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: July 16, 2010 08:30 AM Friday;
Rod Welch
Called to expedite care for Millie to recover UCSF medical mistakes.
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 D8 0000. ref SDS D6 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 68
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 for Millie to recover from UCSF medical mistakes by
040906 - treating cancer as a chronic disease "targeting" the genetic profile
040907 - of cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 68 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 69
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 69 U47P and ref SDS 69
040919 - U49V
040921 - ..
040922 - On 100501 2017 Doctor Rugo reports she will call and collaborate with
040923 - Doctor Johnson at Kaiser to implement the UCSF work plan for treating
040924 - Millie with PARP to recover from UCSF medical mistakes, ref SDS 70
040925 - HH4I, responding to Millie's notice earlier on 100501, that cancer is
040926 - progressing due to UCSF medical mistakes, ref SDS 69 U47P, and
040927 - requesting recovery by implementing Doctor Rugo's work plan on 090616.
040928 - ref SDS 37 KD6L
040930 - ..
040931 - On 100502 2143 Kaiser confirms that some patients respond well to new
040932 - "targeted" therapies. ref SDS 72 YX8L Kaiser contends that all of the
040933 - strategies for "targeted" therapies have been executed for Millie,
040934 - which seems conflicting with the record in this case. ref SDS 72 MZ4N
040936 - ..
040937 - On 100503 1522 Millie notifies medical team that time of the essence
040938 - to get the next treatment going. ref SDS 73 TD5W
040940 - ..
040941 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040942 - with Abraxane chemotherapy that seems to be failing, and then after 3
040943 - more weeks without treatment, following a trip abroad, the doctor will
040944 - discuss "next steps." ref SDS 74 YL5N
040946 - ..
040947 - On 100503 2338 Millie reports to medical team that she will implement
040948 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040949 - letter on 010503, as assurance that recovery will be equal to changing
040950 - treatment immediately on 100505. ref SDS 75 6X7S
040952 - ..
040953 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040954 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040955 - communicate with Doctor Johnson, or had already done so, to coordinate
040956 - with Kaiser on planning Millie's next treatment to recover from the
040957 - 11th relapse of cancer. ref SDS 76 NT5N
040959 - ..
040960 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040961 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040962 - ref SDS 77 KE4K
040964 - ..
040965 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040966 - seemingly on an accelerating rise, which threatens to cascade out of
040967 - control, because Abraxane chemotherapy is not effective. ref SDS 78
040968 - L54I
040970 - ..
040971 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040972 - Abraxane. ref SDS 79 KE4K
040974 - ..
040975 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 80 PK9O
040977 - ..
040978 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040979 - Department for standard of care to recover from 11th relapse of cancer
040980 - caused by medical mistakes getting radiation treatments at UCSF on
040981 - referral from Kaiser. ref SDS 81 IZ7N
040983 - ..
040984 - On 100528 0322 Millie requests support from Medicare to separate
040985 - recovery for medical mistakes getting radiation from UCSF, from health
040986 - care benefits limited by Medicare insurance coverage. ref SDS 82 QQ6N
040988 - ..
040989 - On 100528 1031 called Medicare they have formed a team to review
040990 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040991 - response to Millie's claim. ref SDS 83 4W5F
040993 - ..
040994 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040995 - collaborate with UCSF on treatment for Millie to recover from UCSF
040996 - medical mistakes. He discussed treating Millie with MPA, but this was
040997 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040998 - ended the treatment due to fears about blood clot side effects, which
040999 - were believed to cause breathing problems Millie had, though later
041000 - breathing problems were discovered to be caused by defective radiation
041001 - treatment. Since Doctor Johnson said Kaiser has no more treatments
041002 - for Millie, the only way Millie can get relief from pain caused by
041003 - cancer that is progressing without treatment is get treatment in
041004 - Hospice. Since Hospice is the only choice of care offered today,
041005 - Millie accepted this.
041007 - ..
041008 - On 100601 1531 Sharon called to schedule starting Hospice medical
041009 - services beginning tomorrow between 0900 - 1000. ref SDS 69 036C
041011 - ..
041012 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041013 - Sharon's report yesterday, that if Kaiser performs on the insurance
041014 - agreement to provide standard of care for Millie's patient profile,
041015 - than Millie can elect to recover from 11th relapse of cancer, rather
041016 - than continue with Hospice support for dying peacefully. ref SDS 70
041017 - 036C
041019 - ..
041020 - On 100602 1046 Diane received notice from Medicare to file claim for
041021 - Millie to get treatment for recovering from UCSF medical mistakes; she
041022 - is preparing a statement of claim. ref SDS 88 036C Advised Diane to
041023 - use Millie's statement of claim submitted to Kaiser on 100527.
041024 - ref SDS 88 MZ5H Eileen called later and reported that Kaiser denied
041025 - Millie's claim on the grounds that Medicare does not authorize payment
041026 - for treatment to recover from cancer, after a patient starts Hospice.
041027 - ref SDS 88 UN4M Requested that Eileen read he claim and then make a
041028 - good faith determiantion. ref SDS 88 I33H Eileen called back after
041029 - reading the claim and advised the denial of claim has been withdrawn,
041030 - and the matter is referred to Claims Resolution Department.
041031 - ref SDS 88 UN5P
041033 - ..
041034 - On 100603 0449 Millie notified medical team that Kaiser called today
041035 - about moving forward to resolve medical mistakes getting radiation
041036 - treatment at UCSF on referral from Kaiser. ref SDS 89 IX9Q
041038 - ..
041039 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041040 - has remained fairly stable the past 3 weeks since ending treatment
041041 - with Abraxane on 100512; actually went up less without Abraxane, than
041042 - with it, because Millie's cancer resists chemotherapy. ref SDS 90 036C
041044 - ..
041045 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041046 - cancer marker CA 15-3 606 much smaller rise than exptected after
041047 - ending treatment for 3 weeks. ref SDS 91 036C; asks if Doctor Rugo ever
041048 - returned Doctor Johnson's call from Kaiser, as planned in Doctor
041049 - Rugo's letter on 100501?
041051 - ..
041052 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041053 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041054 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041055 - commitment in UCSF letter sent to the medical team on 100501.
041056 - ref SDS 92 036C
041058 - ..
041059 - On 100607 0932 called Cherry at Medicare about progress on contacting
041060 - Kaiser to process Millie's claim filed on 100527, and planned in the
041061 - call with Medicare (Cherry and Beth) as action item #8, planned the
041062 - next day on 100528 1031, ref SDS 83 PE6P; today, Cherry did not have
041063 - time to return the call. ref SDS 93 036C
041065 - ..
041066 - On 100607 1021 called Paula at Kaiser - she said someone else is
041067 - handling Millie's claim, because the claim has not been denied, and
041068 - Paula only handles denied claims. ref SDS 94 036C; Paula further
041069 - reported that Kaiser no longer objects to demaning UCSF correct
041070 - medical mistakes, so Millie's claim should be easy to resolve.
041071 - ref SDS 94 QN9F
041073 - ..
041074 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041075 - process Millie's claim for care promptly in order to save her life.
041076 - ref SDS 95 036C
041078 - ..
041079 - On 100608 1521 called and talked to Cherry and Beth about expediting
041080 - Millie's claim at Kaiser. ref SDS 96 036C Developed work plan to have
041081 - a conference call with Kaiser tomorrow. ref SDS 96 C354 Submitted
041082 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041083 - ref SDS 96 G84Q
041085 - ..
041086 - On 100609 1114 called CMS to expedite conference call on expediting
041087 - Millie's care. ref SDS 97 036C Cherry called and schedule telecon with
041088 - Kaiesr and CMS today 1300. ref SDS 97 8O4H Received letter from Cherry
041089 - at CMS confirming work plan for conference call at 1300. ref SDS 97
041090 - PRXY
041092 - ..
041093 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041094 - call to review progress on Kaiser resolving Millie's claim for
041095 - recovery from UCSF medical mistakes. ref SDS 98 036C
041097 - ..
041098 - On 100609 1300 CMS and Kaiser conference call to report progress on
041099 - reviewing Millie's claim for treatment to recover from UCSF medical
041100 - mistakes in time to be effective. ref SDS 99 036C
041102 - ..
041103 - On 100609 1522 Jennifer called for assistance processing Millie's
041104 - claim to recover from medical mistakes getting radiation treatment at
041105 - UCSF on referral from Kaiser. ref SDS A0 036C
041107 - ..
041108 - On 100611 1451 Jennifer advised Kaiser extended the date for
041109 - responding to Millie's claim from 100610 to 100624, based on Millie
041110 - filing updated statement of authorized representative. ref SDS A4 036C
041111 - Jennifer reported she reviewed 6-issues discussed on 100609, and will
041112 - address these issues responding to Millie's claim. ref SDS A4 FQ4G
041113 - Jennifer asked how Kaiser can treat Millie to recover from UCSF
041114 - medical mistakes, if Millie refuses chemotherapy and has entered
041115 - Hospice. ref SDS A4 FQ4M
041117 - ..
041118 - On 100611 2326 Millie received Jennifer's letter confirming the date
041119 - for Kaiser to respond to Millie's claim has been extended to 100624,
041120 - ref SDS A5 CV4O, and further advising that issues Kaiser will determine
041121 - responding to Millie's claim for recovering from UCSF medical
041122 - mistakes, ref SDS A5 036C, are as set out in the record for telecon on
041123 - 100609. ref SDS A0 XK50 Jennifer will call on 100615, to report
041124 - progress on respnding to Millie's claim. ref SDS A5 6P53
041126 - ..
041127 - On 100614 0257 letter to Kaiser Medicar CMS claim team requests
041128 - immediate written proposal evaluating treatment options for Millie to
041129 - consider. ref SDS A6 036C
041131 - ..
041132 - On 100616 0832 called Jennifer about her plan to call yesterday on
041133 - Tuesday to report progress Kaiser responding to Millie's claim, as set
041134 - out in Jennifer's letter on 100611. ref SDS A7 036C Jennifer called
041135 - back to ask if Millie wants UCSF or Kaiser to pay for her damages
041136 - caused by UCSF medical mistakes. ref SDS A7 PSSV Jennifer reported
041137 - delays communicating with Millie's medical team have delayed making
041138 - arrangements for Millie to start treatment recovering from UCSF
041139 - medical mistakes. ref SDS A7 OY4T She plans to call on Friday, 100618,
041140 - to report progress responding to Millie's claim. ref SDS A7 1K5J
041142 - ..
041143 - On 100618 0843 called Jennifer at Memeber Case Resolution Department
041144 - about progress responding to Millie's claim. ref SDS A8 036C
041146 - ..
041147 - On 100620 1112 letter to Kaiser claim team with copy to Medicare, and
041148 - the medical team requests call on Monday 100621, planned for previous
041149 - Friday, 100628, to report progress getting Millie treatment.
041150 - ref SDS A9 036C Recommends that delay communicating with medical team
041151 - that has delayed Millie starting treatment in time to be effective,
041152 - ref SDS A9 L59P, can be solved by hiring MD Anderson. ref SDS A9 L59X
041154 - ..
041155 - On 100621 0853 called for Jennifer and left several messages,
041156 - including for her team lead. ref SDS B1 036C Nobody had time today
041157 - for calling back. ref SDS B1 OP3N
041159 - ..
041160 - On 100622 1027 Jennifer called and advised that Doctor Johnson
041161 - responded to request for comment on Millie's claim saying he cannot
041162 - provide care for Millie because she entered Hospice on 100601,
041163 - ref SDS B3 036C; recommended Jennifer check Kaiser's medical chart for
041164 - Millie meeting with Doctor Johnson to see Millie was given no choices
041165 - except to enter Hospice in order to avoid further pain and suffering.
041166 - ref SDS B3 NX68
041168 - ..
041169 - On 100622 1511 letter to claim team and Medicare, and to Millie's
041170 - medical team confirming understanding in Jennifer's call that Millie's
041171 - medical team at Kaiser seems to refuse Millie standard of care to
041172 - recover from UCSF medical mistakes, because she was forced to enter
041173 - Hospice to get relief from pain caused by UCSF medical mistakes.
041174 - ref SDS B4 036C UCSF delays compounded Millie's injuries, pain, and
041175 - suffering; caution must be exercised to enable recovery, based on
041176 - Millie's right to life. ref SDS B4 575U Millie's patient history
041177 - shows the doctor's only issue, ref SDS B4 576V, is having time to
041178 - providing standard of care for Millie to recover from medical
041179 - mistakes, and if not, then Kaiser should assign someone who does.
041180 - ref SDS B4 583Y Kaiser has violated Millie's human rights; a woman's
041181 - right to choose life for herself, should be no less than the right to
041182 - choose for her unborn child, since the right to life and due process
041183 - are protected by the US Constitution. ref SDS B4 584W Kaiser can
041184 - easily solve the time problem by hiring other people to do the work,
041185 - and charging UCSF. ref SDS B4 585P
041187 - ..
041188 - 100624 1616 Jennifer called and asked to extend Kaiser's response to
041189 - Millie's claim another day or so, for review with her boss, and with
041190 - the customer. ref SDS B5 036C Jennifer the original date for Kaiser to
041191 - respond on 100610, required by statute, and then amended to today on
041192 - 100624, can be further amended, and cited unclear authority about 30
041193 - days instead of 14. ref SDS B5 EG5P Agreed that extending Kaiser's
041194 - response another few days until tomorrow, or Monday, is an acceptable
041195 - risk, even though Millie's cancer markier has increased significantly
041196 - to over 1000, and so that an equitable solution can be implented that
041197 - allows treatment in time to be effective for Millie. ref SDS B5 EG73
041198 - Jennifer will submit her draft response, and call tomorrow for
041199 - discussing Kaiser's solution. ref SDS B5 H98M
041201 - ..
041202 - On 100625 0852 letter to Kaiser and Medicare claim teams confirming
041203 - Kaiser's request to extend date for responding to Millie's claim
041204 - another few days until Monday in order to get comprehensive solution.
041205 - ref SDS B6 036C
041207 - ..
041208 - On 100626 0917 received letter from Cherry at Medicare, ref SDS B7
041209 - 036C, submitting CMS regulations, that control due date for Kaiser to
041210 - respond to Millie's claim. ref SDS B7 N64I
041212 - ..
041213 - On 100628 0228 letter to claim teams at Medicare and Kaiser asking how
041214 - CMS regulations received on 100625, apply to extend Kaiser's response
041215 - date for expediting Millie's recovery. ref SDS B8 036C
041217 - ..
041218 - On 100628 1033 called CMS Medicare for Beth Simone on regulations for
041219 - Kaiser to respond to Millie's claim.
041221 - ..
041222 - On 100628 2318 submitted record of telecon with CMS, ref SDS C0 036C,
041223 - and that CMS learned today that Kaiser changed Millie's claim to a
041224 - Grievance, and notified CMS that Kaiser intends to delay response
041225 - until 100710, to Millie's claim filed on 100527.
041227 - ..
041228 - On 100629 00003 received letter from Cherry transmitting Grievance
041229 - procedures, cited in the telecon yesterday as a change Kaiser made to
041230 - delay responding until 100710, to Millie's claim filed on 100527.
041231 - ref SDS C1 036C Review of Grievance regulations show Kaiser required
041232 - to make timely response based on patient health. ref SDS C1 PN5S
041234 - ..
041235 - On 100629 0013 letter thanks CMS for submitting regulations on
041236 - Grievance procedures, and notes requirements for Kaiser to respond
041237 - prior to maximum allowed of 30 days, based on patient health.
041238 - ref SDS C2 036C
041240 - ..
041241 - On 100629 1631 called Medicare (CMS) on results of their
041242 - teleconference with Kaiser on expediting response to Millie's claim.
041243 - ref SDS C3 036C
041245 - ..
041246 - On 100630 0027 Millie thanks Doctor Johnson for reporting on 100606,
041247 - that UCSF did not call Kaiser to provide care for Millie to recover
041248 - from UCSF medical mistakes. ref SDS C4 036C; she reports blood counts
041249 - are good, but cancer progressing because treatment was stopped on
041250 - 100601, for pain relief from chemotherapy. ref SDS C4 V83U Kaiser has
041251 - deferred responding to Millie's claim, ref SDS C4 V87S, and needs to
041252 - know how soon her health status requires Kaiser to make a response.
041253 - ref SDS C4 V88T Millie asks about deferring the meeting with Doctor
041254 - Johnson tomorrow, until Kaiser responds to Millie's claim, or, Millie
041255 - would love to meet, if Doctor Johnson has communicated with Doctor
041256 - Rugo on a work plan for Millie to recover from UCSF medical mistakes.
041257 - ref SDS C4 V89X
041259 - ..
041260 - On 100630 1148 Doctor Johnson notfies Millie, and the Kaiser claim
041261 - team that he is confused about Millie's case, because Kaiser has
041262 - deferred determination on urgent requirement for care. ref SDS C5 036C
041263 - Doctor Johnson notes Millie is in Hospice and states that Millie's
041264 - disease is resistant to all forms of therapy, and that entering
041265 - Hospice is based on patient desire to forego therapy. ref SDS C5 PY4J
041266 - He asks if Millie wants to dis-enroll from Hospice. ref SDS C5 OY5G
041267 - Doctor Johnson further notes that public domain email conflicts with
041268 - HIPAA regulations. ref SDS C5 0W5U
041270 - ..
041271 - On 100630 1537 Millie notified medical team and claim team, thanking
041272 - Doctor Johnson for his letter commenting on Millie feeling better
041273 - after ending chemotherap. Confirms Doctor Johnson's intent to defer
041274 - meeting scheduled for tomorrow until after Kaiser responds to Millie's
041275 - claim, and further confirms Doctor Johnson has still not communicated
041276 - with Doctor Rugo on UCSF providing care for Millie to recover from
041277 - UCSF medical mistakes. ref SDS C6 M86X Advises that Doctor Johnson's
041278 - assertion that Millie's cancer now resists all forms of therapy
041279 - conflicts with the record; Doctor Johnson advised that finding
041280 - effective treatment requires experimentation; Millie's first treatment
041281 - failed, and had to be switched. ref SDS C6 M87Q When UCSF discovered
041282 - medical mistakes, UCSF failed to provide necessary and reasonable care
041283 - for Millie to recover, and instead prescribed chemotherapy, which was
041284 - not effective and caused unbearable pain and suffering, causing Millie
041285 - to enter Hospice. ref SDS C6 M84P The only evident purpose for
041286 - Millie's death is to avoid accountability from medical mistakes and
041287 - avoid cost of recovery, by making Millie suffer, and making Medicare
041288 - pay, while Millie is actually innocent, and Medicare is innocent.
041289 - ref SDS C6 M84S Millie sent 44 letters to medical team requesting
041290 - targeted treatment to recover from UCSF medical mistakes, and
041291 - reporting pain and suffering from chemotherapy; so, on 100601, Millie
041292 - entered Hospice for pain relief for chemotherapy. ref SDS C6 M84Y
041293 - Millie cannot dis-enroll from Hospice providing pain medication until
041294 - Kaiser provides standard of care to recover from UCSF medical
041295 - mistakes. ref SDS C6 M93V Millie explains benefits to saving lives,
041296 - time, and money using public domain email. ref SDS C6 M94W Millie
041297 - notes Doctor Johnson's report today shows Kaiser has violated Medicare
041298 - regulations by delaying response to her claim longer than justified by
041299 - Millie's health status. ref SDS C6 M96P
041301 - ..
041302 - On 100701 0915 Carol called this morning saying she is the Chief of
041303 - Hospice and advised that she was told that Millie wants to dis-enroll
041304 - from Hospice. Millie sent a letter to the medical team, and claim
041305 - teams confirming understandings from the call with Carol. ref SDS C7
041306 - 036C Millie advised Carol that Millie entered Hospice for pain relief
041307 - for chemotherapy, and so she cannot dis-enroll from Hospice providing
041308 - pain medication until Kaiser provides standard of care to recover from
041309 - UCSF medical mistakes. ref SDS C7 Q85S Millie explains she wants a
041310 - written medical opinion on treatments lined up for her to recover from
041311 - UCSF medical mistakes that provides a "roadmap to a future worth
041312 - living." ref SDS C7 Q85Y
041314 - ..
041315 - On 100701 1140, meeting this morning scheduled during a prior meeting
041316 - at Kaiser on 100601, ref SDS 85 7E4S, was canceled because Doctor
041317 - Johnson's letter yesterday, said nothing about receiving instructions
041318 - from Kaiser's claims department on solving Millie's claim for care to
041319 - recover from UCSF medical mistakes, ref SDS C5 036C Since Doctor
041320 - Johnson was not authorized to provide care requested in Millie's claim
041321 - on 100527, ref SDS 81 IZ7N, meeting would jeperodize Millie's rights
041322 - in the case by adding or otherwise modifying her statement of claim.
041323 - ref SDS C8 036C
041325 - ..
041326 - On 100701 1213 Lois called and talked to Rod for explanation of
041327 - Millie's claim, and planned to talk with Doctor Johnson about a
041328 - resolution. ref SDS C9 036C
041330 - ..
041331 - On 100702 1424 Millie received letter from Doctor Johnson submitting
041332 - Kaiser's lab report on results of Millie's blood test on 100622, and
041333 - without comment except the doctor circled with ink CA 15-3 1116.
041334 - ref SDS D0 036C
041336 - ..
041337 - On 100702 1612 Lois called and reported discussing Millie's claim with
041338 - Doctor Johnson, who evidently indicated he cannot find on the Internet
041339 - a provider willing to treat Millie with PARP. ref SDS D1 036C Lois
041340 - asked to talk with Millie in order to verify what Millie wants in her
041341 - claim filed on 100527. Lois was referred to Millie's claim, and to
041342 - the letter to Kaiser on 100701, confirming Millie's telecon with
041343 - Carol, with the Kaiser Hospice program. ref SDS C7 036C
041345 - ..
041346 - On 100705 2050 planning letter to Kaiser and Medicare claim teams
041347 - asking for remedies for damanges caused by Kaiser delaying response to
041348 - Millie's request for urgent care. ref SDS D2 036C
041350 - ..
041351 - On 100708 0038 letter to Kaiser with copy to Medicare asking for
041352 - Millie's remedies for Kaiser delaying response to Millie's claim
041353 - requesting immedicate treatment to recover from UCSF medical mistakes.
041354 - ref SDS D4 036C
041356 - ..
041357 - On 100710 1343 Millie received a letter from Kaiser responding to her
041358 - claim. ref SDS D5 036C Kaiser says the office Millie was directed to
041359 - submit her claim to be held harmless from medical mistakes was
041360 - incorrect. ref SDS D5 X48S Kaiser advises that Doctor Johnson reports
041361 - Millie's patient hsitory makes getting treatment with PARP prescribed
041362 - by Doctor Rugo to recover from UCSF medical mistakes due to
041363 - "eligibility" issues. ref SDS D5 X45V The doctor feels Millie's cancer
041364 - is difficult to treat, and maintains nothing can help her recover from
041365 - UCSF medical mistakes without having tried a single treatment listed
041366 - in Millie's claim; Kaiser does not deny any request in Millie's claim,
041367 - but proposes she discuss her care directly with Doctor Johnson who
041368 - claims to have lost hope. ref SDS D5 X530 Kaiser apoligizes for taking
041369 - 44 days to respond to Millie's claim, because unnamed regulations give
041370 - Kaiser 30 days to respond. ref SDS D5 X547 Kaiser advises Millie can
041371 - dispute the determination through arbitration, but Kaiser does not
041372 - present a disputable issue. ref SDS D5 768G Kaiser advises that Millie
041373 - can appeal to Medicare. ref SDS D5 X54Q
041375 - ..
041376 - On 100713 0007 Millie requests reconsideration Kaiser's determination
041377 - on Millie's claim, ref SDS D6 036C, and appeals to Medicare for
041378 - compliance with CMS regulations. ref SDS D6 J74S
041380 - ..
041381 - On 100714 0742 Millie received copy of an internal letter Paula sent
041382 - notifying the Kaiser claim team that Millie's letter on 100713,
041383 - requests reconsideration and appeals to Medicare Kaiser's letter dated
041384 - 100708, and received on 100710, denying Millie's claim to recover from
041385 - medical mistakes filed on 100527. ref SDS D7 036C
041387 - ..
041388 - On 100715 1802 received securemail from Jennifer with response from
041389 - Kaiesr claim team, ref SDS D8 036C, to the letter on 100713, requesting
041390 - reconsideration and appealing, ref SDS D6 036C, Kaiser's letter dated
041391 - 100708, and received on 100710, ref SDS D5 036C, denying Millie's
041392 - claim filed on 100527. ref SDS 81 IZ7N
041394 - ..
041395 - On 100716 0830 called Beth at CMS (Medicare), ref SDS 0 036C, to
041396 - verify request on 100713 appealing to Medicare, ref SDS D6 J74S,
041397 - Kaiser's claim team letter dated 100708, received on 100710,
041398 - ref SDS D5 036C, denying Millie's appeal for standard of care to
041399 - recover from UCSF medical mistakes beginning with PARP. ref SDS 81
041400 - IZ7N; sent letter to Jullin at CMS asking if anything more needs to be
041401 - filed for Medicare to process Millie's request for appealing Kaiser's
041402 - denial of Millie's claim. ref SDS 0 07FC While hiking at Lafayette
041403 - Reservoir, received call from Paula at Kaiser claim team. Reception
041404 - was poor due to wind, so decided to call again at the house in a few
041405 - hours. ref SDS 0 D69K Received letter from Jullin saying Millie's
041406 - appeal is submitted to Medicare on Kaiser's denial of care.
041407 - ref SDS 0 07FC Paula called from Kaiser claim team, and this became a
041408 - conference call with CMS (Medicare) on advancing Millie's claim for
041409 - recovery from UCSF medical mistakes. ref SDS 0 PW3U
041410 -
041411 -
041412 -
041414 - ..
0415 -
0416 -
0417 - Progress
0418 -
041801 - Called for Beth Simone, following up prior call on 100629 1631.
041802 - ref SDS C3 KT5F
041804 - ..
041805 - 415-744-3617
041806 -
041808 - ..
041809 - Submitted letter to claim team asking if there is anything else Millie
041810 - needs to do for Medicare to process her appeal on 100713, ref SDS D6
041811 - 036C, of Kaiser's letter dated 100708, and received on 100710,
041812 - ref SDS D5 036C, denying her claim filed on 100527. ref SDS 81 IZ7N
041814 - ..
041815 - Letter to claim team says...
041816 -
041817 - 1. Subject: Appeal Reconsideration Kaiser's Denial Millie's Claim
041818 - Date: Fri, 16 Jul 2010 10:18:52 -0700
041827 - ..
041828 - 2. I received a letter, yesterday, from Paula McPhail, evidently
041829 - explaining to Kaiser's claim team that my letter on 100713,
041830 - requests reconsideration of Kaiser's "determination" on 100708,
041831 - telling Millie to discuss her concerns with her doctor, despite
041832 - the fact that "discussion" for a year was fruitless. My
041833 - response thanking Paula for help, includes a video of Mil on
041834 - Sunday, showing her good spirits, despite "pushing a big rock
041835 - up a steep hill" to get critical care in time to be effective.
041837 - ..
041838 - 3. I called for Beth Simone this morning asking if we have to do
041839 - anything more for Medicare to process Millie's appeal, of
041840 - Kaiser's determination refusing to hold Millie harmless from
041841 - UCSF medical mistakes, as set out in the letter to Kaiser on
041842 - 100713, with a copy to your office. ref SDS D6 J74S
041844 - ..
041845 - 4. I've called Paula several times yesterday and again this
041846 - morning to see ask about equitable resolution. She has not
041847 - called back, signaling Kaiser continues to resist helping
041848 - Millie. So, Mil's options are dwindling because her cancer is
041849 - getting worse without care.
041851 - ..
041852 - 5. Just need to know next steps at Medicare to move forward with
041853 - an appeal cited in Kaiser's letter on 100708 [...received on,
041854 - ref SDS D5 X54Q
041855 -
041856 - [...below, received response from Jullin, saying nothing
041857 - further is required for Medicare Millie's appeal.
041858 - ref SDS 0 LY3M
041860 - ..
041861 - [On 100720 0655 submitted another letter to Beth at
041862 - Medidare asking for confirmation that Millie's appeal is
041863 - being processed. ref SDS E1 LB8U
041864 -
041871 -
041872 -
041873 -
041875 - ..
0419 -
0420 -
0421 - 1128
0422 -
042201 - While hiking at Lafayette Reservoir, received call from Paula
042202 - returning calls the past few days.
042204 - ..
042205 - Reception was poor. Agreed to discuss Kaiser's ideas for a solution
042206 - after completing the hike, and before Paula leaves for home at 1500
042207 - today.
042208 -
042209 - [...below called Paula back, and had conference call with
042210 - Kaiser and Medicare (CMS) claim team. ref SDS 0 PW3U
042212 - ..
042213 - [On 100721 1115 called and left messages for Beth asking
042214 - status processing Millie's appeal to Medicare. ref SDS E2
042215 - 036C
042217 - ..
042218 - [On 100722 1516 Beth called and advised that Medicare is
042219 - not processing Millie's appeal, that Beth and Cherry have
042220 - been removed from the case, and that Patty will respond to
042221 - Millie's appeal, letters and calls asking for progress on
042222 - processing Millie's appeal, and that Patty is out of the
042223 - office the rest of the week. ref SDS E3 036C
042224 -
042225 -
042227 - ..
0423 -
0424 -
0425 - 1357
0426 -
042601 - Received letter from Jullin at CMS. She indicates that Medicare has
042602 - Millie's appeal for assistance in her claim against Kaiser, and will
042603 - process it without further action from Millie.
042604 -
042605 - 1. Subject: RE: Appeal Reconsideration Kaiser's Denial Millie's Claim
042606 - Date: Fri, 16 Jul 2010 13:36:40 -0400
042615 - ..
042616 - 2. As I mentioned a while back, I do not work on the Kaiser
042617 - account anymore. Please direct all your inquiries to either
042618 - Cherry or Beth.
042620 - ..
042621 - 3. As for this particular inquiry, given that they have been
042622 - copied, you do not need to re-forward the request to their
042623 - attention.
042624 -
042625 - [On 100720 0655 submitted another letter to Beth at
042626 - Medidare asking for confirmation that Millie's appeal is
042627 - being processed. ref SDS E1 LB8U
042629 - ..
042630 - [On 100721 1115 called and left messages for Beth asking
042631 - status processing Millie's appeal to Medicare. ref SDS E2
042632 - 036C
042634 - ..
042635 - [On 100722 1516 Beth called and advised that Medicare is
042636 - not processing Millie's appeal, that Beth and Cherry have
042637 - been removed from the case, and that Patty will respond to
042638 - Millie's appeal, letters and calls asking for progress on
042639 - processing Millie's appeal, and that Patty is out of the
042640 - office the rest of the week. ref SDS E3 036C
042642 - ..
042643 - 4. Thank you!
042644 -
042645 -
042646 -
042648 - ..
0427 -
0428 -
0429 - 1404
0430 -
043001 - Called Beth.
043002 -
043003 - The receptionist said Beth is working on Millie's case with a
043004 - colleage, probably Cherry.
043005 -
043007 - ..
0431 -
0432 -
0433 - 1407
0434 -
043401 - Called Paula at Kaiser, following up her call this moring, per above.
043402 - ref SDS 0 D69K
043404 - ..
043405 - She initially asked about Jennifer's letter on 100708, that refused to
043406 - hold Millie harmless from costs caused by UCSF medical mistakes,
043407 - reported in the record on 100710. ref SDS D5 X46O
043409 - ..
043410 - Paula asked what Millie really wants?
043412 - ..
043413 - We reviewed Millie's claim filed on 100527, requesting recovery from
043414 - UCSF medical mistakes, calling for immediate treatment with PARP,
043415 - ref SDS 81 IZ7N, and standard of care to determine treatments after
043416 - PARP by comparing trade-offs on list in the claim.
043417 -
043419 - ..
0435 -
0436 -
0437 - 1411
0438 -
043801 - While talking to Paula, Beth called from CMS (Medicare) on the cell
043802 - phone number.
043804 - ..
043805 - Both calls were on speaker phones, and so a conference call was
043806 - conducted. Paula already knows Beth and Cherry. Beth introduced
043807 - Patty.
043808 -
043814 - ..
043815 - Patty explained she has reviewed the record on Millie's claim filed on
043816 - 100527. ref SDS 81 IZ7N Patty seemed to say that she has read
043817 - Kaiser's response dated 100708, received by Millie on 100710,
043818 - ref SDS D5 036C, and that she read the response filed on 100713,
043819 - requesting reconsideration from Kaiser to correct errors of fact and
043820 - conclusions, ref SDS D6 036C, and further appealing to Medicare for
043821 - conforming Kaiser's determination with regulations, equity, and
043822 - justice. ref SDS D6 J74S
043824 - ..
043825 - Beth said she did not get a copy of the letter filed on 100713.
043826 - Examination found that the error in her address that ocurred several
043827 - weeks ago, was repeated on the letter dated 100713.
043829 - ..
043830 - Asked about Jullin's letter this morning, saying Millie does not need
043831 - to do anything further, ref SDS 0 LY3M, for Medicare to process her
043832 - appeal in the letter on 100713, ref SDS D6 J74S, from Kaiser's letter
043833 - on 100708, received on 100710, denying recovery for Millie,
043834 - ref SDS D5 036C, on her appeal filed on 100527. ref SDS 81 IZ7N
043836 - ..
043837 - Cherry commented that Jullin is mostly correct, but there may be an
043838 - issue.
043840 - ..
043841 - Patty advised that she feels Jullin was mistaken, because Jullin had
043842 - not seen all of the documentation.
043844 - ..
043845 - We reviewed the record showing Jullin has been copied on all documents
043846 - sent to Kaiser and to CMS, from inception beginning on 100527.
043848 - ..
043849 - Patty raised 2 concerns...
043850 -
043851 - 1. She indicated that Kasier avoids liability for UCSF
043852 - mistakes while providing care for Millie on referral from
043853 - Kaiser, because Millie is in Hospice, and so Kaiser need
043854 - make no efforts to arrange for life-saving care so long as
043855 - Millie is in Hospice.
043857 - ..
043858 - This position was reviewed and found at best questionable, and likely
043859 - incorrect, in Millie's letter to Kaiser and Medicare on 100630 1537.
043860 - ref SDS C6 M93V
043862 - ..
043863 - Patty's concerns continue...
043864 -
043865 - 2. Patty commented that Kaiser has not denied Millie's claim,
043866 - but rather offers Millie relief from injuries due to UCSF
043867 - medical mistakes, by attending another meeting with the
043868 - doctor to work things out. proposed in Kaiser's letter
043869 - dated 100708, and received on 100710, ref SDS D5 X530, and
043870 - which was Kaiser's determination of Millie's claim filed on
043871 - 100527. ref SDS 81 IZ7N
043873 - ..
043874 - Patty seemed to indicate during the call today, that Medicare cannot
043875 - process Millie's appeal filed on 100713, ref SDS D6 J74S, until after
043876 - Kasier "denies" her claim, and so Kaiser can avoid accountability by
043877 - the simple expedient of offering more meetings, and not using the word
043878 - "denial" in a letter sent to Millie.
043879 -
043880 - [On 100720 0655 letter reports progress on Patty's work
043881 - plan for Medicare to process Millie's appeal, presenting
043882 - evidence that Kaiser has denied Millie's claim, and so
043883 - is ripe for appeal. ref SDS E1 LB8X
043885 - ..
043886 - Since Millie's claim requests immediate treatment with PARP,
043887 - ref SDS 81 IZ7N, and simultaneous standard of care to compare
043888 - trade-offs of additional treatments, ref SDS 81 X766, including review
043889 - in the MD Anderson IBC lab for identifying most likely effective
043890 - treatment to recover from UCSF medical mistakes, ref SDS 81 X78S, then
043891 - Kaiser's offer to merely "discuss" Millie's rapidly failing health
043892 - status due to UCSF medical mistakes, which was offered previously for
043893 - a year without results, constitutes "denial," for Medicare to process
043894 - Millie's appeal to conform Kaiser's determination with evidence of
043895 - Millie's entitlement to be held harmless from UCSF medical mistakes,
043896 - shown by analysis in the record reviewing Kaiser's adverse
043897 - determination on 100710. ref SDS D5 X530
043899 - ..
043900 - Analysis at that time on 100710, shows Kaiser proposing another
043901 - meeting with no work plan to justify "discussion" on holding Millie
043902 - harmless from UCSF medical mistakes is the cause of Millie's claim
043903 - filed on 100527, ref SDS 81 X67R and ref SDS 81 X553, and so cannot be
043904 - the remedy without evidence showing progress can result, otherwise
043905 - this is an endless loop that violates notice requirements for finality
043906 - that enables legal intervention. ref SDS D5 H19L
043908 - ..
043909 - Today, we briefly reviewed again...
043911 - ..
043912 - Millie's letter to Kaiser and UCSF issued on 100501, requests
043913 - implementation of the UCSF work plan on 090616, for Millie to recover
043914 - from UCSF medical mistakes, getting treatment with PARP, and standard
043915 - of care comparing trade-offs on 20 "targeted" therapies required for
043916 - Millie's patient profile. ref SDS 69 U47P, and based on Doctor
043917 - Johnson's examination on 100427, finding Millie's cancer was getting
043918 - worse on Abraxane chemotherapy, ref SDS 68 VL6N, and that Millie was
043919 - getting anemic due to chemotherapy, shown in the medical chart on
043920 - 100330 0830. ref SDS 67 Y889
043922 - ..
043923 - Later that day on 100501, Doctor Rugo notified the medical team that
043924 - she would communicate with Doctor Johnson at Kaiser on Millie's
043925 - request to implement Doctor Rugo's prescription on 090616, to treat
043926 - Millie with PARP to recover from UCSF medical mistakes. ref SDS 70
043927 - HH4I
043929 - ..
043930 - On 100503, Doctor Johnson notified Millie that he would discuss "next
043931 - steps" on Millie's request for treatment with PARP to recover from
043932 - UCSF medical mistakes at the next meeting on 100601. ref SDS 74 HH4I
043934 - ..
043935 - On 100503 2338 Millie reports to medical team that she will implement
043936 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
043937 - letter "today" (on 100503) is assurance that recovery will be equal to
043938 - changing treatment immediately on 100505. ref SDS 75 6X7S
043940 - ..
043941 - On 100527 Millie filed a claim requesting immediate treatment with
043942 - PARP to implement the UCSF work plan for Millie to recover from UCSF
043943 - medical mistakes, ref SDS 81 IZ7N, and citing her letter on 100501, as
043944 - shown in the claim on 100527. ref SDS 81 X553 Doctor Johnson received
043945 - a copy of Millie's claim, summarizing 44 prior requests for treatment
043946 - with PARP beginning a year ago in 2009, and listed in the case study
043947 - on 100622. ref SDS B4 576S
043949 - ..
043950 - On 100601, Millie sent a letter to Doctor Johnson to guide discussion
043951 - of "next steps," ref SDS 84 QQ6N, proposed in the doctor's letter on
043952 - 100503, ref SDS 74 HH4I, and Millie again requested implementation of
043953 - Doctor Rugo's work plan to treat Millie with PARP for recovering from
043954 - UCSF medical mistakes, ref SDS 84 1Q4R, and further as expressly
043955 - presented in her claim filed on 100527. ref SDS 81 IZ7N
043957 - ..
043958 - On 100601, Millie met Doctor Johnson and "discussed" next steps, as
043959 - proposed in Doctor Johnson's letter on 100503. ref SDS 85 4F5J The
043960 - doctor resonded to Millie's claim filed on 100527, and to her request
043961 - in her letter on 100601, by saying he could not communicate with
043962 - Doctor Rugo with email nor the telephone for a month, and so he was
043963 - unable to arrange for Millie to recover from UCSF medical mistakes by
043964 - getting treatment with PARP at UCSF. ref SDS 85 4F6I Since Kaiser
043965 - could not provide treatment to reduce pain from chemotherapy and
043966 - rising cancer, Doctor Johnson could only offer Millie a painful death,
043967 - or medication to relieve pain until death through Hospice. ref SDS 85
043968 - 4H3K
043970 - ..
043971 - On 100606, Doctor Johnson reported he has still not heard from Doctor
043972 - Rugo for starting Millie with PART at UCSF to recover from UCSF
043973 - medical mistakes. ref SDS 92 036C
043975 - ..
043976 - On 100622, letter to Kaiser and Medicare claim teams lists 44 letters
043977 - and meetings going back to March 2009, asking Kaiser to treat Millie's
043978 - IBC have been fruitless. ref SDS B4 576S
043980 - ..
043981 - On 100630, Millie's letter asked Doctor Johnson if he was prepared to
043982 - provide treatment for Millie to recover from UCSF medical mistakes,
043983 - and if not then the meeting scheduled for 100701, should be deferred
043984 - until Kaiser can proceed on its obligations to repair Millie's
043985 - injuries. ref SDS C4 V89U
043987 - ..
043988 - Today, we considered that another meeting cannot yield different
043989 - resutls without guidance from Case Resolution Department providing a
043990 - budget for Doctor Johnson to provide relief for Millie's injuries
043991 - caused by UCSF medical mistakes.
043993 - ..
043994 - Paula seemed to present personal understandings that Doctor Johnson
043995 - has new authority now to correct past mistakes. She urged meeting
043996 - with the doctor, as proposed in Kaiser's response dated 100708, and
043997 - received on 100710, ref SDS D5 X530, to Millie's claim filed on
043998 - 100527.
044000 - ..
044001 - Paula asked what can Kaiser do to hold Millie harmless from UCSF
044002 - medical mistakes?
044003 -
044004 - 1. Millie's claim on 100527, asks Kaiser to provide necessary and
044005 - reasonable steps to implement Doctor Rugo's work plan starting
044006 - with PARP. ref SDS 81 IZ7N
044008 - ..
044009 - 2. Provide standard of care comparing trade-offs on follow on
044010 - traetments, ref SDS 81 X74T, including review by MD Anderson
044011 - IBC lab. ref SDS 81 X78S
044013 - ..
044014 - 3. Refund Millie's oncology expenses since March 2009, that were
044015 - incurred as a result of UCSF medical mistakes, discussed with
044016 - Jennifer on 100609 1522. ref SDS A0 TV3W
044018 - ..
044019 - Paula feels Millie should make a justure of good faith to help Doctor
044020 - Johnson save face by asking to come in and meet with him.
044021 -
044022 - [...below, agree that Millie will send a letter to the
044023 - doctor offering to meet and discuss implmentation of the
044024 - UCSF work plan for holding Millie harmless from UCSF
044025 - medical mistakes. ref SDS 0 EQ44
044027 - ..
044028 - Patty indicated that her office at Medicare will consider Millie's
044029 - claim denied by Kaiser, if Doctor Johnson does not provide relief for
044030 - Millie's injuries suffered from UCSF medical mistakes, and in that
044031 - case, Medicare will process Millie's appeal, as noted in Jullin's
044032 - letter this morning, per above. ref SDS 0 LY3M
044034 - ..
044035 - Explained Medicare's position is erroneous, since it extends Kaiser
044036 - and UCSF pattern and practice of delay to deny Millie essential care
044037 - for the past year, and enables Kaiser to avoid finality to their claim
044038 - process by the simple expedient of not using the word "deny" in its
044039 - documents, and continually offering meetings without solutions, per
044040 - above. ref SDS 0 JQ6L
044042 - ..
044043 - Decided to send Doctor Johnson a letter explaining understandings from
044044 - the meeting today that Millie will meet with the doctor to discuss
044045 - implementation of the UCSF work plan holding Millie harmless from UCSF
044046 - medical mistakes, including treatment with PARP, upon receipt of a
044047 - letter from the doctor saying Kaiser will implement the UCSF work
044048 - plan for Millie to recover.
044050 - ..
044051 - [On 100719 0522 Millie submitted letter to primary care
044052 - physician with work plan to resolve Millie's claim, and
044053 - offered to meet with the doctor to discuss implementation.
044054 - ref SDS D9 JH5V
044056 - ..
044057 - [On 100719 1312 Kaiser proposes only another meeting to
044058 - "discuss next steps," and not to implement UCSF or any
044059 - alternate work plan for Millie to recover from UCSF
044060 - medical mistakes, and ignores Kaiser's fiduciary duty
044061 - to hold Millie harmless from UCSF medical mistakes
044062 - providing care on referral from Kaiser. ref SDS D0 036C
044064 - ..
044065 - Patty said the Medicare claim team participated in the call today in
044066 - order to provide good news for Millie on the weekend, by indicating
044067 - Medicare is working hard to find an equitable solution.
044069 - ..
044070 - Thanked everyone at Kaiser (Paula), and Medicare (Patty, Cherry,
044071 - Beth) for generous considerations on Millie's account.
044072 -
044073 -
044074 -
044075 -
044076 -
044077 -
044078 -
044079 -
044080 -
044081 -
0441 -