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 9, 2010 01:00 PM Wednesday; Rod Welch

Kaiser CMS call on Millie's claim to recover from UCSF medical mistakes.

1...Summary/Objective
........Statement of Claim


..............
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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 31 0000. ref SDS 30 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
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 29 036C  Developed work plan to have
041071 - a conference call with Kaiser tomorrow. ref SDS 29 C354  Submitted
041072 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041073 - ref SDS 29 G84Q
041075 -  ..
041076 - On 100609 1114 called CMS to expedite conference call on expediting
041077 - Millie's care. ref SDS 30 036C  Cherry called and schedule telecon with
041078 - Kaiesr and CMS today 1300. ref SDS 30 8O4H  Received letter from Cherry
041079 - at CMS confirming work plan for conference call at 1300. ref SDS 30
041080 - PRXY
041082 -  ..
041083 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041084 - call to review progress on Kaiser resolving Millie's claim for
041085 - recovery from UCSF medical mistakes. ref SDS 31 036C
041087 -  ..
041088 - On 100609 1300 CMS and Kaiser conference call to report progress on
041089 - reviewing Millie's claim for treatment to recover from UCSF medical
041090 - mistakes in time to be effective. ref SDS 0 036C
041091 -
041092 -
041094 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - CMS called.  Talked to Cherry and Beth, following up the call
041402 - yesterday on 100608 1521. ref SDS 29 036C
041404 -  ..
041405 - Cherry's boss Julie Payiatas supported the call on the speaker phone
041406 - in the conference room.
041407 -
041408 -                    415-744-3617
041410 -  ..
041411 - Asked who will be representing Kaiser.
041413 -  ..
041414 - Cherry said that she understands Paula will represent Kaiser along
041415 - with a senior management person.
041417 -  ..
041418 - There was a problem getting the Kaiser team included in the
041419 - conference call.  Hung.
041420 -
041422 -  ..
0415 -
0416 -
0417 - 1307
0418 -
041801 - Received call from Kasier represented by....
041802 -
041803 -        Irene Tsai........................ senior manager
041804 -        Susan Morris...................... reviewing Millie's claim
041805 -
041809 -  ..
041810 - Paula did not support the call.
041812 -  ..
041813 - Irene spoke for Kaiser, saying that Susan has been assigned to
041814 - process Millie's claim.
041816 -  ..
041817 - Asked if everyone received the agenda, submitted earlier today on
041818 - 100609 1232, ref SDS 31 R66R
041820 -  ..
041821 - Cherry advised that she, Beth, and Julie are on the conference room,
041822 - so they cannot see their computer.
041824 -  ..
041825 - Irene seemed to indicate that Paula did not forward the agenda to her
041826 - and Susan.
041828 -  ..
041829 - We addressed the agenda items...
041830 -
041831 -    1.  Who is assigned at Kaiser to process Millie's claim, and
041832 -        how can this person be added to the claim team
041833 -        communication distribution list, so there is audit trail
041834 -        showing all of the stakeholders (patient, Kaiser, CMS) have
041835 -        the same information.
041837 -  ..
041838 - Irene advised that Susan is responsible for processing Millie's claim
041839 - at Kaiser.  Susan gave an email address for timely communication on
041840 - the team.
041844 -         ..
041845 -    2.  Has everyone on the claim team read Millie's claim submitted to
041846 -        Paula and to Jullin on 100527. ref SDS 16 IZ7N
041848 -  ..
041849 - Cherry advised that she and Beth have read parts of Millie's claim.
041851 -  ..
041852 - Susan said she has just been assigned, and so has not read the claim.
041854 -  ..
041855 - Susan or Irene further advised that Susan will not make the actual
041856 - claim review.  Susan seems to be in charge of the claim review team.
041858 -  ..
041859 - Irene indicated that Paula may have the assignment to review Millie's
041860 - claim, but nobody participating in the call this afternoon actually
041861 - knows who has the assignment, and nobody knows if anybody at Kaiser
041862 - has read Millie's claim.
041864 -         ..
041865 -    3.  Is Millie's claim being reviewed as presented, or is Kaiser
041866 -        processing some other claim constructed by people at Kaiser?
041867 -        We need to know precisely what language Kaiser is processing as
041868 -        Millie's claim.
041870 -  ..
041871 - Irene seemed to say that Kaiser will respond to Millie's claim as
041872 - presented, and that Kaiser's claims procedures classify remedies
041873 - requested by patients.  This requires Kaiser's claims analysts to fit
041874 - patient's requests into Kaiser classifications.
041875 -
041876 -    4.  On 100602 Eileen in a Kaiser office advised that Kaiser
041877 -        sent a letter to Millie denying her claim filed on 100527;
041878 -        Eileen called back later and said that after reading, the
041879 -        claim, Kaiser withdrew the denial letter, and forwarded
041880 -        Millie's claim to Paula's office. ref SDS 21 UN5P
041882 -  ..
041883 - Irene advised that Millie's claim is being processed in Kaiser's Case
041884 - Resolution Department as "Not Denied."  As a result, Paula may not get
041885 - the assignement to process the claim, because Paula is a senioir
041886 - analyst who generally only processes claims that have been denied.
041888 -  ..
041889 - Irene further noted that Paula's extensive experience working on
041890 - Millie's prior claim for 2 months in 2007, and more importantly
041891 - Paula's work from May - November in 2009 investigating and advising
041892 - Millie on her rights to recover from UCSF medical mistakes, as set out
041893 - in Millie's claim filed with Paula on 100527, ref SDS 16 X94P, show
041894 - that Paula is the best person at Kaiser to process Millie's claim.  As
041895 - a result, even if another analyst is assigned to process Millie's
041896 - claim, because the claim has "not been denied," Irene feels that Paula
041897 - will work closely to apply her knowledge from prior experience to help
041898 - shape Kaiser's work product in this matter.
041900 -         ..
041901 -    5.  What action has Kaiser taken since receiving Millie's claim
041902 -        from Eileen on 100602?
041904 -  ..
041905 - Irene said that nobody representing Kaiser in the conference call
041906 - knows who is actually doing the work, and so nobody has been asked
041907 - for a progress report.
041909 -  ..
041910 - Since Paula is not participating in the call, she cannot tell us about
041911 - status.
041913 -  ..
041914 - There was a question on Susan's work assigning an analyst to process
041915 - Millie's claim.
041917 -  ..
041918 - Susan seemed to clarify that she does not make the actual assignment,
041919 - but she has some mangement role over the department.  This issue seems
041920 - fuzzy.
041922 -  ..
041923 - Irene proposed a follow up call tomorrow.  She will find out who is
041924 - doing the work, and have that person participate in a follow up call
041925 - tomorrow with the claim team participating in the call today.
041927 -  ..
041928 - Asked if Irene will call back later today scheduling the time for the
041929 - call tomorrow.
041931 -  ..
041932 - Irene feels she can get this done by calling tomorrow morning to
041933 - schedule another conference call with the claim team later tomorrow in
041934 - order to discuss progress processing Millie's claim.
041935 -
041936 -            [On 100610 1327 Irene did not call back. ref SDS 34 GU6N
041938 -  ..
041939 - Irene said that whoever Kaiser has assigned that person must be making
041940 - progress determining Millie's claim, because Kaiser must issue a
041941 - determination tomorrow on 100610.  Irene explained that the 100610,
041942 - date was not set by discussing with the analyst to determine that good
041943 - faith review can be accomplished on 100610, but rather because Kaiser
041944 - is required to respond to Millie's claim within 14 days.
041946 -  ..
041947 - Julie with CMS advised that Medicare regulations require Kaiser to
041948 - respond within 14 days based on statutory authority.
041949 -
041950 -            [...in another record today, on 100609 1522, received call
041951 -            from Jennifer with the Case Resolution Department advising
041952 -            that Kaiser will issue a determination tomorrow on 100610,
041953 -            to resolve Millie's claim filed on 100527. ref SDS 32 6W3N
041955 -             ..
041956 -            [On 100610 0352 Millie's letter to the Kaiser and CMS claim
041957 -            teams, confirms Kaiser's work plan to issue a determination
041958 -            tomorrow on 100610, ref SDS 33 036C, and asks Jennifer to
041959 -            call Rod tomorrow morning to verify understandings on
041960 -            issues to be determined by Kaiser responding to Millie's
041961 -            claim. ref SDS 33 DZ4X
041963 -             ..
041964 -            [On 100625 0852 Jennifer extended Kaiser's response to
041965 -            Millie claim another few days, without regard to statutory
041966 -            authority cited by Julie; letter to claim team at Medicare
041967 -            requests citation of controlling authoirty. ref SDS 44 1X5W
041969 -             ..
041970 -            [On 100626 0917 received letter from CMS where Cherry
041971 -            submits CMS regulations on MA response date for Millie's
041972 -            claim; there is nothing evident on extending the response
041973 -            date. ref SDS 45 036C
041975 -  ..
041976 - Susan noted that since Millie submitted the claim to Paula on 100527,
041977 - Kaiser must respond NLT 100610, event though Cherry at CMS learned the
041978 - next day on 100528, that nobody at Kaiser saw Millie's claim until the
041979 - following Tuesday, on 100601, due to the long Memorial day weekend,
041980 - reported on 100528 1031. ref SDS 18 IM5R
041982 -  ..
041983 - Additionally, Eileen reported that she did not forward Millie's claim
041984 - back to Paula until Wednesday, 100602. ref SDS 21 I36J  At that time,
041985 - she advised that someone from Claims Resolution would call in the next
041986 - few days, but nobody has called until today.
041988 -  ..
041989 - We reviewed the prior claim processed by Paula in 2007.
041991 -  ..
041992 - Paula called on 071006, which was a Saturday afternoon.  She asked for
041993 - help to work through a 50 page fax she received from Jullin at CMS.
041994 - ref SDS 1 Z87L  During that call, we spent several hours carefully
041995 - reviewing relevant patient history.
041997 -  ..
041998 - Over the next 2 months, Paula called numerous times for additional
041999 - help.  The case was ultimately resolved favorably by a board hearing
042000 - at Kaiser in Oakland.
042002 -  ..
042003 - How can all this be accomplished by tomorrow afternoon on a matter
042004 - much more complicated, especially if Paula is not doing the work, so a
042005 - new person must start from scratch?
042007 -  ..
042008 - At this time, there is no evidence that anybody has read the claim,
042009 - other than the date of filing on 100527 0217. ref SDS 16 IZ7N
042011 -  ..
042012 - Irene explained that Kaiser delayed processing Millie's claim, because
042013 - of confusing terminology.  Kaiser uses "claim" to process requests for
042014 - payment, and Kaiser uses "request" when a patient claims entitlement
042015 - to medical services.  She feels the claim would have been processed
042016 - sooner, if Millie demanded payment of substantial monetary damages;
042017 - and equally, if Millie "requested medical services," then Kaiser would
042018 - also processed this "request" faster, but since Millie used the word
042019 - "claim" and did not request payment, Kaiser was confused and
042020 - processing was delayed to provide Millie treatment in time to be
042021 - effective.
042023 -             ..
042024 -            [On 100710 1343 Kaiser denied Millie's claim to be "held
042025 -            harmless" from medical mistakes on grounds that this is not
042026 -            a "covered benefit of the health plan," and said to send
042027 -            claims for payment to another office. ref SDS 48 447F
042029 -  ..
042030 - We then took a moment during the call to read the first para of
042031 - Millie's letter submitted to Kaiser and CMS on 100527...
042033 -         ..
042034 -        Statement of Claim
042036 -         ..
042037 -        I request Kaiser perform section 2 of the insurance agreement
042038 -        to provide standard of care for my 11th relapse of cancer based
042039 -        on best evidence for my patient profile after 9-years of
042040 -        treatment for stage IV inflammatory breast cancer (IBC), and
042041 -        pulmonary embolism (PE).  I need immediate treatment, with PARP
042042 -        or equal... 100527 0217, ref SDS 16 IZ7N
042044 -  ..
042045 - There seemed to be agreement during the call that Millie's claim
042046 - demonstrates compliance with Kaiser procedures to "request" medical
042047 - services for life-saving care.
042049 -  ..
042050 - Irene feels the best course is for Kaiser's claims analyst to call as
042051 - soon as possible this afternoon to review Millie's request for medical
042052 - services, as Paula did for Millie's claim in 2007, per above.
042053 - ref SDS 0 6G36
042054 -
042055 -            [On 100609 1522 Jennifer called reporting Kaiser progress
042056 -            processing Millie's claim to recover from UCSF medical
042057 -            mistakes, and implementing Irene's work plan for Kaiser to
042058 -            issue timely determination. ref SDS 32 036C
042060 -             ..
042061 -            [On 100610 0352 Millie's letter to Jennifer transmits
042062 -            record of telecon today with Jennifer for confirming
042063 -            understandings on issues to be determined by Kaiser
042064 -            responding to Millie's claim. ref SDS 33 036C
042066 -             ..
042067 -            [On 100610 1327 Millie did not receive respnose to her
042068 -            claim filed on 100527, requesting life-saving treatment to
042069 -            recover from UCSF medical mistakes, and did not return
042070 -            calls asking about status of the case. ref SDS 34 036C
042072 -             ..
042073 -            [On 100611 1521 Jennifer called and reported receiving
042074 -            Millie's letter, ref SDS 35 FP5M, submitting the record of
042075 -            telecon with Jennifer on 100609 1522, ref SDS 32 036C,
042076 -            Jennifer further advised that Kaiser did not respond to
042077 -            Millie's claim on 100610, as reported is required by
042078 -            regulations, but somehow extended Kaiser's date of response
042079 -            to 100624, based on Millie filing a Statement of Authorized
042080 -            Representation. ref SDS 35 FP5L
042082 -             ..
042083 -            [On 100611 2326 Millie received Jennifer's letter
042084 -            confirming that Kaiser will respond, ref SDS 36 036C, to
042085 -            6-issues listed in the record of telecon on 100609,
042086 -            ref SDS 32 XK50, and transmitted to the Kaiser and CMS
042087 -            claim teams, and to Doctor Johnson and Doctor Rugo in
042088 -            Millie's letter on 100610. ref SDS 33 DZ4X
042090 -             ..
042091 -            [On 100614 0257 Millie's letter to claim team confirmed
042092 -            discussion today on Millie's right to choose Hospice based
042093 -            on evidence of alternatives. ref SDS 37 SR8Y
042095 -             ..
042096 -            [On 100616 0832 Jennifer did not have time to call on
042097 -            Tuesday, 100615; telecon the next day on 100616, indicated
042098 -            Jennifer made progress on Millie's compensation issue to be
042099 -            held harmless from UCSF medical mistakes, but she has been
042100 -            unable to schedule treatment for Millie due to delays
042101 -            communicating with the medical team; she scheduled to call
042102 -            on Friday, 100618, to report progress on Kaiser prescribing
042103 -            treatment for Millie. ref SDS 38 PSSV
042105 -             ..
042106 -            [On 100618 0843 Jennifer did not call on Friday, and did
042107 -            not return call asking about progress getting Millie a
042108 -            prescription. ref SDS 39 036C
042110 -             ..
042111 -            [On 100620 1112 letter to Kaiser, Medicare, and UCSF
042112 -            notifies of delays communicating with medical team delays
042113 -            timely treatment for Millie. ref SDS 40 L58U
042115 -             ..
042116 -            [On 100622 1027 Jennifer called and reported that Doctor
042117 -            Johnson refuses to provide standard of care for Millie to
042118 -            recover from UCSF medical mistakes, on grounds that Millie
042119 -            was forced to enter Hospice for relief from pain and
042120 -            suffering caused by UCSF medical mistakes. ref SDS 41 036C
042121 -            Asked Jennifer to check Kaiser's medical chart for 100601
042122 -            for evidnece showing Millie was given no choice except to
042123 -            enter Hospice. ref SDS 41 NX68
042125 -             ..
042126 -            [On 100622 1511 letter notifies Jennifer with copies to
042127 -            claim teams and medical team, that Millie's right to choose
042128 -            life is protected by Constitutional due process, even more
042129 -            than a woman's right to choose for her unborn child.
042130 -            ref SDS 42 574Y   Millie requested in 44 letters treatment
042131 -            targeted to cancer without painful side effects, and claims
042132 -            that denial of right to choose treatment for a road map to
042133 -            a future worth living violates Millie's human rights.
042134 -            ref SDS 42 576S
042136 -             ..
042137 -            [On 100624 1616 Jennifer called to request another few days
042138 -            delay issuing Kaiser's response to Millie's claim
042139 -            originally due on 100610, and in order from internal
042140 -            review; she will submit a draft, and call on Friday discuss
042141 -            the proposed response with the customer in order for Kaiser
042142 -            to provide a comprehensive solution. ref SDS 43 LE4G
042144 -             ..
042145 -            [On 100625 0852 letter to claim teams at Kaiser and
042146 -            Medicare, and to medical team confirms Kaiser's response
042147 -            deferred several days for deliberation to increase accuracy
042148 -            of solution. ref SDS 44 1X5R
042150 -             ..
042151 -            [On 100626 0917 received letter from CMS where Cherry
042152 -            submits CMS regulations on MA response date for Millie's
042153 -            claim; there is nothing evident on extending the response
042154 -            date. ref SDS 45 036C
042156 -             ..
042157 -            [On 100628 1033 CMS reported that Kaiser notified CMS that
042158 -            Kaiser intends to delay responding to Millie's claim until
042159 -            100710. ref SDS 46 UQ99
042161 -             ..
042162 -            [On 100628 2318 Millie notified CMS and Kaiser that
042163 -            delaying treatment places Millie in grave jeopardy.
042164 -            ref SDS 47 R44W
042166 -  ..
042167 - Irene will call tomorrow morning on schedule claim team review,
042168 - following up this conference call, and any call that may occur with
042169 - Kaiser's analyst assigned to Millie's claim.
042171 -  ..
042172 - Thanked everyone for professional, thorough meeting.
042173 -
042174 -
042175 -
042176 -
042177 -
042178 -
042179 -
042180 -
0422 -