So we are tossing around the idea of moving to Nevada from California due to high cost of living. I contacted UCSF and told them we can be in California for Zoom calls and of course treatment. But could Jim get his Lupron and bloodwork out of state. We were told you have to be a permanent California resident to be treated at UCSF. I thought a person could travel to any hospital for treatment as long as they were willing to travel and had the insurance. I cannot find a prostate center of excellence in Nevada. They have prostate center in Las Vegas, but no psma scan available. Do all cancer centers require that you be a state resident? It seems I read people traveling a lot. Maybe they'd be too overwhelmed if they accepted out of state patients? Feeling perplexed and disappointed. Thank you as always.
UC San Fran: So we are tossing around... - Advanced Prostate...
UC San Fran
I live in Florida but travel regularly to MD Anderson in Texas. No problem at all.
Thank you very much! I'm sure puzzled by this.
Could be because USCF is a state funded school, not a private institution.
Also, maybe an insurance issue.
I have treatments in Miami and Vail, no issues; both are private centers
Thank you.Jim has original Medicare, not a regional advantage or supplemental insurance. So it's not an insurance issue.
It’s a foolish state law that they can’t have out of state telemedicine. There’s a bill in Congress to change it. But who knows if our gridlocked Congress will pass it.
I'm shocked that even if we go in person, they won't treat him if we're not residents. Is UCLA the same? Do you know of any excellent centers in Nevada? I couldn't find one just searching.
That surprises me too.
Here are the messages. I asked for clarification about traveling in person.
Hi Linda
Not sure who to check with. We are tossing around the idea of moving out of California. We understand that zoom appointments have to be instate and of course scans, treatment etc. Thats no problem we can make that work. My question is, can you all authorize Lupron shots and bloodwork at out of state centers? Our number one priority in all of our decisions is Jim's continued care at UCSF.
Thank you for your time.
Hi Jim and Paula,
Thank you for looping me in on your plans. We unfortunately are unable to provide care to patients whose permanent residence is outside of California and are no longer California residents. We also cannot place orders such as Lupron to a facility that is out-of-state.
I hope this information is helpful. Keep us posted! As always, take care and be well.
Best,
Linda
--
Linda McMullen, FNP-C, AOCNP
Oncology Nurse Practitioner
Genitourinary Medical Oncology
UCSF Helen Diller Comprehensive Cancer Center
I received Brachyboost therapy and year long Orgovyx/Nubeqa prescription from UCLA last August and I live in Seattle. My labs are done in Seattle. Don’t know if it’s a recent ruling or if the person you’re corresponding with is clear on the guidelines. Maybe try someone else there?
Or maybe they reinstated rules they relaxed during Covid. I did have one doc in Chicago last June who wouldn’t televisit with me anymore because the rules had apparently reverted back to in-state only. But then UCLA had no problem so I don’t know what to think.
Thank you. I'm thinking a phone call might be in order.
It is true that many hospitals have tightened up their out of state care since Covid.
It sounds fishy to me. Why would the rules be so different for UCSF than for UCLA since they are both part of the UC system? Is there any way you can communicate directly with the doctor, without going through Linda? I know a patient who lives in NM and visits an RO at UCLA. The UC hospitals take many out-of-state patients -- they are regional centers of excellence.
Thank you. I will go ahead and contact Dr Borno. Should have gone to her first, but Jim's last two FU appointments have been with Linda, so I contacted her. It sounded off to me also, and now even more so since hearing UCLA is not restrictive like that. I got to wondering if it's an attempt to discourage more moves out of California, but why would you turn down revenue. Makes no sense. Appreciate your time a great deal.
I live in Georgia and was treated at UCLA. After treatment, I've had quarterly, and now semi annual, calls with the doctor or his PA. This wasn't raised as an issue at any time.
Thank you.
You can go in person and be treated. The law (and I've been going around and around with it) prohibits MD's from doing Telemedicine to a patient in a state they aren't licensed to practice in. This law was exempted during Covid, so MD's could do zoom visits with patients anywhere.
It has caused issues requiring me to travel into NYC for visits with my medical practitioners there. Some of the staff doing scheduling seem to enforce it much more rigidly than others. I had my last visit with my MO done by cell-phone, there wasn't any real reason that video would be needed.
TA - would you happen to know the bill# in Congress - I think our representative in Congress isn't currently in court for theft and corruption like our Senator is. Our congressional representative does live in VA despite claiming to be a NJ resident. We won't go into the reasons that hoax has been allowed to continue, but I will approach him and see what he has to say about the bill.
Call Renown Institute for Cancer in Reno, ask them about their affiliation with UCSF
Thank you! I just called them and the girl answering the phone said they have no affiliation with UCSF. She may not know. But they do treat prostate cancer there, and Jim said he's fine with that. It's his decision. He said people in Nevada have cancer too, so they must know how to treat it.
My MIL lived in Reno had lung cancer, and Renown was using UCSF for procedures they could not do. Albeit 10 years ago. It's the biggest facility there. I also remember they were aligned with University hospital at UNR. (My daughter graduated from UNR) Needless to say I spent a lot of time in Reno. (Living in LA) It wasn't a 3rd world city back then!!
Hope it work out for you. Reno might ne my next residence.
Thank you so much again! I called them again with more questions and they were so nice and helpful. Wow. Looks like a great facility. Really appreciate the info.
We live in TX and my husband’s oncologist is Dr. Rahul Aggarwal. We have monthly Zoom calls. My husband is given his ADT shots here in Dallas. We had to go out once to establish a patient/doc relation. Otherwise it is all virtual.
Great to know! Wow. I'm calling tomorrow. I wish we had Dr Aggarwal, I've heard very good things about him. Thank you.
Try Stanford
I left Sunnyvale CA for Oklahoma for the same reasons. I was blessed with Veterans Admin coverage though. Any chance either of you were prior military?
Hi JWPMP….
My wife worked for UCSF S.F. , for decades, as a field Physicians Liasion and problems like this are something she handled many times on a daily basis. She’s asleep right now but I’ll ask her to help if possible and possibly give you any direct contact information if available. I’ll have her read this and let you know.
I’ll get back to you as soon as possible.
❤️❤️❤️
hello again jwpmp … my wife woke up and says to tell you she will call her contacts tomorrow morning and we’ll P.M you.
It sounds odd for UCSF to say that because part of her territory was northern Nevada and UCSF has transplant clinics and patients all over her territory in Northern Nevada. It’s not impossible that some clinics may have special qualifying rules tho.
We’ll get back to you after business hours open up this morning.
❤️❤️❤️
I'm so overwhelmed by the generous outpouring of help here. It is remarkable and brings me to tears. Thank you!
We’re waiting for the liaison group to return our call. It would have been minutes back in the day when the hammer was senior field liaison…. But nowadays it’ll be longer lol.
❤️❤️
Oh gosh, please don't spend too much time on this. You all are just too kind 🥲💙
The ladies are on it …. The clinic isn’t responding yet. No one messes with the liaison service, there must be big stuff happening in the clinic. ( staff missing, doctor off the grounds etc. ) there might be logistics reasons the clinic is functioning the way it is … this is kinda interesting.
They don’t want to get to the “ don’t make me come over there “ level rotflol.
❤️😁❤️
Lol... From my working days, I know that level well 😉I'm not familiar with liason services, although I know what they are.
It was interesting. I always get same day responses when I message (although it'sunderstood thats not required, but they always did). It took a little over 2 days for them to get back to me.
I kept telling Jim it was odd. Now I'm more curious...
Thank you !!
i go to a support group that meets on zoom weekly, and many of the members are treated at ucsf and some of those are out of state. If you’d like to attend a meeting you can find contact info at mymarinhealth.org/programs-...
Stan Rosenfeld has been facilitating this weekly group for over 20 years, he would be happy to chat with you.
Las Vegas does have a medical facility that does perform PSMA testing. I live in LV and just had one performed.
Thank you! When I looked on the website during my research it wasn't listed. Really appreciate it
I've had my scans done at Simon Med imaging in the Phoenix area. I googled Simon Med in Las Vegas and got:
bing.com/search?q=simonmed+...
Thank-you, really appreciate the info!
If anyone ever wondered how helpful and caring the members of this site can be, this thread is a perfect example!
Omg you just said it. Im amazed and overwhelmed with gratitude.
is it an insurance issue? Medicare and Medicare supplements (medigap) cross state lines while many Medicare Advantage programs are PPO and you have to stay in your state or area for coverage.
Medicare Advantage programs have a huge amount of variability. Ours is good anywhere in the US and does cover ER visits outside the US.
He has original medicare and secondary is his union insurance, anthem blue cross. I checked and there's no issues with the insurance. Thank you
we live in Nevada and we are being treated at UC Davis with no issues.
Thank you. Where in Nevada do you live?
We are in Reno Tahoe area.
Oh beautiful, thank you. Jim's looking at a property in Fallon.
Oh that’s nice. It would be about a 5ish hour drive to San Fran, and about 3ish to UC Davis from there
wow! Never heard of that before. If the hospital is receiving any federal funding, it cannot deny you medical care based on what state you live in. Same if they’re receiving any Medicare reimbursements. The Fred Hutchinson Cancer Center in Seattle takes people from all over the world.
I live in OR and my insurance does not pay for treatment out of state.
adventist health in Lodi CA. Has PSMA pet scan and may accept you. I go to UCSF but have PSMA done in Lodi
5 years ago we lived in Florida and established contact and treatment with UCSF recommended to us. No problem then. Now we live in The Bay Area and my husband still gets treatment there.
In my humble opinion I think they take in too many new patients since response times for his treatments and feedbacks slowed down considerably.
That's something else I was wondering, perhaps capacity issue...
Use a friends address?
So if we had a 911 disaster in Nevada close to the California border, would that mean that California hospitals would not treat the victims? We are so fuckedup........
Good Luck, Good Health and Good Humor.
j-o-h-n
I'm a patient of UCSF Oncology for prostate cancer. My doc is Eric Small. I do all my appointments on Zoom and my labs are done through LabCorp in Reno. I also have a cancer doc here in Reno as a liaison to UCSF when body scans need to be ordered. UCSF set this up for me. It all works well. I also have a GI doc and colonoscopy doc at UCSF. When I have in person procedures I go to SF. I refuse to have any invasive procedures done in Reno because of the poor quality of medicine. Too many of my clients have died from post op infections here. Not a safe medical community in my opinion.
Wow! That's disturbing, and also very good to know. Thank you. I'm going to wait until when/if we decide to make an offer on the property. At that⁶ point, I will speak with his actual MO and the liason dept if necessary. Is it the Renown Center in Reno you go to, or would you rather not say. I totally understand if that's the case. Appreciate you sharing your experience. This situation is confusing. Thank you!
The Cancer Care Specialist group with Dr. Santhosh Ambika. UCSF coordinates my care through him when anything needs to be ordered that they can't do. He just ordered a body scan for me that I'm completing in Reno next month. If there is something not offered or better I'll go to UCSF. Anything invasive I'll go to UCSF. I had very complex back surgery done at UCSF.
In the past I went to Stanford but they have lowered their quality of care significantly. That's why I go to UCSF. I'm currently on vacation from all cancer meds for more than a year. They still monitor me.
I hope this all helps you.
Just another reason to not live in California
UCSF vs Kaiser? Which would you choose?
Medicare Open Enrollment 
Treatment options for metastatic prostate cancer? 
