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 23, 2010 06:10 PM Friday;
Rod Welch
Kaiser called about Millie's claim and appeal to Medicare.
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 E9 0000. ref SDS E7 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 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 1413 Paula called about processing Millie's case for appeal
041437 - to Medicare from Kaiser's denial of Millie's claim requesting recovery
041438 - from UCSF medical mistakes providing care for Millie on referral from
041439 - Kaiser. ref SDS E3 036C
041441 - ..
041442 - On 100719 1618 Regina called to process Millie's Expedited Claim
041443 - ordered by Paula in Case Resolution. ref SDS E4 036C
041445 - ..
041446 - On 100720 1059 Sheilla called about processing Millie's "2nd claim"
041447 - that Paula filed yeserday, ref SDS E5 036C; she was referred to Paula
041448 - for an explanation of Paula's intent. ref SDS E5 E66H Sheilla called
041449 - back in the afternoon and advised that the "2nd claim" which had been
041450 - filed by Paula for Millie was denied for expedited processing and sent
041451 - to the Case Resolution Department for standard processing. ref SDS E5
041452 - O59M
041454 - ..
041455 - On 100721 1115 called and left message for Beth to call back and
041456 - report Medicare progess processing Millie's appeal filed on 100713,
041457 - and following up the letter to Medicare yesterday, on 100720, also
041458 - asking Medicare to confirm processing Millie's appeal. ref SDS E6 036C
041460 - ..
041461 - On 100722 1328 Paula called about getting care for Millie in time to
041462 - be effective. ref SDS E7 036C Reviewed the record meeting with Doctor
041463 - Johnson at Kaiser on 100601, ref SDS E7 J14F, showing Millie requested
041464 - care with PARP or equal, to recover from UCSF medical mistakes as
041465 - requested in Millie's claim filed on 100527, and in Millie's letter on
041466 - 100601. ref SDS E7 UG3J Doctor Johnson reported he could not provide
041467 - necessary and reasonable care to recover from UCSF medical mistakes,
041468 - because he could not communicate for a month with UCSF using the
041469 - telephone and email. ref SDS E7 CK6M The doctor told Millie he could
041470 - only provide medication to relieve pain from chemotherapy and cancer
041471 - by Millie entering Hospice. ref SDS E7 UG8H This record shows another
041472 - meeting meerly "discuss next steps" is fruitless unless there is
041473 - commitment for Kaiser to provide necessary and reasonable care to
041474 - satisify Millie's entitlement to recover from UCSF medical mistakes.
041475 - ref SDS E7 UG4O Paula's next step is to call Doctor Johnson about how
041476 - Kaiesr can perform its agreement to provide standard of care for
041477 - Millie to recover from UCSF medical mistakes. ref SDS E7 645L
041479 - ..
041480 - On 100722 1516 Beth called back and advised that she and Cherry are no
041481 - longer processing Millie's appeal; she indicated that Patty has given
041482 - instructions that she will respond to Millie's appeal, and that Patty
041483 - is out of the office this week. ref SDS E8 036C
041485 - ..
041486 - On 100723 1323 Julie called and advised that Medicare relies on the
041487 - written record rather than verbal communications to resolve medical
041488 - disputes. ref SDS E9 036C; Julie related that Patty feels Kaiser
041489 - enrolling Millie in Hospice for pain relief relieves everybody of
041490 - responsibility for medical mistakes; the record shows Millie has at
041491 - all times relied on assurance that Kaiser and UCSF hold Millie
041492 - harmless from medical mistakes. ref SDS E9 SA3M Julie indicated
041493 - Medicare refuses to apply notification regulations that protect
041494 - patient health, because everybody believed Rod filed Millie's clain on
041495 - 100527, and Kaiser was justified to reclassify the claim to a
041496 - "grievance" because Millie filed statment of authorized representative
041497 - on 100610, which further allowed Kaiser to respond on 100710; however,
041498 - this was an error, because Millie filed the claim on 100527, and this
041499 - was independent from filing statement of authorized representative, so
041500 - Kaiser violated statutory requirements to notify Millie if
041501 - determnation on 100610, of Millie's claim filed on 100527. ref SDS E9
041502 - Q44I Julie is reviewing the documents again. ref SDS E9 K55N
041504 - ..
041505 - On 100723 1413 received letter from Sheila at Kaiser Expedited Claims
041506 - Department reporting that Kaiser misrepresented Millie's 2nd claim,
041507 - ref SDS E0 036C, and denied expedited processing the 2nd claim for
041508 - Millie, which was filed by Paula, and so the 2nd claim was sent the
041509 - Kasiser Case Resolution Department for standard processing, and on
041510 - grounds that Millie's case requiring immediate life-saving treatment
041511 - is not "time sensitive." ref SDS E0 V65N,
041513 - ..
041514 - On 100723 1810 someone called claiming to represent Kaiser's Claims
041515 - Resolution Department and insisted on talking to Millie. The caller
041516 - refused to give a name nor the purpose of the call, and cited HIPAA
041517 - regulations as justification for unnanounced call to a dying patient.
041518 - ref SDS 0 036C
041519 -
041520 -
041522 - ..
0416 -
0417 -
0418 - Progress
0419 -
041901 - Received call from someone who claimed to represent Kaiser's Case
041902 - Resolution Department. This was suspicious, since Kaiser's offices
041903 - close afer 1700. The caller asked for Millie, and when asked the
041904 - purpose of the call, refused to say.
041906 - ..
041907 - The caller was asked if Kaiser needed information from Millie on her
041908 - claim, filed 100527, or the request for reconsideration and appeal to
041909 - Medicare filed on 100713, requesting correction to Kaiser's denial on
041910 - 100708, refusing to provide help for Millie to recover from medical
041911 - mistakes, ref SDS D7 J74S, and as discussed with Julie earlier in the
041912 - afternoon, reported on 100723 1323. ref SDS E9 HN5O
041914 - ..
041915 - The caller said neither of these matters were the subject and purpose
041916 - of Kaiser's call this afternoon.
041918 - ..
041919 - Asked again for the purpose of the call, since Millie has been
041920 - weakened by Kaiser's failure to provide treatment.
041922 - ..
041923 - Called claimed HIPAA prevents telling anyone but Millie the purpose
041924 - of the call.
041926 - ..
041927 - Previously, on 071009, another person called claiming to represent
041928 - Kaiser and misrepresented the call as a matter which HIPAA required
041929 - talking only to Millie about personal and sensitive medical
041930 - information. ref SDS 13 JW7M After invoking HIPAA to talk with Millie
041931 - the caller berrated and verbally abused Millie with invective and name
041932 - calling on behalf of UCSF requesting payment from Millie which was
041933 - owed and eventually paid by Kaiser. ref SDS 13 JW59
041935 - ..
041936 - Told the caller to submit questions in writing, and that Millie would
041937 - not speak with unidentified people on the telephone for unknown
041938 - purposes.
041939 -
041940 -
041941 -
041942 -
041943 -
041944 -
041945 -
041946 -
041947 -
041948 -
041949 -
041950 -
0420 -