CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS E4 0000. ref SDS E2 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 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 plans to collaborate with Doctor
040923 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040924 - of cancer caused by UCSF medical mistakes. ref SDS 70 HH4I
040926 -  ..
040927 - On 100502 2143 Kaiser confirms that some patients respond well to new
040928 - "targeted" therapies. ref SDS 72 YX8L  Kaiser contends that all of the
040929 - strategies for "targeted" therapies have been executed for Millie,
040930 - which seems conflicting with the record in this case. ref SDS 72 MZ4N
040932 -  ..
040933 - On 100503 1522 Millie notifies medical team that time of the essence
040934 - to get the next treatment going. ref SDS 73 TD5W
040936 -  ..
040937 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040938 - with Abraxane chemotherapy that seems to be failing, and then after 3
040939 - more weeks without treatment, following a trip abroad, the doctor will
040940 - discuss "next steps." ref SDS 74 YL5N
040942 -  ..
040943 - On 100503 2338 Millie reports to medical team that she will implement
040944 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040945 - letter on 010503, as assurance that recovery will be equal to changing
040946 - treatment immediately on 100505. ref SDS 75 6X7S
040948 -  ..
040949 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040950 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040951 - communicate with Doctor Johnson, or had already done so, to coordinate
040952 - with Kaiser on planning Millie's next treatment to recover from the
040953 - 11th relapse of cancer. ref SDS 76 NT5N
040955 -  ..
040956 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040957 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040958 - ref SDS 77 KE4K
040960 -  ..
040961 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040962 - seemingly on an accelerating rise, which threatens to cascade out of
040963 - control, because Abraxane chemotherapy is not effective. ref SDS 78
040964 - L54I
040966 -  ..
040967 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040968 - Abraxane. ref SDS 79 KE4K
040970 -  ..
040971 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 80 PK9O
040973 -  ..
040974 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040975 - Department for standard of care to recover from 11th relapse of cancer
040976 - caused by medical mistakes getting radiation treatments at UCSF on
040977 - referral from Kaiser. ref SDS 81 IZ7N
040979 -  ..
040980 - On 100528 0322 Millie requests support from Medicare to separate
040981 - recovery for medical mistakes getting radiation from UCSF, from health
040982 - care benefits limited by Medicare insurance coverage. ref SDS 82 QQ6N
040984 -  ..
040985 - On 100528 1031 called Medicare they have formed a team to review
040986 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040987 - response to Millie's claim. ref SDS 83 4W5F
040989 -  ..
040990 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040991 - collaborate with UCSF using email or the telephone on treatment for
040992 - Millie to recover from UCSF medical mistakes. ref SDS 85 4F6I  He
040993 - discussed treating Millie with MPA, but this was not prescribed
040994 - because Millie was treated with MPA in 2009, and UCSF ended the
040995 - treatment due to fears about blood clot side effects, which were
040996 - believed to cause breathing problems Millie had, though later
040997 - breathing problems were discovered to be caused by defective radiation
040998 - treatment. ref SDS 85 WG7J  Since Doctor Johnson said Kaiser has no
040999 - more treatments for Millie, the only way Millie can get relief from
041000 - pain caused by cancer that is progressing without treatment is get
041001 - treatment in Hospice.  Since Hospice is the only choice of care
041002 - offered today, Millie accepted this. ref SDS 85 4H3K
041004 -  ..
041005 - On 100601 1531 Sharon called to schedule starting Hospice medical
041006 - services beginning tomorrow between 0900 - 1000. ref SDS 86 036C
041008 -  ..
041009 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041010 - Sharon's report yesterday, that if Kaiser performs on the insurance
041011 - agreement to provide standard of care for Millie's patient profile,
041012 - than Millie can elect to recover from 11th relapse of cancer, rather
041013 - than continue with Hospice support for dying peacefully. ref SDS 87
041014 - 036C
041016 -  ..
041017 - On 100602 1046 Diane received notice from Medicare to file claim for
041018 - Millie to get treatment for recovering from UCSF medical mistakes; she
041019 - is preparing a statement of claim. ref SDS 88 036C  Advised Diane to
041020 - use Millie's statement of claim submitted to Kaiser on 100527.
041021 - ref SDS 88 MZ5H  Eileen called later and reported that Kaiser denied
041022 - Millie's claim on the grounds that Medicare does not authorize payment
041023 - for treatment to recover from cancer, after a patient starts Hospice.
041024 - ref SDS 88 UN4M  Requested that Eileen read he claim and then make a
041025 - good faith determiantion. ref SDS 88 I33H  Eileen called back after
041026 - reading the claim and advised the denial of claim has been withdrawn,
041027 - and the matter is referred to Claims Resolution Department.
041028 - ref SDS 88 UN5P
041030 -  ..
041031 - On 100603 0449 Millie notified medical team that Kaiser called today
041032 - about moving forward to resolve medical mistakes getting radiation
041033 - treatment at UCSF on referral from Kaiser. ref SDS 89 IX9Q
041035 -  ..
041036 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041037 - has remained fairly stable the past 3 weeks since ending treatment
041038 - with Abraxane on 100512; actually went up less without Abraxane, than
041039 - with it, because Millie's cancer resists chemotherapy. ref SDS 90 036C
041041 -  ..
041042 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041043 - cancer marker CA 15-3 606 much smaller rise than exptected after
041044 - ending treatment for 3 weeks. ref SDS 91 036C; asks if Doctor Rugo
041045 - ever returned Doctor Johnson's call from Kaiser, as planned in Doctor
041046 - Rugo's letter on 100501?
041048 -  ..
041049 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041050 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041051 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041052 - commitment in UCSF letter sent to the medical team on 100501.
041053 - ref SDS 92 036C
041055 -  ..
041056 - On 100607 0932 called Cherry at Medicare about progress on contacting
041057 - Kaiser to process Millie's claim filed on 100527, and planned in the
041058 - call with Medicare (Cherry and Beth) as action item #8, planned the
041059 - next day on 100528 1031, ref SDS 83 PE6P; today, Cherry did not have
041060 - time to return the call. ref SDS 93 036C
041062 -  ..
041063 - On 100607 1021 called Paula at Kaiser - she said someone else is
041064 - handling Millie's claim, because the claim has not been denied, and
041065 - Paula only handles denied claims. ref SDS 94 036C; Paula further
041066 - reported that Kaiser no longer objects to demaning UCSF correct
041067 - medical mistakes, so Millie's claim should be easy to resolve.
041068 - ref SDS 94 QN9F
041070 -  ..
041071 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041072 - process Millie's claim for care promptly in order to save her life.
041073 - ref SDS 95 036C
041075 -  ..
041076 - On 100608 1521 called and talked to Cherry and Beth about expediting
041077 - Millie's claim at Kaiser. ref SDS 96 036C  Developed work plan to have
041078 - a conference call with Kaiser tomorrow. ref SDS 96 C354  Submitted
041079 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041080 - ref SDS 96 G84Q
041082 -  ..
041083 - On 100609 1114 called CMS to expedite conference call on expediting
041084 - Millie's care. ref SDS 97 036C  Cherry called and schedule telecon with
041085 - Kaiesr and CMS today 1300. ref SDS 97 8O4H  Received letter from Cherry
041086 - at CMS confirming work plan for conference call at 1300. ref SDS 97
041087 - PRXY
041089 -  ..
041090 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041091 - call to review progress on Kaiser resolving Millie's claim for
041092 - recovery from UCSF medical mistakes. ref SDS 98 036C
041094 -  ..
041095 - On 100609 1300 CMS and Kaiser conference call to report progress on
041096 - reviewing Millie's claim for treatment to recover from UCSF medical
041097 - mistakes in time to be effective. ref SDS 99 036C
041099 -  ..
041100 - On 100609 1522 Jennifer called for assistance processing Millie's
041101 - claim to recover from medical mistakes getting radiation treatment at
041102 - UCSF on referral from Kaiser. ref SDS A0 036C
041104 -  ..
041105 - On 100611 1451 Jennifer advised Kaiser extended the date for
041106 - responding to Millie's claim from 100610 to 100624, based on Millie
041107 - filing updated statement of authorized representative. ref SDS A4 036C
041108 - Jennifer reported she reviewed 6-issues discussed on 100609, and will
041109 - address these issues responding to Millie's claim. ref SDS A4 FQ4G
041110 - Jennifer asked how Kaiser can treat Millie to recover from UCSF
041111 - medical mistakes, if Millie refuses chemotherapy and has entered
041112 - Hospice. ref SDS A4 FQ4M
041114 -  ..
041115 - On 100611 2326 Millie received Jennifer's letter confirming the date
041116 - for Kaiser to respond to Millie's claim has been extended to 100624,
041117 - ref SDS A5 CV4O, and further advising that issues Kaiser will determine
041118 - responding to Millie's claim for recovering from UCSF medical
041119 - mistakes, ref SDS A5 036C, are as set out in the record for telecon on
041120 - 100609. ref SDS A0 XK50  Jennifer will call on 100615, to report
041121 - progress on respnding to Millie's claim. ref SDS A5 6P53
041123 -  ..
041124 - On 100614 0257 letter to Kaiser Medicar CMS claim team requests
041125 - immediate written proposal evaluating treatment options for Millie to
041126 - consider. ref SDS A6 036C
041128 -  ..
041129 - On 100616 0832 called Jennifer about her plan to call yesterday on
041130 - Tuesday to report progress Kaiser responding to Millie's claim, as set
041131 - out in Jennifer's letter on 100611. ref SDS A7 036C   Jennifer called
041132 - back to ask if Millie wants UCSF or Kaiser to pay for her damages
041133 - caused by UCSF medical mistakes. ref SDS A7 PSSV  Jennifer reported
041134 - delays communicating with Millie's medical team have delayed making
041135 - arrangements for Millie to start treatment recovering from UCSF
041136 - medical mistakes. ref SDS A7 OY4T  She plans to call on Friday, 100618,
041137 - to report progress responding to Millie's claim. ref SDS A7 1K5J
041139 -  ..
041140 - On 100618 0843 called Jennifer at Memeber Case Resolution Department
041141 - about progress responding to Millie's claim. ref SDS A8 036C
041143 -  ..
041144 - On 100620 1112 letter to Kaiser claim team with copy to Medicare, and
041145 - the medical team requests call on Monday 100621, planned for previous
041146 - Friday, 100628, to report progress getting Millie treatment.
041147 - ref SDS A9 036C  Recommends that delay communicating with medical team
041148 - that has delayed Millie starting treatment in time to be effective,
041149 - ref SDS A9 L59P, can be solved by hiring MD Anderson. ref SDS A9 L59X
041151 -  ..
041152 - On 100621 0853 called for Jennifer and left several messages,
041153 - including for her team lead. ref SDS B1 036C  Nobody had time today
041154 - for calling back. ref SDS B1 OP3N
041156 -  ..
041157 - On 100622 1027 Jennifer called and advised that Doctor Johnson
041158 - responded to request for comment on Millie's claim saying he cannot
041159 - provide care for Millie because she entered Hospice on 100601,
041160 - ref SDS B3 036C; recommended Jennifer check Kaiser's medical chart for
041161 - Millie meeting with Doctor Johnson to see Millie was given no choices
041162 - except to enter Hospice in order to avoid further pain and suffering.
041163 - ref SDS B3 NX68
041165 -  ..
041166 - On 100622 1511 letter to claim team and Medicare, and to Millie's
041167 - medical team confirming understanding in Jennifer's call that Millie's
041168 - medical team at Kaiser seems to refuse Millie standard of care to
041169 - recover from UCSF medical mistakes, because she was forced to enter
041170 - Hospice to get relief from pain caused by UCSF medical mistakes.
041171 - ref SDS B4 036C  UCSF delays compounded Millie's injuries, pain, and
041172 - suffering; caution must be exercised to enable recovery, based on
041173 - Millie's right to life. ref SDS B4 575U   Millie's patient history
041174 - shows the doctor's only issue, ref SDS B4 576V, is having time to
041175 - providing standard of care for Millie to recover from medical
041176 - mistakes, and if not, then Kaiser should assign someone who does.
041177 - ref SDS B4 583Y  Kaiser has violated Millie's human rights; a woman's
041178 - right to choose life for herself, should be no less than the right to
041179 - choose for her unborn child, since the right to life and due process
041180 - are protected by the US Constitution. ref SDS B4 584W  Kaiser can
041181 - easily solve the time problem by hiring other people to do the work,
041182 - and charging UCSF. ref SDS B4 585P
041184 -  ..
041185 - 100624 1616 Jennifer called and asked to extend Kaiser's response to
041186 - Millie's claim another day or so, for review with her boss, and with
041187 - the customer. ref SDS B5 036C  Jennifer the original date for Kaiser to
041188 - respond on 100610, required by statute, and then amended to today on
041189 - 100624, can be further amended, and cited unclear authority about 30
041190 - days instead of 14. ref SDS B5 EG5P  Agreed that extending Kaiser's
041191 - response another few days until tomorrow, or Monday, is an acceptable
041192 - risk, even though Millie's cancer markier has increased significantly
041193 - to over 1000, and so that an equitable solution can be implented that
041194 - allows treatment in time to be effective for Millie. ref SDS B5 EG73
041195 - Jennifer will submit her draft response, and call tomorrow for
041196 - discussing Kaiser's solution. ref SDS B5 H98M
041198 -  ..
041199 - On 100625 0852 letter to Kaiser and Medicare claim teams confirming
041200 - Kaiser's request to extend date for responding to Millie's claim
041201 - another few days until Monday in order to get comprehensive solution.
041202 - ref SDS B6 036C
041204 -  ..
041205 - On 100626 0917 received letter from Cherry at Medicare, ref SDS B7
041206 - 036C, submitting CMS regulations, that control due date for Kaiser to
041207 - respond to Millie's claim. ref SDS B7 N64I
041209 -  ..
041210 - On 100628 0228 letter to claim teams at Medicare and Kaiser asking how
041211 - CMS regulations received on 100625, apply to extend Kaiser's response
041212 - date for expediting Millie's recovery. ref SDS B8 036C
041214 -  ..
041215 - On 100628 1033 called CMS Medicare for Beth Simone on regulations for
041216 - Kaiser to respond to Millie's claim.
041218 -  ..
041219 - On 100628 2318 submitted record of telecon with CMS, ref SDS C0 036C,
041220 - and that CMS learned today that Kaiser changed Millie's claim to a
041221 - Grievance, and notified CMS that Kaiser intends to delay response
041222 - until 100710, to Millie's claim filed on 100527.
041224 -  ..
041225 - On 100629 00003 received letter from Cherry transmitting Grievance
041226 - procedures, cited in the telecon yesterday as a change Kaiser made to
041227 - delay responding until 100710, to Millie's claim filed on 100527.
041228 - ref SDS C1 036C  Review of Grievance regulations show Kaiser required
041229 - to make timely response based on patient health. ref SDS C1 PN5S
041231 -  ..
041232 - On 100629 0013 letter thanks CMS for submitting regulations on
041233 - Grievance procedures, and notes requirements for Kaiser to respond
041234 - prior to maximum allowed of 30 days, based on patient health.
041235 - ref SDS C2 036C
041237 -  ..
041238 - On 100629 1631 called Medicare (CMS) on results of their
041239 - teleconference with Kaiser on expediting response to Millie's claim.
041240 - ref SDS C3 036C
041242 -  ..
041243 - On 100630 0027 Millie thanks Doctor Johnson for reporting on 100606,
041244 - that UCSF did not call Kaiser to provide care for Millie to recover
041245 - from UCSF medical mistakes. ref SDS C4 036C; she reports blood counts
041246 - are good, but cancer progressing because treatment was stopped on
041247 - 100601, for pain relief from chemotherapy. ref SDS C4 V83U  Kaiser has
041248 - deferred responding to Millie's claim, ref SDS C4 V87S, and needs to
041249 - know how soon her health status requires Kaiser to make a response.
041250 - ref SDS C4 V88T  Millie asks about deferring the meeting with Doctor
041251 - Johnson tomorrow, until Kaiser responds to Millie's claim, or, Millie
041252 - would love to meet, if Doctor Johnson has communicated with Doctor
041253 - Rugo on a work plan for Millie to recover from UCSF medical mistakes.
041254 - ref SDS C4 V89X
041256 -  ..
041257 - On 100630 1148 Doctor Johnson notfies Millie, and the Kaiser claim
041258 - team that he is confused about Millie's case, because Kaiser has
041259 - deferred determination on urgent requirement for care. ref SDS C5 036C
041260 - Doctor Johnson notes Millie is in Hospice and states that Millie's
041261 - disease is resistant to all forms of therapy, and that entering
041262 - Hospice is based on patient desire to forego therapy. ref SDS C5 PY4J
041263 - He asks if Millie wants to dis-enroll from Hospice. ref SDS C5 OY5G
041264 - Doctor Johnson further notes that public domain email conflicts with
041265 - HIPAA regulations. ref SDS C5 0W5U
041267 -  ..
041268 - On 100630 1537 Millie notified medical team and claim team, thanking
041269 - Doctor Johnson for his letter commenting on Millie feeling better
041270 - after ending chemotherap.  Confirms Doctor Johnson's intent to defer
041271 - meeting scheduled for tomorrow until after Kaiser responds to Millie's
041272 - claim, and further confirms Doctor Johnson has still not communicated
041273 - with Doctor Rugo on UCSF providing care for Millie to recover from
041274 - UCSF medical mistakes. ref SDS C6 M86X  Advises that Doctor Johnson's
041275 - assertion that Millie's cancer now resists all forms of therapy
041276 - conflicts with the record; Doctor Johnson advised that finding
041277 - effective treatment requires experimentation; Millie's first treatment
041278 - failed, and had to be switched. ref SDS C6 M87Q  When UCSF discovered
041279 - medical mistakes, UCSF failed to provide necessary and reasonable care
041280 - for Millie to recover, and instead prescribed chemotherapy, which was
041281 - not effective and caused unbearable pain and suffering, causing Millie
041282 - to enter Hospice. ref SDS C6 M84P  The only evident purpose for
041283 - Millie's death is to avoid accountability from medical mistakes and
041284 - avoid cost of recovery, by making Millie suffer, and making Medicare
041285 - pay, while Millie is actually innocent, and Medicare is innocent.
041286 - ref SDS C6 M84S  Millie sent 44 letters to medical team requesting
041287 - targeted treatment to recover from UCSF medical mistakes, and
041288 - reporting pain and suffering from chemotherapy; so, on 100601, Millie
041289 - entered Hospice for pain relief for chemotherapy. ref SDS C6 M84Y
041290 - Millie cannot dis-enroll from Hospice providing pain medication until
041291 - Kaiser provides standard of care to recover from UCSF medical
041292 - mistakes. ref SDS C6 M93V  Millie explains benefits to saving lives,
041293 - time, and money using public domain email. ref SDS C6 M94W  Millie
041294 - notes Doctor Johnson's report today shows Kaiser has violated Medicare
041295 - regulations by delaying response to her claim longer than justified by
041296 - Millie's health status. ref SDS C6 M96P
041298 -  ..
041299 - On 100701 0915 Carol called this morning saying she is the Chief of
041300 - Hospice and advised that she was told that Millie wants to dis-enroll
041301 - from Hospice.  Millie sent a letter to the medical team, and claim
041302 - teams confirming understandings from the call with Carol. ref SDS C7
041303 - 036C  Millie advised Carol that Millie entered Hospice for pain relief
041304 - for chemotherapy, and so she cannot dis-enroll from Hospice providing
041305 - pain medication until Kaiser provides standard of care to recover from
041306 - UCSF medical mistakes. ref SDS C7 Q85S  Millie explains she wants a
041307 - written medical opinion on treatments lined up for her to recover from
041308 - UCSF medical mistakes that provides a "roadmap to a future worth
041309 - living." ref SDS C7 Q85Y
041311 -  ..
041312 - On 100701 1140, meeting this morning scheduled during a prior meeting
041313 - at Kaiser on 100601, ref SDS 85 7E4S, was canceled because Doctor
041314 - Johnson's letter yesterday, said nothing about receiving instructions
041315 - from Kaiser's claims department on solving Millie's claim for care to
041316 - recover from UCSF medical mistakes, ref SDS C5 036C   Since Doctor
041317 - Johnson was not authorized to provide care requested in Millie's claim
041318 - on 100527, ref SDS 81 IZ7N, meeting would jeperodize Millie's rights
041319 - in the case by adding or otherwise modifying her statement of claim.
041320 - ref SDS C8 036C
041322 -  ..
041323 - On 100701 1213 Lois called and talked to Rod for explanation of
041324 - Millie's claim, and planned to talk with Doctor Johnson about a
041325 - resolution. ref SDS C9 036C
041327 -  ..
041328 - On 100702 1424 Millie received letter from Doctor Johnson submitting
041329 - Kaiser's lab report on results of Millie's blood test on 100622, and
041330 - without comment except the doctor circled with ink CA 15-3 1116.
041331 - ref SDS D0 036C
041333 -  ..
041334 - On 100702 1612 Lois called and reported discussing Millie's claim with
041335 - Doctor Johnson, who evidently indicated he cannot find on the Internet
041336 - a provider willing to treat Millie with PARP. ref SDS D1 036C  Lois
041337 - asked to talk with Millie in order to verify what Millie wants in her
041338 - claim filed on 100527.  Lois was referred to Millie's claim, and to
041339 - the letter to Kaiser on 100701, confirming Millie's telecon with
041340 - Carol, with the Kaiser Hospice program. ref SDS C7 036C
041342 -  ..
041343 - On 100705 2050 planning letter to Kaiser and Medicare claim teams
041344 - asking for remedies for damanges caused by Kaiser delaying response to
041345 - Millie's request for urgent care. ref SDS D2 036C
041347 -  ..
041348 - On 100708 0038 letter to Kaiser with copy to Medicare asking for
041349 - Millie's remedies for Kaiser delaying response to Millie's claim
041350 - requesting immedicate treatment to recover from UCSF medical mistakes.
041351 - ref SDS D4 036C
041353 -  ..
041354 - On 100710 1343 Millie received a letter from Kaiser responding to her
041355 - claim. ref SDS D5 036C  Kaiser says the office Millie was directed to
041356 - submit her claim to be held harmless from medical mistakes was
041357 - incorrect. ref SDS D5 X48S  Kaiser advises that Doctor Johnson reports
041358 - Millie's patient hsitory makes getting treatment with PARP prescribed
041359 - by Doctor Rugo to recover from UCSF medical mistakes due to
041360 - "eligibility" issues. ref SDS D5 X45V  The doctor feels Millie's cancer
041361 - is difficult to treat, and maintains nothing can help her recover from
041362 - UCSF medical mistakes without having tried a single treatment listed
041363 - in Millie's claim; Kaiser does not deny any request in Millie's claim,
041364 - but proposes she discuss her care directly with Doctor Johnson who
041365 - claims to have lost hope. ref SDS D5 X530  Kaiser apoligizes for taking
041366 - 44 days to respond to Millie's claim, because unnamed regulations give
041367 - Kaiser 30 days to respond. ref SDS D5 X547   Kaiser advises Millie can
041368 - dispute the determination through arbitration, but Kaiser does not
041369 - present a disputable issue. ref SDS D5 768G  Kaiser advises that Millie
041370 - can appeal to Medicare. ref SDS D5 X54Q
041372 -  ..
041373 - On 100713 0007 Millie requests reconsideration Kaiser's determination
041374 - on Millie's claim, ref SDS D6 036C, and appeals to Medicare for
041375 - compliance with CMS regulations. ref SDS D6 J74S
041377 -  ..
041378 - On 100714 0742 Millie received copy of an internal letter Paula sent
041379 - notifying the Kaiser claim team that Millie's letter on 100713,
041380 - requests reconsideration and appeals to Medicare Kaiser's letter dated
041381 - 100708, and received on 100710, denying Millie's claim to recover from
041382 - medical mistakes filed on 100527. ref SDS D7 036C
041384 -  ..
041385 - On 100715 1802 received securemail from Jennifer with response from
041386 - Kaiesr claim team, ref SDS D8 036C, to the letter on 100713, requesting
041387 - reconsideration and appealing, ref SDS D6 036C, Kaiser's letter dated
041388 - 100708, and received on 100710, ref SDS D5 036C, denying Millie's
041389 - claim filed on 100527. ref SDS 81 IZ7N
041391 -  ..
041392 - On 100716 0830 called Beth at CMS (Medicare), ref SDS D9 036C, to
041393 - verify request on 100713 appealing to Medicare, ref SDS D6 J74S,
041394 - Kaiser's claim team letter dated 100708, received on 100710,
041395 - ref SDS D5 036C, denying Millie's appeal for standard of care to
041396 - recover from UCSF medical mistakes beginning with PARP. ref SDS 81
041397 - IZ7N; sent letter to Jullin at CMS asking if anything more needs to be
041398 - filed for Medicare to process Millie's request for appealing Kaiser's
041399 - denial of Millie's claim. ref SDS D9 07FC  While hiking at Lafayette
041400 - Reservoir, received call from Paula at Kaiser claim team.  Reception
041401 - was poor due to wind, so decided to call again at the house in a few
041402 - hours. ref SDS D9 D69K  Received letter from Jullin saying Millie's
041403 - appeal is submitted to Medicare on Kaiser's denial of care.
041404 - ref SDS D9 07FC  Paula called from Kaiser claim team, and this became a
041405 - conference call with CMS (Medicare) on advancing Millie's claim for
041406 - recovery from UCSF medical mistakes. ref SDS D9 PW3U
041408 -  ..
041409 - On 100719 0522 Millie sent a letter to Doctor Johnson explaining
041410 - background on claim team, ref SDS E0 036C, suggestions for another
041411 - meeting. ref SDS E0 JH5V  Millie notified the doctor that she wants a
041412 - written work plan from Kaiser on recovering from UCSF medical
041413 - mistakes. ref SDS E0 JH5Y  She submits a draft to illustrate elements
041414 - of the work plan. ref SDS E0 JH8P  Millie will meet with the doctor to
041415 - implment the work plan. ref SDS E0 JH4T
041417 -  ..
041418 - On 100719 1413 Paula called about processing Millie's case for appeal
041419 - to Medicare from Kaiser's denial of Millie's claim requesting recovery
041420 - from UCSF medical mistakes providing care for Millie on referral from
041421 - Kaiser. ref SDS E2 036C  Paula plans to talk with Doctor Johnson on
041422 - solving the claim, ref SDS E2 HI8F; she also filed a 2nd claim on
041423 - Millie's behalf with Expedited Claims in order to get a denial, so
041424 - that she can personally handle the case. ref SDS E2 4G4L
041426 -  ..
041427 - On 100719 1618 Regina called to process Millie's Expedited Claim
041428 - ordered by Paula in Case Resolution. ref SDS E4 036C
041430 -  ..
041431 - On 100720 0655 letter requests again confirmation, ref SDS 0 036C,
041432 - that Medicare is processing her appeal filed on 100713, ref SDS D6
041433 - J74S, and notifies Medicare of progress performing work plan proposed
041434 - on 100719, by Medicare and Kaiser (Paula), for Millie to offer meeting
041435 - with primary care physician, ref SDS E2 H538; and Millie notified
041436 - Medicare that Paula issued a 2nd claim for Millie, with intent for
041437 - processing of her first claim to be transferred to Paula, ref SDS E2
041438 - 4G4L; notified Medicare that while Paula's intention is honorable,
041439 - starting a 2nd claim complicates claim review, and delays Millie
041440 - getting treatment, and so Millie objects to the 2nd claim.
041441 -
041442 -
041443 -
041445 -  ..
0415 -
0416 -
0417 - Progress
0418 -
041801 - Millie's letter to Medicare and to Kaiser (Paula) says...
041802 -
041803 -    1.  Subject: Appeal Reconsideration Kaiser's Denial Millie's Claim
041804 -        Date: Tue, 20 Jul 2010 07:45:43 -0700
041814 -         ..
041815 -    2.  Please confirm that Medicare is now processing Millie's appeal
041816 -        filed with Medicare on 100713, ref SDS D6 J74S, to Kaiser's
041817 -        adverse determination on 100708 [...received on 100710 1343.
041818 -        ref SDS D5 X530, and Millie's letter on 100716, to Medicare
041819 -        requesting confirmation that Millie's appeal was being
041820 -        processed, ref SDS D9 LX4J...] of Millie's claim filed on
041821 -        100527, requesting life-saving care in time to be effective.
041822 -        ref SDS 81 IZ7N
041824 -         ..
041825 -    3.  This request is based on progress performing Patty's work plan
041826 -        proposed in the conference call with Paula at Kaiser last
041827 -        Friday, on 100716. ref SDS D9 GR5K
041829 -         ..
041830 -    4.  At that time, Paula suggested Millie offer to meet with Doctor
041831 -        Johnson again, as proposed in Kaiser's letter on 100708,
041832 -        responding to Millie's claim filed on 100527.
041834 -         ..
041835 -    5.  In sum, since "meetings with the doctor" are cited for delaying
041836 -        Millie's care over the past year, thereby causing Millie's
041837 -        claim requesting relief from medical mistakes, then having
041838 -        another "meeting" cannot be the remedy without evidence that
041839 -        meeting will yield a different outcome, for example, by
041840 -        discussing details implementing care rather than whether care
041841 -        will be provided. Without evidence of progress, another meeting
041842 -        with the doctor violates notice requirements for finality in
041843 -        contracts that enables legal protection.
041845 -         ..
041846 -    6.  Based on this core principle, I therefore request that Medicare
041847 -        (CMS) proceed with Millie's appeal from Kaiser's denial on
041848 -        100708, of Millie's claim filed on 100527, seeking recovery
041849 -        from UCSF medical mistakes providing care on referral from
041850 -        Kaiser, and as shown in para 11 and 12 of Millie's letter dated
041851 -        100713. ref SDS D6 J66X
041853 -         ..
041854 -    7.  Kaiser's response on 100715, and received yesterday afternoon
041855 -        on 100719 (thanks to Paula), makes clear that appeal to
041856 -        Medicare is now Millie's only effective redress. ref SDS E3
041857 -        ER9U
041859 -         ..
041860 -    8.  Though not required, Millie sent a letter to the doctor
041861 -        yesterday, and offering to meet and discuss implementation of a
041862 -        work plan to recover from UCSF medical mistakes, and which has
041863 -        been pending for over a year, since 090616.  Medicare received
041864 -        a copy of Millie's letter to the doctor sent on 100719,
041865 -        offering to meet. ref SDS E0 036C
041867 -         ..
041868 -    9.  The doctor responded later that day, offering only to meet and
041869 -        discuss "next steps", and expressly avoiding Kaiser's fiduciary
041870 -        duty to help Millie recover from UCSF medical mistakes.
041871 -        ref SDS E1 036C
041873 -         ..
041874 -   10.  Review shows this is the same offer the doctor proposed on
041875 -        100503, to Millie's prior request for help on 100501, i.e., not
041876 -        to provide care, but merely discuss "next steps," and so does
041877 -        not meet minimum standard of evidence for progress on Millie's
041878 -        claim, shown by analysis in the record on 100719. ref SDS E1
041879 -        0X78
041881 -         ..
041882 -   11.  Paula called yesterday afternoon, after receiving the doctor's
041883 -        letter earlier in the morning.  She planned to call and discuss
041884 -        with the doctor making a stronger response to Millie's claim
041885 -        seeking recovery from UCSF medical mistakes [...reported
041886 -        on 100719 1413. ref SDS E2 HI8F...]
041887 -
041888 -            [On 100722 1328 Paula reported that Doctor Johnson has not
041889 -            had time to return her calls on arranging for Millie's care
041890 -            to recover from UCSF medical mistakes. ref SDS E5 036C
041892 -         ..
041893 -   12.  During the call [...on 100719...] Paula decided to file another
041894 -        claim on Millie's behalf with Kaiser's Expedited Claims
041895 -        Department, and for the purpose of getting a "denial," so that
041896 -        the claim would come to her desk for further processing, and so
041897 -        she can attempt in good faith to resolve the matter equitably
041898 -        and quickly in time for Millie to get effective care.
041899 -        ref SDS E2 H538
041901 -         ..
041902 -   13.  This seems a well intentioned effort by Kaiser to resolve
041903 -        Millie's claim, and can run concurrent with Medicare review of
041904 -        Millie's appeal filed on 100713, ref SDS D6 J74S, since parties
041905 -        can settle at any time.
041907 -         ..
041908 -   14.  In the late afternoon yesterday, I received a call from Regina
041909 -        in Kaiser's Expedited Claims office in Oakland.  She had
041910 -        received a big stack of paper and asked what she is supposed to
041911 -        do?   Regina disclosed a new claim number, and said that
041912 -        Millie's claim is so complicated that she will ask her boss to
041913 -        call today and discuss what is intended. ref SDS E4 036C
041915 -         ..
041916 -   15.  This raises a concern that Millie's rights to timely care will
041917 -        be delayed by complications processing multiple claims, and so
041918 -        to this extent Millie objects to the second filing, even though
041919 -        Paula did this with intent of getting an official "denial,"
041920 -        which Patty seemed to indicate last Friday is needed for
041921 -        Medicare to proceed with Millie's appeal [...reported on 100716
041922 -        0830. ref SDS D9 H35M...]  Millie holds that Kaiser failing to
041923 -        provide requested and adequate relief for her injuries from
041924 -        UCSF medical mistakes providing care on referral from Kaiser is
041925 -        sufficient for "denial" of her claim, under the rule that
041926 -        "delay is the surest form of denial," and so cannot be
041927 -        sustained particularly involving issues of getting life-saving
041928 -        care in time to be effective.
041930 -         ..
041931 -   16.  Please confirm that Medicare is now processing Millie's appeal
041932 -        from Kaiser's adverse determination dated 100708, of Millie's
041933 -        claim filed on 100527, and now confirmed in Kaiser's letter
041934 -        dated 100715.
041935 -
041942 -
041943 -
041944 -
041945 -
041946 -
041947 -
041948 -
041949 -
041950 -
041951 -
041952 -
041953 -
041954 -
0420 -