CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 28 0000. ref SDS 27 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 4
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 4 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 5 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 6 HH4I
040920 -  ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 7 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 7 MZ4N
040926 -  ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 8 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 9 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 10 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 11 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 12 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 13
040958 - L54I
040960 -  ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 14 KE4K
040964 -  ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 15 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 16 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 17 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 18 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 5 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 6
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 21 036C  Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 21 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 21 UN4M  Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 21 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 21 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 22 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 23 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 24 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 25 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 18 PE6P; today, Cherry did not have
041053 - time to return the call. ref SDS 26 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 27 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 27 QN9F
041063 -  ..
041064 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041065 - process Millie's claim for care promptly in order to save her life.
041066 - ref SDS 28 036C
041068 -  ..
041069 - On 100608 1521 called and talked to Cherry and Beth about expediting
041070 - Millie's claim at Kaiser. ref SDS 0 036C  Developed work plan to have
041071 - a conference call with Kaiser tomorrow. ref SDS 0 C354  Submitted
041072 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041073 - ref SDS 0 G84Q
041074 -
041075 -
041076 -
041078 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Talked to Cherry and Beth, following up telecon on 100528 1031.
041402 - ref SDS 18 P28U
041404 -  ..
041405 - Cherry said that Jullin has been forwarding all correspondence she has
041406 - received on Millie's claim to Beth and to Cherry.  CMS has faxed this
041407 - record to Kaiser demonstrating urgency for processing Millie's claim
041408 - to get treatment in time to be effective.
041410 -  ..
041411 - This aligns with practice the past year, including Paula in
041412 - distribution to all communications between Millie and the medical
041413 - team, so that Paula is fully aware of Millie's entitlement.
041415 -  ..
041416 - Cherry seemed to say in the call this afternoon that Paula has
041417 - objected to CMS about getting the record of Millie's patient history.
041419 -  ..
041420 - There is nothing in the record showing Paula has asked to be removed
041421 - from distribution of the record on Millie's claim for recovery from
041422 - medical mistakes caused by UCSF providing radiation services on
041423 - referral from Kaiser.
041425 -  ..
041426 - Background on Paula's support for Millie's claim is reported in case
041427 - study listed on 090727 1153. ref SDS 2 BD5I
041429 -  ..
041430 - Cherry indicated that she talked to Paula or someone at Kaiser today
041431 - and they represented that processing Millie's claim was being held on
041432 - some grounds related to billings showing that Millie has not claimed
041433 - recovery from  money in her claim.
041435 -  ..
041436 - Cherry further seemed to indicte that she checked a CMS computer that
041437 - can access Kaiser data base on processing patient claims, and this
041438 - also showed Millie's claim was not being processed because of
041439 - something related to billings.
041441 -  ..
041442 - Neither Beth nor Cherry could state precisely what legitimate reason
041443 - there is for delaying processing Millie's entitlement to recover from
041444 - medical mistakes to get care in time to save her life.
041446 -  ..
041447 - Cherry and Beth will call Kaiser tomorrow and talk to CMS lead contact
041448 - at Kaiesr.  They will schedule a conference call tomorrow on 100609
041449 - with Rod, Cherry, Beth, Paula and anyone else at Kaiser who can help,
041450 - and for the purpose of idnetifying any grounds for Kaiser to delay
041451 - processing Millie's claim, and what Millie can do to advance her
041452 - claim.
041454 -  ..
041455 - Beth and Cherry provided email addresses for the purpose of expediting
041456 - communications required to provide medical services for Millie in time
041457 - to save her life.
041458 -
041459 -
041460 -
041461 -
041462 -
041463 -
041464 -
0415 -

SUBJECTS
Default Null Subject Account for Blank Record

0503 -
050401 -  ..
050402 - Submitted following letter to Kaiser and CMS claims people...
050403 -
050404 -    1.  Subject: Work Plan Claim Recover UCSF Medical Mistakes
050405 -        Date: Tue, 08 Jun 2010 17:11:51 -0700
050415 -         ..
050416 -    3.  This confirms our telecon this afternoon, involving Cherry,
050417 -        Beth, and Rod, ref SDS 0 036C, developing work plan to advance
050418 -        Millie's claim at Kaiser for review in time to save her life
050419 -        (see "Work Plan," below, ref SDS 0 G84Q,
050421 -         ..
050422 -    4.  By copy I thank Jullin for facilitating expedited review.  By
050423 -        copy I further thank Paula for assistance at Kaiser, and
050424 -        confirm my voice message this morning.
050426 -         ..
050427 -    5.  Background...
050429 -         ..
050430 -    6.  The call to the Medicare team this afternoon inquired about
050431 -        progress on the work plan developed in the call we all had on
050432 -        100528.  Step 8, was for Medicare to call me with results of
050433 -        Medicare follow up calling Paula last Tuesday on 100601 [...
050434 -        reported on 100528 1031. ref SDS 18 PE6P...]
050436 -         ..
050437 -    7.  Today, we had that call.
050439 -         ..
050440 -    8.  Since I had not heard from anyone, I called Paula yesterday.
050441 -        She explained that since Millie's claim has not been denied,
050442 -        she personally could not process the claim, because she only
050443 -        handles denied claims [... reported on 100607 1021, ref SDS 27
050444 -        036C...].  She said Millie's claim sent to Paula on 100527, was
050445 -        therefore forwarded to another department, and since it has now
050446 -        been returned to Paula's department for action and has not been
050447 -        denied, another person will process it.  Paula also said that
050448 -        she would assist whoever is assigned Millie's claim, in order
050449 -        to expedite review. ref SDS 27 GG5K
050451 -         ..
050452 -    9.  Since time of the essence, I sent a letter (see below) asking
050453 -        Paula to process Millie's claim, because Paula has direct
050454 -        knowledge of case history, from working on this problem last
050455 -        year from June - November [reported on 100607 1117. ref SDS 28
050456 -        036C...].
050458 -         ..
050459 -   10.  This morning, I called and left a message for Paula that if her
050460 -        schedule was too busy, it would fine for someone else to make
050461 -        the review, and for Paula to assist as needed.
050463 -         ..
050464 -   11.  My concern today, is that in the prior matter Millie never
050465 -        submitted a claim to anybody.  Millie sent a letter to Jullin
050466 -        asking about a Medicare rule in relation to conduct at Kaiser
050467 -        and UCSF.  A week later I got a call from Paula, saying she had
050468 -        received a stack of paper faxed from Jullin, and would I help
050469 -        her understand the problem, so she could write up a claim.
050470 -        Nothing was sent to another department, the matter was
050471 -        expedited and resolved.  Today, a week later there is no
050472 -        evidence of any progress on a matter involving the patients
050473 -        life.
050475 -         ..
050476 -   12.  In our call today, Cherry seemed to relate calling Kaiser this
050477 -        morning, and being told something about Millie's claim is not
050478 -        being processed because there are no billings involved.  Cherry
050479 -        further cited some computer records prepared at Kaiser which
050480 -        she can access directly at Medicare, and which say essentially
050481 -        the same thing -- Kaiser is waiting to treat Millie in order to
050482 -        continue her life, until some perceived documentation issue is
050483 -        resolved.
050485 -         ..
050486 -   13.  Cherry advised that nothing in Kaiser's records nor in her
050487 -        communications with Kaiser show that Millie has been notified
050488 -        that her treatment has been delayed due to a claim
050489 -        documentation problem.  Cherry asked if Millie has received any
050490 -        feedback from Kaiser, as she received from Medicare in Cherry's
050491 -        letter dated 100528, the same day of my call to Medicare.
050493 -         ..
050494 -   14.  I advised you this afternoon that Millie has not received
050495 -        anything from Kaiser on her claim filed 100527.
050497 -         ..
050498 -   15.  I further noted during the call today, that Eileen in one of
050499 -        Kaiser's offices called me last week on Wednesday, 100602, and
050500 -        advised that her office reviewed Millie's claim received from
050501 -        Paula and from Medicare, and that Kaiser denied the claim
050502 -        because Millie was forced to enter Hospice in order to get
050503 -        medication to relieve pain caused by UCSF medical mistakes.
050504 -        After discussion, Eileen agreed to read Millie's claim.  She
050505 -        called back an hour later and said Kaiser withdrew the denial
050506 -        letter, and sent Millie's claim to Paula's office for
050507 -        processing. 100602 1046, ref SDS 21 9N62
050509 -         ..
050510 -   16.  I called today, because the matter has been at the Claims
050511 -        Resolution Department since that date on 100602.
050513 -         ..
050514 -   17.  We decided in the call today that Millie needs expedited
050515 -        review.
050517 -         ..
050518 -   18.  Work Plan...
050519 -
050520 -        Tomorrow Cherry and Beth will call Kaiser's lead contact for
050521 -        Medicare, and schedule a conference call with all of us, and
050522 -        who ever has been assigned at Kaiser to actually review the
050523 -        claim, and for the purpose of determining Kaiser's progress
050524 -        determining Millie's claim, so that additional information can
050525 -        be provided promptly, if needed.  Hoping Paula can sit in on
050526 -        the conference call, if her schedule permits, since she is most
050527 -        familiar with the record.
050528 -
050529 -            [On 100609 1114 Cherry called and scheduled conference call
050530 -            with CMS and Kaiser 100609 1300; and also received a letter
050531 -            from Cherry confirming this work plan. ref SDS 29 OX3J
050533 -         ..
050534 -   19.  I start early, so anytime is good for me.
050536 -         ..
050537 -   20.  Cherry will call me to advise the time for the conference call.
050538 -        I gave my cell phone in case I am away, and can then plan to be
050539 -        available to take the conference call at the computer, so we
050540 -        have the record readily available, as needed.
050542 -         ..
050543 -   21.  Thanks for assistance in this matter.
050544 -
050551 -
050552 -
050553 -
050554 -
050555 -
050556 -
050557 -
050558 -
050559 -
050560 -
0506 -