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 22, 2010 01:28 PM Thursday; Rod Welch

Paula called about equitable resolution of Millie's claim to recover from
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 E6 0000. ref SDS E4 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 69
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 69 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 70
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 70 U47P and ref SDS 70
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 71 HH4I
040926 -  ..
040927 - On 100502 2143 Kaiser confirms that some patients respond well to new
040928 - "targeted" therapies. ref SDS 73 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 73 MZ4N
040932 -  ..
040933 - On 100503 1522 Millie notifies medical team that time of the essence
040934 - to get the next treatment going. ref SDS 74 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 75 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 76 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 77 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 78 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 79
040964 - L54I
040966 -  ..
040967 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040968 - Abraxane. ref SDS 80 KE4K
040970 -  ..
040971 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 81 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 82 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 83 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 84 4W5F
040989 -  ..
040990 - On 100601 0136 Millie submitted agenda to medical team for meeting
040991 - with Doctor Johnson at Kaiser, ref SDS 85 QQ6N, initially notifying the
040992 - team that cancer has gotten worse due to improper treatment for a
040993 - year. ref SDS 85 1P6U; Millie reports new medical problem of swelling
040994 - her lower legs. ref SDS 85 1Q3S, and that appetite and energy continue
040995 - to decline caused by improper treatment with chemotherapy the past
040996 - year, ref SDS 85 1Q3V; so, "everybody is now on board" that
040997 - chemotherapy has failed to relieve Millie's cancer, causes agonizing
040998 - pain and suffering, causes fatal infection, and anemia, ref SDS 85
040999 - 1Q5T; Millie requests again implementing UCSF work plan presented on
041000 - 090616, using treatment targeted to Millie's cancer beginning with
041001 - PARP or equal, and for the purpose of recovering from UCSF medical
041002 - mistakes, ref SDS 85 1Q3Y, and as planned in Doctor Rugo's letter on
041003 - 100501, and as further requested in Millie's claim filed on 100527,
041004 - with copy to Doctor Johnson. ref SDS 85 1Q5W  Critical step is starting
041005 - treatment with PARP immediately. ref SDS 85 1Q6U
041007 -  ..
041008 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
041009 - collaborate with UCSF using email or the telephone on treatment for
041010 - Millie to recover from UCSF medical mistakes. ref SDS 86 4F6I  He
041011 - discussed treating Millie with MPA, but this was not prescribed
041012 - because Millie was treated with MPA in 2009, and UCSF ended the
041013 - treatment due to fears about blood clot side effects, which were
041014 - believed to cause breathing problems Millie had, though later
041015 - breathing problems were discovered to be caused by defective radiation
041016 - treatment. ref SDS 86 WG7J  Since Doctor Johnson said Kaiser has no
041017 - more treatments for Millie, the only way Millie can get relief from
041018 - pain caused by cancer that is progressing without treatment is get
041019 - treatment in Hospice.  Since Hospice is the only choice of care
041020 - offered today, Millie accepted this. ref SDS 86 4H3K
041022 -  ..
041023 - On 100601 1531 Sharon called to schedule starting Hospice medical
041024 - services beginning tomorrow between 0900 - 1000. ref SDS 87 036C
041026 -  ..
041027 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041028 - Sharon's report yesterday, that if Kaiser performs on the insurance
041029 - agreement to provide standard of care for Millie's patient profile,
041030 - than Millie can elect to recover from 11th relapse of cancer, rather
041031 - than continue with Hospice support for dying peacefully. ref SDS 88
041032 - 036C
041034 -  ..
041035 - On 100602 1046 Diane received notice from Medicare to file claim for
041036 - Millie to get treatment for recovering from UCSF medical mistakes; she
041037 - is preparing a statement of claim. ref SDS 89 036C  Advised Diane to
041038 - use Millie's statement of claim submitted to Kaiser on 100527.
041039 - ref SDS 89 MZ5H  Eileen called later and reported that Kaiser denied
041040 - Millie's claim on the grounds that Medicare does not authorize payment
041041 - for treatment to recover from cancer, after a patient starts Hospice.
041042 - ref SDS 89 UN4M  Requested that Eileen read he claim and then make a
041043 - good faith determiantion. ref SDS 89 I33H  Eileen called back after
041044 - reading the claim and advised the denial of claim has been withdrawn,
041045 - and the matter is referred to Claims Resolution Department.
041046 - ref SDS 89 UN5P
041048 -  ..
041049 - On 100603 0449 Millie notified medical team that Kaiser called today
041050 - about moving forward to resolve medical mistakes getting radiation
041051 - treatment at UCSF on referral from Kaiser. ref SDS 90 IX9Q
041053 -  ..
041054 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041055 - has remained fairly stable the past 3 weeks since ending treatment
041056 - with Abraxane on 100512; actually went up less without Abraxane, than
041057 - with it, because Millie's cancer resists chemotherapy. ref SDS 91 036C
041059 -  ..
041060 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041061 - cancer marker CA 15-3 606 much smaller rise than exptected after
041062 - ending treatment for 3 weeks. ref SDS 92 036C; asks if Doctor Rugo
041063 - ever returned Doctor Johnson's call from Kaiser, as planned in Doctor
041064 - Rugo's letter on 100501?
041066 -  ..
041067 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041068 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041069 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041070 - commitment in UCSF letter sent to the medical team on 100501.
041071 - ref SDS 93 036C
041073 -  ..
041074 - On 100607 0932 called Cherry at Medicare about progress on contacting
041075 - Kaiser to process Millie's claim filed on 100527, and planned in the
041076 - call with Medicare (Cherry and Beth) as action item #8, planned the
041077 - next day on 100528 1031, ref SDS 84 PE6P; today, Cherry did not have
041078 - time to return the call. ref SDS 94 036C
041080 -  ..
041081 - On 100607 1021 called Paula at Kaiser - she said someone else is
041082 - handling Millie's claim, because the claim has not been denied, and
041083 - Paula only handles denied claims. ref SDS 95 036C; Paula further
041084 - reported that Kaiser no longer objects to demaning UCSF correct
041085 - medical mistakes, so Millie's claim should be easy to resolve.
041086 - ref SDS 95 QN9F
041088 -  ..
041089 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041090 - process Millie's claim for care promptly in order to save her life.
041091 - ref SDS 96 036C
041093 -  ..
041094 - On 100608 1521 called and talked to Cherry and Beth about expediting
041095 - Millie's claim at Kaiser. ref SDS 97 036C  Developed work plan to have
041096 - a conference call with Kaiser tomorrow. ref SDS 97 C354  Submitted
041097 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041098 - ref SDS 97 G84Q
041100 -  ..
041101 - On 100609 1114 called CMS to expedite conference call on expediting
041102 - Millie's care. ref SDS 98 036C  Cherry called and schedule telecon with
041103 - Kaiesr and CMS today 1300. ref SDS 98 8O4H  Received letter from Cherry
041104 - at CMS confirming work plan for conference call at 1300. ref SDS 98
041105 - PRXY
041107 -  ..
041108 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041109 - call to review progress on Kaiser resolving Millie's claim for
041110 - recovery from UCSF medical mistakes. ref SDS 99 036C
041112 -  ..
041113 - On 100609 1300 CMS and Kaiser conference call to report progress on
041114 - reviewing Millie's claim for treatment to recover from UCSF medical
041115 - mistakes in time to be effective. ref SDS A0 036C
041117 -  ..
041118 - On 100609 1522 Jennifer called for assistance processing Millie's
041119 - claim to recover from medical mistakes getting radiation treatment at
041120 - UCSF on referral from Kaiser. ref SDS A1 036C
041122 -  ..
041123 - On 100611 1451 Jennifer advised Kaiser extended the date for
041124 - responding to Millie's claim from 100610 to 100624, based on Millie
041125 - filing updated statement of authorized representative. ref SDS A5 036C
041126 - Jennifer reported she reviewed 6-issues discussed on 100609, and will
041127 - address these issues responding to Millie's claim. ref SDS A5 FQ4G
041128 - Jennifer asked how Kaiser can treat Millie to recover from UCSF
041129 - medical mistakes, if Millie refuses chemotherapy and has entered
041130 - Hospice. ref SDS A5 FQ4M
041132 -  ..
041133 - On 100611 2326 Millie received Jennifer's letter confirming the date
041134 - for Kaiser to respond to Millie's claim has been extended to 100624,
041135 - ref SDS A6 CV4O, and further advising that issues Kaiser will determine
041136 - responding to Millie's claim for recovering from UCSF medical
041137 - mistakes, ref SDS A6 036C, are as set out in the record for telecon on
041138 - 100609. ref SDS A1 XK50  Jennifer will call on 100615, to report
041139 - progress on respnding to Millie's claim. ref SDS A6 6P53
041141 -  ..
041142 - On 100614 0257 letter to Kaiser Medicar CMS claim team requests
041143 - immediate written proposal evaluating treatment options for Millie to
041144 - consider. ref SDS A7 036C
041146 -  ..
041147 - On 100616 0832 called Jennifer about her plan to call yesterday on
041148 - Tuesday to report progress Kaiser responding to Millie's claim, as set
041149 - out in Jennifer's letter on 100611. ref SDS A8 036C   Jennifer called
041150 - back to ask if Millie wants UCSF or Kaiser to pay for her damages
041151 - caused by UCSF medical mistakes. ref SDS A8 PSSV  Jennifer reported
041152 - delays communicating with Millie's medical team have delayed making
041153 - arrangements for Millie to start treatment recovering from UCSF
041154 - medical mistakes. ref SDS A8 OY4T  She plans to call on Friday, 100618,
041155 - to report progress responding to Millie's claim. ref SDS A8 1K5J
041157 -  ..
041158 - On 100618 0843 called Jennifer at Memeber Case Resolution Department
041159 - about progress responding to Millie's claim. ref SDS A9 036C
041161 -  ..
041162 - On 100620 1112 letter to Kaiser claim team with copy to Medicare, and
041163 - the medical team requests call on Monday 100621, planned for previous
041164 - Friday, 100628, to report progress getting Millie treatment.
041165 - ref SDS B0 036C  Recommends that delay communicating with medical team
041166 - that has delayed Millie starting treatment in time to be effective,
041167 - ref SDS B0 L59P, can be solved by hiring MD Anderson. ref SDS B0 L59X
041169 -  ..
041170 - On 100621 0853 called for Jennifer and left several messages,
041171 - including for her team lead. ref SDS B2 036C  Nobody had time today
041172 - for calling back. ref SDS B2 OP3N
041174 -  ..
041175 - On 100622 1027 Jennifer called and advised that Doctor Johnson
041176 - responded to request for comment on Millie's claim saying he cannot
041177 - provide care for Millie because she entered Hospice on 100601,
041178 - ref SDS B4 036C; recommended Jennifer check Kaiser's medical chart for
041179 - Millie meeting with Doctor Johnson to see Millie was given no choices
041180 - except to enter Hospice in order to avoid further pain and suffering.
041181 - ref SDS B4 NX68
041183 -  ..
041184 - On 100622 1511 letter to claim team and Medicare, and to Millie's
041185 - medical team confirming understanding in Jennifer's call that Millie's
041186 - medical team at Kaiser seems to refuse Millie standard of care to
041187 - recover from UCSF medical mistakes, because she was forced to enter
041188 - Hospice to get relief from pain caused by UCSF medical mistakes.
041189 - ref SDS B5 036C  UCSF delays compounded Millie's injuries, pain, and
041190 - suffering; caution must be exercised to enable recovery, based on
041191 - Millie's right to life. ref SDS B5 575U   Millie's patient history
041192 - shows the doctor's only issue, ref SDS B5 576V, is having time to
041193 - providing standard of care for Millie to recover from medical
041194 - mistakes, and if not, then Kaiser should assign someone who does.
041195 - ref SDS B5 583Y  Kaiser has violated Millie's human rights; a woman's
041196 - right to choose life for herself, should be no less than the right to
041197 - choose for her unborn child, since the right to life and due process
041198 - are protected by the US Constitution. ref SDS B5 584W  Kaiser can
041199 - easily solve the time problem by hiring other people to do the work,
041200 - and charging UCSF. ref SDS B5 585P
041202 -  ..
041203 - 100624 1616 Jennifer called and asked to extend Kaiser's response to
041204 - Millie's claim another day or so, for review with her boss, and with
041205 - the customer. ref SDS B6 036C  Jennifer the original date for Kaiser to
041206 - respond on 100610, required by statute, and then amended to today on
041207 - 100624, can be further amended, and cited unclear authority about 30
041208 - days instead of 14. ref SDS B6 EG5P  Agreed that extending Kaiser's
041209 - response another few days until tomorrow, or Monday, is an acceptable
041210 - risk, even though Millie's cancer markier has increased significantly
041211 - to over 1000, and so that an equitable solution can be implented that
041212 - allows treatment in time to be effective for Millie. ref SDS B6 EG73
041213 - Jennifer will submit her draft response, and call tomorrow for
041214 - discussing Kaiser's solution. ref SDS B6 H98M
041216 -  ..
041217 - On 100625 0852 letter to Kaiser and Medicare claim teams confirming
041218 - Kaiser's request to extend date for responding to Millie's claim
041219 - another few days until Monday in order to get comprehensive solution.
041220 - ref SDS B7 036C
041222 -  ..
041223 - On 100626 0917 received letter from Cherry at Medicare, ref SDS B8
041224 - 036C, submitting CMS regulations, that control due date for Kaiser to
041225 - respond to Millie's claim. ref SDS B8 N64I
041227 -  ..
041228 - On 100628 0228 letter to claim teams at Medicare and Kaiser asking how
041229 - CMS regulations received on 100625, apply to extend Kaiser's response
041230 - date for expediting Millie's recovery. ref SDS B9 036C
041232 -  ..
041233 - On 100628 1033 called CMS Medicare for Beth Simone on regulations for
041234 - Kaiser to respond to Millie's claim.
041236 -  ..
041237 - On 100628 2318 submitted record of telecon with CMS, ref SDS C1 036C,
041238 - and that CMS learned today that Kaiser changed Millie's claim to a
041239 - Grievance, and notified CMS that Kaiser intends to delay response
041240 - until 100710, to Millie's claim filed on 100527.
041242 -  ..
041243 - On 100629 00003 received letter from Cherry transmitting Grievance
041244 - procedures, cited in the telecon yesterday as a change Kaiser made to
041245 - delay responding until 100710, to Millie's claim filed on 100527.
041246 - ref SDS C2 036C  Review of Grievance regulations show Kaiser required
041247 - to make timely response based on patient health. ref SDS C2 PN5S
041249 -  ..
041250 - On 100629 0013 letter thanks CMS for submitting regulations on
041251 - Grievance procedures, and notes requirements for Kaiser to respond
041252 - prior to maximum allowed of 30 days, based on patient health.
041253 - ref SDS C3 036C
041255 -  ..
041256 - On 100629 1631 called Medicare (CMS) on results of their
041257 - teleconference with Kaiser on expediting response to Millie's claim.
041258 - ref SDS C4 036C
041260 -  ..
041261 - On 100630 0027 Millie thanks Doctor Johnson for reporting on 100606,
041262 - that UCSF did not call Kaiser to provide care for Millie to recover
041263 - from UCSF medical mistakes. ref SDS C5 036C; she reports blood counts
041264 - are good, but cancer progressing because treatment was stopped on
041265 - 100601, for pain relief from chemotherapy. ref SDS C5 V83U  Kaiser has
041266 - deferred responding to Millie's claim, ref SDS C5 V87S, and needs to
041267 - know how soon her health status requires Kaiser to make a response.
041268 - ref SDS C5 V88T  Millie asks about deferring the meeting with Doctor
041269 - Johnson tomorrow, until Kaiser responds to Millie's claim, or, Millie
041270 - would love to meet, if Doctor Johnson has communicated with Doctor
041271 - Rugo on a work plan for Millie to recover from UCSF medical mistakes.
041272 - ref SDS C5 V89X
041274 -  ..
041275 - On 100630 1148 Doctor Johnson notfies Millie, and the Kaiser claim
041276 - team that he is confused about Millie's case, because Kaiser has
041277 - deferred determination on urgent requirement for care. ref SDS C6 036C
041278 - Doctor Johnson notes Millie is in Hospice and states that Millie's
041279 - disease is resistant to all forms of therapy, and that entering
041280 - Hospice is based on patient desire to forego therapy. ref SDS C6 PY4J
041281 - He asks if Millie wants to dis-enroll from Hospice. ref SDS C6 OY5G
041282 - Doctor Johnson further notes that public domain email conflicts with
041283 - HIPAA regulations. ref SDS C6 0W5U
041285 -  ..
041286 - On 100630 1537 Millie notified medical team and claim team, thanking
041287 - Doctor Johnson for his letter commenting on Millie feeling better
041288 - after ending chemotherap.  Confirms Doctor Johnson's intent to defer
041289 - meeting scheduled for tomorrow until after Kaiser responds to Millie's
041290 - claim, and further confirms Doctor Johnson has still not communicated
041291 - with Doctor Rugo on UCSF providing care for Millie to recover from
041292 - UCSF medical mistakes. ref SDS C7 M86X  Advises that Doctor Johnson's
041293 - assertion that Millie's cancer now resists all forms of therapy
041294 - conflicts with the record; Doctor Johnson advised that finding
041295 - effective treatment requires experimentation; Millie's first treatment
041296 - failed, and had to be switched. ref SDS C7 M87Q  When UCSF discovered
041297 - medical mistakes, UCSF failed to provide necessary and reasonable care
041298 - for Millie to recover, and instead prescribed chemotherapy, which was
041299 - not effective and caused unbearable pain and suffering, causing Millie
041300 - to enter Hospice. ref SDS C7 M84P  The only evident purpose for
041301 - Millie's death is to avoid accountability from medical mistakes and
041302 - avoid cost of recovery, by making Millie suffer, and making Medicare
041303 - pay, while Millie is actually innocent, and Medicare is innocent.
041304 - ref SDS C7 M84S  Millie sent 44 letters to medical team requesting
041305 - targeted treatment to recover from UCSF medical mistakes, and
041306 - reporting pain and suffering from chemotherapy; so, on 100601, Millie
041307 - entered Hospice for pain relief for chemotherapy. ref SDS C7 M84Y
041308 - Millie cannot dis-enroll from Hospice providing pain medication until
041309 - Kaiser provides standard of care to recover from UCSF medical
041310 - mistakes. ref SDS C7 M93V  Millie explains benefits to saving lives,
041311 - time, and money using public domain email. ref SDS C7 M94W  Millie
041312 - notes Doctor Johnson's report today shows Kaiser has violated Medicare
041313 - regulations by delaying response to her claim longer than justified by
041314 - Millie's health status. ref SDS C7 M96P
041316 -  ..
041317 - On 100701 0915 Carol called this morning saying she is the Chief of
041318 - Hospice and advised that she was told that Millie wants to dis-enroll
041319 - from Hospice.  Millie sent a letter to the medical team, and claim
041320 - teams confirming understandings from the call with Carol. ref SDS C8
041321 - 036C  Millie advised Carol that Millie entered Hospice for pain relief
041322 - for chemotherapy, and so she cannot dis-enroll from Hospice providing
041323 - pain medication until Kaiser provides standard of care to recover from
041324 - UCSF medical mistakes. ref SDS C8 Q85S  Millie explains she wants a
041325 - written medical opinion on treatments lined up for her to recover from
041326 - UCSF medical mistakes that provides a "roadmap to a future worth
041327 - living." ref SDS C8 Q85Y
041329 -  ..
041330 - On 100701 1140, meeting this morning scheduled during a prior meeting
041331 - at Kaiser on 100601, ref SDS 86 7E4S, was canceled because Doctor
041332 - Johnson's letter yesterday, said nothing about receiving instructions
041333 - from Kaiser's claims department on solving Millie's claim for care to
041334 - recover from UCSF medical mistakes, ref SDS C6 036C   Since Doctor
041335 - Johnson was not authorized to provide care requested in Millie's claim
041336 - on 100527, ref SDS 82 IZ7N, meeting would jeperodize Millie's rights
041337 - in the case by adding or otherwise modifying her statement of claim.
041338 - ref SDS C9 036C
041340 -  ..
041341 - On 100701 1213 Lois called and talked to Rod for explanation of
041342 - Millie's claim, and planned to talk with Doctor Johnson about a
041343 - resolution. ref SDS D0 036C
041345 -  ..
041346 - On 100702 1424 Millie received letter from Doctor Johnson submitting
041347 - Kaiser's lab report on results of Millie's blood test on 100622, and
041348 - without comment except the doctor circled with ink CA 15-3 1116.
041349 - ref SDS D1 036C
041351 -  ..
041352 - On 100702 1612 Lois called and reported discussing Millie's claim with
041353 - Doctor Johnson, who evidently indicated he cannot find on the Internet
041354 - a provider willing to treat Millie with PARP. ref SDS D2 036C  Lois
041355 - asked to talk with Millie in order to verify what Millie wants in her
041356 - claim filed on 100527.  Lois was referred to Millie's claim, and to
041357 - the letter to Kaiser on 100701, confirming Millie's telecon with
041358 - Carol, with the Kaiser Hospice program. ref SDS C8 036C
041360 -  ..
041361 - On 100705 2050 planning letter to Kaiser and Medicare claim teams
041362 - asking for remedies for damanges caused by Kaiser delaying response to
041363 - Millie's request for urgent care. ref SDS D3 036C
041365 -  ..
041366 - On 100708 0038 letter to Kaiser with copy to Medicare asking for
041367 - Millie's remedies for Kaiser delaying response to Millie's claim
041368 - requesting immedicate treatment to recover from UCSF medical mistakes.
041369 - ref SDS D5 036C
041371 -  ..
041372 - On 100710 1343 Millie received a letter from Kaiser responding to her
041373 - claim. ref SDS D6 036C  Kaiser says the office Millie was directed to
041374 - submit her claim to be held harmless from medical mistakes was
041375 - incorrect. ref SDS D6 X48S  Kaiser advises that Doctor Johnson reports
041376 - Millie's patient hsitory makes getting treatment with PARP prescribed
041377 - by Doctor Rugo to recover from UCSF medical mistakes due to
041378 - "eligibility" issues. ref SDS D6 X45V  The doctor feels Millie's cancer
041379 - is difficult to treat, and maintains nothing can help her recover from
041380 - UCSF medical mistakes without having tried a single treatment listed
041381 - in Millie's claim; Kaiser does not deny any request in Millie's claim,
041382 - but proposes she discuss her care directly with Doctor Johnson who
041383 - claims to have lost hope. ref SDS D6 X530  Kaiser apoligizes for taking
041384 - 44 days to respond to Millie's claim, because unnamed regulations give
041385 - Kaiser 30 days to respond. ref SDS D6 X547   Kaiser advises Millie can
041386 - dispute the determination through arbitration, but Kaiser does not
041387 - present a disputable issue. ref SDS D6 768G  Kaiser advises that Millie
041388 - can appeal to Medicare. ref SDS D6 X54Q
041390 -  ..
041391 - On 100713 0007 Millie requests reconsideration Kaiser's determination
041392 - on Millie's claim, ref SDS D7 036C, and appeals to Medicare for
041393 - compliance with CMS regulations. ref SDS D7 J74S
041395 -  ..
041396 - On 100714 0742 Millie received copy of an internal letter Paula sent
041397 - notifying the Kaiser claim team that Millie's letter on 100713,
041398 - requests reconsideration and appeals to Medicare Kaiser's letter dated
041399 - 100708, and received on 100710, denying Millie's claim to recover from
041400 - medical mistakes filed on 100527. ref SDS D8 036C
041402 -  ..
041403 - On 100715 1802 received securemail from Jennifer with response from
041404 - Kaiesr claim team, ref SDS D9 036C, to the letter on 100713, requesting
041405 - reconsideration and appealing, ref SDS D7 036C, Kaiser's letter dated
041406 - 100708, and received on 100710, ref SDS D6 036C, denying Millie's
041407 - claim filed on 100527. ref SDS 82 IZ7N
041409 -  ..
041410 - On 100716 0830 called Beth at CMS (Medicare), ref SDS E0 036C, to
041411 - verify request on 100713 appealing to Medicare, ref SDS D7 J74S,
041412 - Kaiser's claim team letter dated 100708, received on 100710,
041413 - ref SDS D6 036C, denying Millie's appeal for standard of care to
041414 - recover from UCSF medical mistakes beginning with PARP. ref SDS 82
041415 - IZ7N; sent letter to Jullin at CMS asking if anything more needs to be
041416 - filed for Medicare to process Millie's request for appealing Kaiser's
041417 - denial of Millie's claim. ref SDS E0 07FC  While hiking at Lafayette
041418 - Reservoir, received call from Paula at Kaiser claim team.  Reception
041419 - was poor due to wind, so decided to call again at the house in a few
041420 - hours. ref SDS E0 D69K  Received letter from Jullin saying Millie's
041421 - appeal is submitted to Medicare on Kaiser's denial of care.
041422 - ref SDS E0 07FC  Paula called from Kaiser claim team, and this became a
041423 - conference call with CMS (Medicare) on advancing Millie's claim for
041424 - recovery from UCSF medical mistakes. ref SDS E0 PW3U
041426 -  ..
041427 - On 100719 0522 Millie sent a letter to Doctor Johnson explaining
041428 - background on claim team, ref SDS E1 036C, suggestions for another
041429 - meeting. ref SDS E1 JH5V  Millie notified the doctor that she wants a
041430 - written work plan from Kaiser on recovering from UCSF medical
041431 - mistakes. ref SDS E1 JH5Y  She submits a draft to illustrate elements
041432 - of the work plan. ref SDS E1 JH8P  Millie will meet with the doctor to
041433 - implment the work plan. ref SDS E1 JH4T
041435 -  ..
041436 - On 100719 1312 Kaiser proposes only another meeting to "discuss next
041437 - steps," and not to implement UCSF or any alternate work plan for
041438 - Millie to recover from UCSF medical mistakes, and ignores Kaiser's
041439 - fiduciary duty to hold Millie harmless from UCSF medical mistakes
041440 - providing care on referral from Kaiser. ref SDS E2 036C
041442 -  ..
041443 - On 100719 1413 Paula called about processing Millie's case for appeal
041444 - to Medicare from Kaiser's denial of Millie's claim requesting recovery
041445 - from UCSF medical mistakes providing care for Millie on referral from
041446 - Kaiser. ref SDS E3 036C
041448 -  ..
041449 - On 100719 1618 Regina called to process Millie's Expedited Claim
041450 - ordered by Paula in Case Resolution. ref SDS E4 036C
041452 -  ..
041453 - On 100719 1312 at 2013 Millie read Kaiser's reponse on 100708, to her
041454 - claim filed on 100708, and burst into tears, saying erroneous account
041455 - of entering Hospice on 100601 breaks her heart, ref SDS E2 RM9G;
041456 - Millie feels now that her request for treatment cannot be approved in
041457 - time for her to recover, ref SDS E2 RM62, and the only way to correct
041458 - Kaiser's conduct is to file a claim monetary damages for wrongful
041459 - death. ref SDS E2 RN3L
041461 -  ..
041462 - On 100720 1059 Sheilla called about processing Millie's "2nd claim"
041463 - that Paula filed yeserday, ref SDS E6 036C; she was referred to Paula
041464 - for an explanation of Paula's intent. ref SDS E6 E66H  Sheilla called
041465 - back in the afternoon and advised that the "2nd claim" which had been
041466 - filed by Paula for Millie was denied for expedited processing and sent
041467 - to the Case Resolution Department for standard processing. ref SDS E6
041468 - O59M
041470 -  ..
041471 - On 100721 1115 called and left message for Beth to call back and
041472 - report Medicare progess processing Millie's appeal filed on 100713,
041473 - and following up the letter to Medicare yesterday, on 100720, also
041474 - asking Medicare to confirm processing Millie's appeal. ref SDS E7 036C
041476 -  ..
041477 - On 100722 1328 Paula called about getting care for Millie in time to
041478 - be effective. ref SDS 0 036C  Reviewed the record meeting with Doctor
041479 - Johnson at Kaiser on 100601, ref SDS 0 J14F, showing Millie requested
041480 - care with PARP or equal, to recover from UCSF medical mistakes as
041481 - requested in Millie's claim filed on 100527, and in Millie's letter on
041482 - 100601. ref SDS 0 UG3J  Doctor Johnson reported he could not provide
041483 - necessary and reasonable care to recover from UCSF medical mistakes,
041484 - because he could not communicate for a month with UCSF using the
041485 - telephone and email. ref SDS 0 CK6M  The doctor told Millie he could
041486 - only provide medication to relieve pain from chemotherapy and cancer
041487 - by Millie entering Hospice. ref SDS 0 UG8H  This record shows another
041488 - meeting meerly "discuss next steps" is fruitless unless there is
041489 - commitment for Kaiser to provide necessary and reasonable care to
041490 - satisify Millie's entitlement to recover from UCSF medical mistakes.
041491 - ref SDS 0 UG4O  Paula's next step is to call Doctor Johnson about how
041492 - Kaiesr can perform its agreement to provide standard of care for
041493 - Millie to recover from UCSF medical mistakes. ref SDS 0 645L
041494 -
041495 -
041497 -  ..
0415 -
0416 -
0417 - Progress
0418 -
041801 - Paula advised that Doctor Johnson has not returned her calls planned
041802 - this past Monday, on 100719 1413, ref SDS E3 HI8F, and cited in the
041803 - letter on Tuesday, 100720 0655. ref SDS E5 LB6T  This aligns with
041804 - Jennifer's report that Doctor Johnson was delayed responding to calls,
041805 - reported on 100611 1521. ref SDS A5 SK3O
041807 -  ..
041808 - Paula said she has seen a copy of Sheila's letter dated 2-days ago on
041809 - 100720.  She said that Sheila's letter is Kaiser's denial of Paula's
041810 - request for epedited processing of the claim Paula filed on Monday for
041811 - the purpose of giving her control of Millie's claim, reported on
041812 - 100719 1413. ref SDS E3 4G4L
041814 -  ..
041815 - Advised that Sheila's letter has not yet been received, so it must
041816 - have been sent in the mail.
041818 -  ..
041819 - Paula explained that she has immediate access to Sheila's letter
041820 - through Kaiser's electronic case management system.
041822 -  ..
041823 - Paula noted that Doctor Johnson said in a letter on Monday that he
041824 - will only meet with Millie and "discuss next steps" after Millie ends
041825 - Hospice care to relieve pain caused by UCSF medical mistakes, and by
041826 - Kaiser and UCSF providing chemotherapy that was not appropriate for
041827 - Millie's patient profile, and that Kaiser offers no work plan for
041828 - holding Millie harmless from UCSF medical mistakes providing radiation
041829 - services on referral from Kaiser, reported on 100719 1312, ref SDS E2
041830 - 036C, and responding to Millie's letter to the doctor earlier that day
041831 - on 100719 0522. ref SDS E1 036C
041833 -  ..
041834 - Paula suggested that Millie send another letter to request a meeting
041835 - with Doctor Johnson without an agenda for recovering from UCSF medical
041836 - mistakes.  She seemed to indicate this would show compliance with
041837 - Kaiser's determination on 100708, received on 100710, ref SDS D6 X530,
041838 - and responding to Millie's claim for medical services filed on 100527.
041839 - ref SDS 82 IZ7N
041841 -  ..
041842 - We reviewed response submitted to Kaiser on 100713, advising that
041843 - Kaiser's remedy, in its letter on 100708, for Millie to meet with
041844 - Doctor Johnson, conflicts with Millie's claim seeking relief from
041845 - Doctor Johnson's failure to order care in meetings for the past year,
041846 - and most recently on 100601. ref SDS D7 J64Y  Millie feels that
041847 - medical care requires finality in transactions in order for patients
041848 - to obtain relief in time to be effective.
041850 -  ..
041851 - Paula asked what happened at Millie's last meeting with the doctor on
041852 - 100601?
041854 -  ..
041855 - During the call today, we opened the record on Millie's meeting with
041856 - Doctor Johnson on 100601, using the Internet for transparency and
041857 - efficient communication. ref SDS 86 036C
041859 -  ..
041860 - Paula noticed that during the meeting on 100601...
041861 -
041862 -    1.  Doctor Johnson diagnosed commonly fatal infection Phlebitis,
041863 -        and prescribed a 2 week treatment. ref SDS 86 OP4G
041864 -
041865 -        Phlebitis is the 2nd near-fatal infection Millie has suffered
041866 -        due to incorrect treatment with chemotherapy ordered by Doctor
041867 -        Johnson, and Doctor Rugo at UCSF. ref SDS 86 OP5L  Case study
041868 -        on 090213, shows Doctor Johnson has told Millie numerous times
041869 -        that chemotherapy is no longer effective and is harmful for
041870 -        Millie's patient profile. ref SDS 21 PT3N  On 090515, Doctor
041871 -        Johnson said he would get in trouble from an audit showing he
041872 -        ordered chemotherapy for Millie. ref SDS 32 658J
041874 -         ..
041875 -    2.  Doctor Johnson received a copy of Millie's claim filed on
041876 -        100527, requesting treatment with PARP or equal to implement
041877 -        the UCSF work plan providing necessary and reasonable care for
041878 -        Millie to recover from UCSF medical mistakes.
041880 -         ..
041881 -    3.  Doctor Johnson received Millie's letter on 100601, ref SDS 86
041882 -        4F5J, sent earlier in the morning with an agenda for meeting
041883 -        with the doctor at at 0830, and reporting...
041884 -
041885 -        1.  Cancer has gotten worse due to improper treatment for a
041886 -            year. ref SDS 85 1P6U;
041888 -             ..
041889 -        2.  New medical problem of swelling her lower legs. ref SDS 85
041890 -            1Q3S,
041892 -             ..
041893 -        3.  Appetite and energy continue to decline caused by improper
041894 -            treatment with chemotherapy the past year, ref SDS 85 1Q3V;
041895 -            so, "everybody is now on board" that chemotherapy has
041896 -            failed to relieve Millie's cancer that causes agonizing
041897 -            pain and suffering, causes fatal infection, and anemia.
041898 -            ref SDS 85 1Q5T
041900 -             ..
041901 -        4.  Millie requests again implementing UCSF work plan presented
041902 -            on 090616, using treatment targeted to Millie's cancer
041903 -            beginning with PARP or equal, and for the purpose of
041904 -            recovering from UCSF medical mistakes, ref SDS 85 1Q3Y, and
041905 -            as planned in Doctor Rugo's letter on 100501, and as
041906 -            further requested in Millie's claim filed on 100527, with
041907 -            copy to Doctor Johnson. ref SDS 85 1Q5W
041909 -             ..
041910 -        5.  Critical next step is starting treatment with PARP
041911 -            immediately. ref SDS 85 1Q6U
041913 -         ..
041914 -    4.  Doctor Johnson during the meeting on 100601, responded to
041915 -        Millie's request for care in her claim filed on 100527,
041916 -        ref SDS 82 IZ7N, and as presented in her letter on 100601.
041917 -        Doctor Johnson told Millie that he could not provide requested
041918 -        care necessary and reasonable to recover from UCSF medical
041919 -        mistakes, because he could not communicate with Doctor Rugo at
041920 -        UCSF using email nor the telephone for an entire month,
041921 -        ref SDS 86 4F6I, since 100501, when Doctor Rugo notified Millie
041922 -        that she (Doctor Rugo) would communicate directly with Doctor
041923 -        Johnson on Millie's request for care, ref SDS 71 456L, in
041924 -        Millie's letter to the medical team on 100501, requesting that
041925 -        Kaiser implement the UCSF work plan to treat Millie with PARP
041926 -        for recovering from UCSF medical mistakes. ref SDS 70 U47P
041928 -         ..
041929 -    5.  Doctor Johnson further told Millie that since he could not
041930 -        communicate for a month with Doctor Rugo by telephone nor by
041931 -        email for UCSF to provide necessary and reasonable care to
041932 -        recover from UCSF medical mistakes, the only care Kaiser can
041933 -        offer is Hospice to get medication that relieves pain until
041934 -        death; so Millie's only option to Hospice was to die a long
041935 -        torturous, painful death. ref SDS 86 4H4J
041937 -  ..
041938 - This record shows that Millie did not choose to enter Hospice in order
041939 - to end treatment; rather she was forced to enter Hospice as the only
041940 - relief from painful side effects accumulating for the past year from
041941 - incorrect treatment with chemotherapy, and from cancer spreading also
041942 - caused by incorrect treatment with chemotherapy the past year, was to
041943 - enter Hospice while Kaiser worked to overcome telephone and email
041944 - problems that prevent performing Kaiser's duty to provide necessary
041945 - and reasonable care to recover from UCSF medical mistakes, which were
041946 - promised on 090616, and to which Millie is entitled under Medicare
041947 - regulations, her contract with Kaiser, and applicable statues.
041949 -  ..
041950 - This record further shows the "next step" in Millie's care is not
041951 - another meeting with Doctor Johnson to "discuss next steps," as
041952 - offered in the doctor's recent letter on 100719 1312. ref SDS E2 036C,
041953 - because this merely repeats the same offer in Kaiser's letter on
041954 - 100503 1945. ref SDS 75 HH4I  Rather the "next step" in Millie's care
041955 - is to order necessary and reasonable treatment with PARP or equal to
041956 - recover from UCSF medical mistakes, as requested in Millie's claim
041957 - filed on 100527 0217. ref SDS 82 IZ7N, requested again on 100713,
041958 - ref SDS D7 J64Y, responding to Kaiser's determination dated 100708,
041959 - and ordering relief for failed meetings with the doctor by having
041960 - another meeting, reported on 100710 1343, ref SDS D6 X530; and
041961 - requested again at Paula's urging in Millie's letter to the doctor on
041962 - 100719 0522. ref SDS E1 JH5Y
041964 -  ..
041965 - Paula plans to review the record more carefully, and discuss further
041966 - with Doctor Johnson Kaiser's duty to provide relief for Millie to
041967 - recover from UCSF medical mistakes.
041968 -
041969 -
041970 -
041971 -
041972 -
041973 -
041974 -
041975 -
041976 -
041977 -
041978 -
0420 -