progress on contacting
041050 - Kaiser to process Millie's claim filed on 100527, and planned in the
041051 - call with Medicare (Cherry and Beth) as action item #8, planned the
041052 - next day on 100528 1031, ref SDS 17 PE6P; today, Cherry did not have
041053 - time to return the call. ref SDS 25 036C
041055 -  ..
041056 - On 100607 1021 called Paula at Kaiser - she said someone else is
041057 - handling Millie's claim, because the claim has not been denied, and
041058 - Paula only handles denied claims. ref SDS 0 036C; Paula further
041059 - reported that Kaiser no longer objects to demaning UCSF correct
041060 - medical mistakes, so Millie's claim should be easy to resolve.
041061 - ref SDS 0 QN9F
041062 -
041063 -
041064 -
041066 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Called Paula at Kaiser Claims Resolution Department.
041402 -
041403 - Paula said she had read through Millie's claim sent to Paula on 100527
041404 - 0217. ref SDS 15 IZ7N
041406 -  ..
041407 - Paula advised that she received Millie's claim faxed by Cherry at CMS,
041408 - implementing action item #8 in the Medicare work plan prepared during
041409 - telecon with Cherry and Beth on 100528 1031. ref SDS 17 PE6P
041411 -  ..
041412 - Explained call from Eileen last week on Friday, saying Kaiser sent a
041413 - denial letter on Millie's claim, reported on 100602 1046. ref SDS 20
041414 - 9N62; but, after reading the claim Eileen called back and said Kaiser
041415 - withdrew the denial letter and sent the claim to Paula, reported on
041416 - 100602 1046, ref SDS 20 UN5P
041418 -  ..
041419 - Paula said she is not handling Millie's claim because she only works
041420 - on claims that have been denied, and since Millie's claim has not been
041421 - denied someone else will get the assignment.
041423 -  ..
041424 - We reviewed patient history in this case showing that Paula processed
041425 - Millie's prior claim, reported on 071006. ref SDS 1 0001
041427 -  ..
041428 - Paula said she processed Millie's claim in 2007, because the claim had
041429 - been denied.
041431 -  ..
041432 - Further review showed that Millie never sent a claim to Kaiser in
041433 - 2007.  Millie sent a letter to Jullin Kwok at Medicare (CMS) asking
041434 - about Medicare regulations in relation to Kaiser's conduct.  Millie
041435 - never made a claim to anyone.
041437 -  ..
041438 - On 071006, Paula called Millie and talked to Rod, asking for help
041439 - understanding 50 pages Paula received via fax from Jullin at CMS.
041440 - 071006 1539, ref SDS 1 Z87L  Paula prepared a claim and processed it
041441 - for Millie.
041443 -  ..
041444 - Why can't Paula handle this matter so that Kaiser and Millie benefit
041445 - from Paula's extensive experience with Millie's case.  In the past
041446 - year, Paula has received all of the relevant correspondence
041447 - demonstrating Millie's entitlement, most recently Millie's claim filed
041448 - on 100527 0217. ref SDS 15 IZ7N
041450 -  ..
041451 - We discussed briefly that Millie's claim should be easy to process,
041452 - since Kaiser does not have grounds for denying Millie necessary and
041453 - reasonable care to recover from medical mistakes getting radiation
041454 - treatment at UCSF on referral from Kaiser, as set out in Millie's
041455 - claim submitted to Paula on 100527 0217. ref SDS 15 IZ7N
041457 -  ..
041458 - Paula said she does not have time to process Millie's claim because
041459 - she has a lot of other work to do for other patients.
041461 -  ..
041462 - Advised Paula about the letter from Doctor Johnson last night on
041463 - Sunday.  The doctor advised that Doctor Rugo has never returned Doctor
041464 - Johnson's call, 100606 2314, ref SDS 24 036C, placed in respose to
041465 - Doctor Rugo's letter to the medical team a month earlier on 100501,
041466 - saying she would speak to Doctor Johnson about the work plan for
041467 - Millie to recover from the 11th relapse of cancer, reported on 100501
041468 - 2017. ref SDS 5 456L
041470 -  ..
041471 - We discussed Paula's report on 091112, that her research at that time
041472 - found that someone at Kaiser told Paula that Kaiser will never demand
041473 - that UCSF repair injuries Millie suffered from medical mistakes
041474 - getting radiation treatment at UCSF on referral from Kaiser, because
041475 - Kaiser does not want to damage a good business relationship with UCSF.
041476 - ref SDS 2 A593
041478 -  ..
041479 - Paula seemed to say in the call today that she does not recall now
041480 - being told that Kaiser will not demand UCSF fix medical misakes in
041481 - order to keep good business relationship with UCSF.
041482 -
041483 -            [On 100607 1117 letter to Paula confirms new understanding
041484 -            today, that Kaiser does not object to demanding UCSF
041485 -            correct medical mistakes that occurred providing Millie's
041486 -            care on referral from Kaiser. ref SDS 26 R34P
041488 -  ..
041489 - We further noted that Kaiser can resolve Millie's claim simply by
041490 - demanding UCSF provide care promised on 090616, and Kaiser and Millie
041491 - can send UCSF the bills for work treating Millie in oncology since
041492 - 090616, and if Kaiser fails to perform, then Kaiser can have the work
041493 - done by others and bill UCSF under the referral agreement.
041494 -
041495 -            [On 100607 1117 letter to Paula notes that Kaiser can
041496 -            resolve Millie's claim by notifying UCSF to commence work
041497 -            within 10 days to repair Millie's injuires caused by UCSF
041498 -            medical mistakes, and if Kaiser fails to perform, then
041499 -            Kaiser will hire someone else and bill UCSF. ref SDS 26
041500 -            R34P
041502 -  ..
041503 - Paula said the other person handling Millie's case should call and
041504 - resolution can be discussed then.
041505 -
041506 -
041507 -
041508 -
041509 -
041510 -
041511 -
041512 -
0416 -