This evidentiary record constitutes a formal demand for audit pursuant to California Government Code § 8546.7, which provides that every contract involving expenditure of public funds exceeding $10,000 “shall be subject to the examination and audit of the California State Auditor.” The Legislature specifically intended this provision to apply to the Regents of the University of California. The contracts at issue — including UC’s systemwide agreements with Anthem Blue Cross, Accolade, and Via Benefits (Willis Towers Watson) — each involve public fund expenditures far exceeding this threshold.
The University of California constitutes a “public trust” under California Constitution, Article IX, Section 9. As a self-insured employer, UC is bound by Cal. Code Regs. Title 8, § 15400.2: claim files where future benefits may be payable “shall not” be destroyed.
A prior formal audit request was submitted November 9, 2021, to Chief Compliance & Audit Officer Alexander Bustamante. UC has never responded. This is the second such demand.
URGENT: IMMEDIATE HOLD ON ALL COVERAGE CHANGES
PENDING CANCER SURGERY — FEBRUARY 2026
TO: University of California, Anthem Blue Cross, RASC Insurance Team, Accolade
FROM: Charles A. Harold DATE: February 3, 2026
RE: IMMEDIATE HOLD on all coverage changes, transitions, or modifications to current UC Blue Cross medical insurance for Charles A. Harold and Harold's wife, pending completion of scheduled cancer surgery in February 2026.
DEMAND: Do not change, cancel, transfer, interrupt, modify, or otherwise alter the current UC Blue Cross of California UC High Option Supplement medical coverage for the undersigned or his spouse. RASC’s own message dated January 30, 2026 states: “Please ensure that your new coverage through Via Benefits becomes effective on 04/01/2026.” This confirms RASC is planning a coverage transition. No such transition shall occur, EVER, until the undersigned’s cancer surgery and post-operative recovery are complete.
BASIS: As documented below, four separate UC/federal systems currently provide four mutually exclusive answers about whether this coverage even exists. Until these contradictions are reconciled, any change to coverage status would cause irreparable harm to a cancer patient during active treatment.
As of February 1, 2026, four separate institutional systems administered by or on behalf of the University of California provide four mutually exclusive answers to the question: “Does Charles A. Harold have active Blue Cross of California medical insurance coverage?”
| System | What It Shows | Coverage Status | Evidence |
|---|---|---|---|
| UCRAYS (UC’s Own Portal) | Enrolled: UC High Option Supplement. Medicare Coordination: Yes. Premium deducted: $727.48/month from gross pension of $2,916.21. Banner states: “An insurance change is currently in progress.” | ACTIVE — Paying $727.48/mo (currently; for many years paid close to $900/month deducted from regular retirement pension) | Retiree Insurance page screenshot (undated, current) |
| Medicare.gov (Federal CMS) | Other Insurance: BLUE CROSS OF CALIFORNIA. Coverage start date: 1/1/2026. Shows alongside Original Medicare Parts A & B and Navitus MedicareRx (PDP). | ACTIVE — Recognized by CMS | Medicare.gov “Your plans” screenshot (current) |
| Anthem Blue Cross Portal (Insurer) | Plan Documents dropdown shows only three periods: Jan 1, 2024 to Dec 31, 2024; Jan 1, 2025 to Dec 31, 2025; Jan 1, 2026 to Present. No records exist prior to January 1, 2024 despite 20+ years of continuous coverage and premium payments. | PARTIAL — No history before 2024 | Anthem portal Plan Documents dropdown screenshot (01/30/2026) |
| Accolade App (UC’s Contracted Healthcare Advocate) | Healthcare Services Coverage page displays: “0 Services Available.” This is the same system that approved Prior Authorization #8749806 on November 25, 2025 for the PSMA PET/CT scan at issue in this report. | NO COVERAGE SHOWING | Accolade app screenshot (02/01/2026, 11:29 AM) |
The Contradiction: UC’s UCRAYS system is deducting $727.48 per month from a gross pension of $2,916.21 — that is 24.9% of gross pension income — for medical insurance that UC’s own contracted healthcare advocate (Accolade) simultaneously reports does not exist. The federal government (Medicare.gov) confirms coverage exists. The insurer (Anthem Blue Cross) confirms current coverage but has no records prior to January 2024.
Pension Verification: UC Retirement Administration Service Center Verification of UCRP Income dated January 13, 2026 confirms Charles A. Harold receives monthly UCRP income of $2,286.99 gross plus COLA of $629.22, totaling $2,916.21 gross monthly. After the $727.48 medical insurance deduction, the net available amount is reduced before any tax withholding occurs.
Tax Withholding Note: UCRAYS Payee Account Tax Withholding Maintenance shows both Federal Tax and CA State Tax withholding set to 0.00% with “Do Not Withhold” checked, start date 06/01/2015, status Approved. This 06/01/2015 date corresponds to the period when Charles Harold’s status was reclassified from disability income to service retirement.
On January 30, 2026, two separate RASC representatives sent secure messages through UCRAYS confirming that a coverage change process is underway:
| From | Date/Time | Content |
|---|---|---|
| Farzana, RASC | 01/30/2026 04:18:02 PM | “Dear CHARLES A HAROLD, Thank you for your message to the UC Retirement Administration Service Center (RASC). A request has been submitted to pause all outbound enrollment calls from Via Benefits until 03/01/2026 due to upcoming medical procedure. Your current UC coverage will continue through 03/31/2026 and new coverage through Via Benefits should become effective 04/01/2026. Please send a new message if you have any other questions or concerns. Thank you, Farzana, RASC. Phone: 1-800-888-8267, Monday–Friday, 7:00 a.m. to 4:30 p.m. (PT). Fax: 800-792-5178. Mail: University of California - RASC, PO Box 24570…” |
| Jeanine, RASC Insurance Team | 01/30/2026 03:59:15 PM | “Dear Charles A. Harold, I wanted to let you know that I have submitted a request to pause all outbound calls from Via Benefits for enrollment assistance until 03/01/2026, as your UC coverage will continue through 03/31/2026. I understand that you have an upcoming medical procedure and wish to avoid any interruption to your current coverage. Outbound enrollment calls will resume in March, and you can remain on your current UC coverage until 03/31/2026. Please ensure that your new coverage through Via Benefits becomes effective on 04/01/2026. Please reach out if you have any questions or need further assistance. Best regards, Jeanine, RASC Insurance Team, 800-888-8267” |
Analysis: Both RASC messages confirm: (1) UC acknowledges the upcoming medical procedure (cancer surgery); (2) UC intends to terminate current UC coverage on 03/31/2026; (3) UC expects coverage to transfer to Via Benefits effective 04/01/2026; (4) UC only paused Via Benefits outbound calls until 03/01/2026 — not the coverage change itself. Given the four-system contradiction documented in Section 1, and the active billing disputes documented in Section 3, transferring coverage to a third-party administrator during cancer treatment when the current systems cannot even agree on whether coverage exists would create immediate and irreparable harm.
On December 1, 2025, Charles Harold underwent a PSMA PET/CT scan at SMIL Southwest Diagnostic Imaging, Gilbert Mercy Commons, 3645 S. Rome St., Ste. 101, Gilbert, AZ 85297 (NPI: 1902896236). This procedure was pre-authorized by Accolade (Prior Authorization #8749806, approved November 25, 2025) as medically necessary. The following chronology documents five mutually exclusive representations of what Charles Harold owes for this single procedure.
| Date | Event |
|---|---|
| November 22, 2025 | SMIL Patient Responsibility Estimate generated. Based on BCBS of Arizona verification. Patient: CHARLES A HAROLD, DOB [DOB ON FILE WITH UC]. Insurance: BCBS of Arizona, Subscriber ID VUC-XXX-XXXXX, Patient Account: ACCT-XXXXXXXX. Two procedure line items: CPT 78815 (PET-CT Imaging Skull Base-Mid Thigh) billed $7,211.00, insurance discount $3,509.58, allowable $3,701.42; and A9595 (Pifulufolastat F18 / Pylarify, NDC 71258002200) billed $29,110.00, insurance discount $18,746.70, allowable $10,363.30. Total billed: $36,321.00. Insurance allowed: $13,674.54. Estimated insurance payment: $9,551.18. Deductible: $0.00. Coinsurance 30%. Co-pay: $30.00. Total estimated patient responsibility: $4,123.36. |
| November 24, 2025 1:07 PM PT | Chuck Harold calls SMIL at (480) 425-5098. Call duration: 4 minutes 43 seconds. Per contemporaneous written documentation (email to SMIL dated November 27, 2025): SMIL representative stated the procedure costs approximately $14,000. SMIL’s contract with Blue Cross pays just under $14,000. Chuck’s portion: $30.00 co-pay. Chuck would only hear from billing “if the insurance company somehow denied the procedure cost.” Representative said she would send a revised estimate. No revised estimate was ever received. |
| November 25, 2025 | Accolade Prior Authorization #8749806 APPROVED. For Outpatient Procedure(s). Accolade’s system states: “Your Outpatient Procedure(s) has been approved. Prior authorization approval means the service is determined to be medically necessary.” |
| December 1, 2025 11:00 AM | PROCEDURE PERFORMED. PSMA PET/CT scan performed at Gilbert Mercy Commons, Gilbert, AZ. |
| December 1–2, 2025 | CO-PAY PAID: $30.00. UNIFY Financial Credit Union bank statement shows debit card charge of $30.00 to “RPY*SOUTHWEST DIAGSCOTTSD SCOTTSDALE AZ Date 12/01/25.” Posted date: 12/2/2025. |
| December 23, 2025 | CLAIMS PROCESSED — TWO CONTRADICTORY RESULTS under Claim Number 2534OMF1526. Same service date (Dec 1, 2025), same provider (Southwest Diagnostic Imaging), same patient, same insurer, same claim number. See Section 3B below for detailed breakdown. |
| January 25, 2026 12:07 PM | SMIL collection text message #1 received from +1 480-525-5467: “SMIL Southwest Diagnostic Imaging: As a friendly reminder, you have a statement of $2725.16 waiting for payment.” |
| February 1, 2026 11:01 AM | SMIL collection text message #2 received from +1 480-525-5467: “SMIL Southwest Diagnostic Imaging: As a friendly reminder, you have a statement of $2725.16 waiting for payment.” |
On December 23, 2025, Anthem/Accolade processed Claim Number 2534OMF1526 and produced two contradictory results for services rendered on the same date, at the same facility, for the same patient, under the same insurance plan:
| Line Item | CPT 78815 — PET-CT Imaging | A9595 — Pylarify Drug |
|---|---|---|
| Provider Billed | $7,211.00 | $29,110.00 |
| Insurance Discount | $0.00 | −$18,943.04 |
| Insurance Paid | $0.00 | −$7,441.80 |
| Deductible | $0.00 | $0.00 |
| Coinsurance | $0.00 | $2,725.16 |
| Patient Responsibility | $7,211.00 | $2,725.16 |
| Process Date | Dec 23, 2025 | Dec 23, 2025 |
| Claim Number | 2534OMF1526 | 2534OMF1526 |
| Network Status | In-Network | In-Network |
The Impossibility: The CPT 78815 imaging component was processed as if Charles Harold had zero insurance. No discount was applied. No payment was made. The full billed amount of $7,211.00 was assigned to patient responsibility. Yet the A9595 Pylarify drug component — for the same procedure, on the same date, at the same facility, under the same claim number — was processed normally with an $18,943.04 insurance discount and $7,441.80 insurance payment. The system simultaneously recognized and denied coverage for the same patient on the same claim.
Coordination of Benefits Error — Institutional Admission: On December 31, 2025, in a recorded telephone call (Arizona one-party consent, A.R.S. § 13-3005), Accolade representative acknowledged that coordination of benefits “was not updated” in the system and updated it during the call with Anthem representative “Dynasty.” This admission confirms the system was looking for a phantom secondary insurer that did not exist, which would explain why the imaging component was processed as if the patient had no primary coverage.
| Source | Amount | Date | Basis |
|---|---|---|---|
| SMIL representative (phone) | $30.00 | Nov 24, 2025 | Verbal quote, Blue Cross contract |
| SMIL Patient Responsibility Estimate | $4,123.36 | Nov 22, 2025 | BCBS verification, 30% coinsurance + $30 copay |
| Anthem processed claim (Pylarify only) | $2,725.16 | Dec 23, 2025 | 30% coinsurance on drug component only |
| Anthem processed claim (Imaging only) | $7,211.00 | Dec 23, 2025 | Zero insurance applied — full billed amount to patient |
| Combined Anthem processed total | $9,936.16 | Dec 23, 2025 | Sum of both claim lines |
| Amount actually paid by patient | $30.00 | Dec 1–2, 2025 | Debit card, UNIFY Financial CU bank statement |
SMIL is currently sending collection text messages for $2,725.16 (the Pylarify coinsurance). The $7,211.00 imaging balance — where insurance paid nothing — has not yet appeared in collection texts but remains on the Accolade claims record as patient responsibility.
The following table shows all claims processed through Accolade for Charles Harold during December 2025. Every claim other than the SMIL PET/CT processed normally:
| Date | Provider | Type | Patient Owes | Status |
|---|---|---|---|---|
| Dec 1 | SOUTHWEST DIAGNOSTIC IMAG | Medical | $7,211.00 | ABNORMAL |
| Dec 1 | SOUTHWEST DIAGNOSTIC IMAG | Medical | $2,725.16 | ABNORMAL |
| Dec 2 | ARIZONA ONCOLOGY ASSOC | Medical | $32.89 | Normal |
| Dec 5 | CVS PHARMACY #09293 | Pharmacy | $60.00 | Normal |
| Dec 8 | CVS PHARMACY #09293 | Pharmacy | $10.00 | Normal |
| Dec 8 | CVS PHARMACY #09293 | Pharmacy | −$10.00 | Normal |
| Dec 9 | CVS PHARMACY #09293 | Pharmacy | $10.00 | Normal |
| Dec 18 | SONORA QUEST LABORATORIES | Medical | $0.00 | Normal |
| Dec 24 | USACS EMERGENCY MEDICINE | Medical | $0.00 | Normal |
| Dec 24–25 | HONORHEALTH FOUR PEAKS ME | Medical | $0.00 | Normal |
| Dec 25 | CVS PHARMACY #09293 | Pharmacy | $0.00 | Normal |
| Dec 25 | CVS PHARMACY #09293 | Pharmacy | $0.00 | Normal |
| Dec 26 | SONORA QUEST LABORATORIES | Medical | $0.00 | Normal |
Of particular note: The December 24–25 claims represent a Christmas Eve/Christmas Day emergency room visit at HonorHealth Four Peaks and USACS Emergency Medicine, processed at $0.00 patient responsibility. Insurance worked correctly for an emergency room visit in the same month it refused to pay for a pre-authorized outpatient cancer diagnostic scan. This selective failure pattern is consistent with the “coordination of benefits” error that Accolade admitted to on December 31, 2025.
During recorded telephone calls on December 31, 2025 (transcripts on file), Accolade representatives made the following commitments. As of February 1, 2026 (32 calendar days later), none have been fulfilled:
| Commitment | Promised Date | Status as of 02/01/2026 | Impact |
|---|---|---|---|
| Email claim summaries to [email protected] | Dec 31, 2025 | NOT RECEIVED | Cannot reconcile billing without claim documentation |
| Callback once email sent | Dec 31, 2025 | NO CALLBACK | No follow-through on acknowledged system errors |
| Denied claims reprocess automatically within 30 business days | ~Feb 10, 2026 | NOT REPROCESSED | Claims still showing patient responsibility; collection texts ongoing |
| Coordination of benefits updated during call with Anthem rep “Dynasty” | Dec 31, 2025 | NO EVIDENCE OF CORRECTION | System still showing $7,211 + $2,725.16 patient responsibility |
| Item | Amount |
|---|---|
| Amount quoted to patient (SMIL phone rep, Nov 24, 2025) | $30.00 |
| Amount paid by patient (bank statement, Dec 1–2, 2025) | $30.00 |
| Amount now claimed as patient responsibility (imaging, Claim 2534OMF1526) | $7,211.00 |
| Amount now claimed as patient responsibility (drug, Claim 2534OMF1526) | $2,725.16 |
| TOTAL DISPUTED PATIENT RESPONSIBILITY | $9,936.16 |
| Amount in active collection (SMIL text messages) | $2,725.16 |
| Amount pending collection (imaging — insurance paid $0) | $7,211.00 |
| AMOUNT THAT SHOULD HAVE BEEN PATIENT RESPONSIBILITY | $30.00 |
This $9,936.16 in disputed charges appears to be being pursued against a retiree whose gross monthly pension is $2,916.21, meaning the disputed amount for this single procedure represents 3.4 months of gross pension income. This retiree has scheduled cancer surgery in February 2026.
All calls made from Arizona (one-party consent state, A.R.S. § 13-3005). Charles Harold was a party to all calls. Accolade and Medicare systems announced recording. Full transcripts on file.
| Time | Entity Called | Duration | Key Admissions/Findings |
|---|---|---|---|
| 1:22 PM | Accolade (866-406-1182) | 9m 25s | Initial call re: denied claims and coordination of benefits errors |
| 1:44 PM | Accolade/Blue Cross | — | Three-way with Anthem rep “Dynasty”; coordination of benefits “was not updated”; updated on call; claims to reprocess in 30 business days |
| 2:30 PM | UCOP | — | UC closed for holiday — no answer (attempt documented) |
| 2:34 PM | UCOP | — | UC closed for holiday — no answer (attempt documented) |
| 2:36 PM | Medicare (800-633-4227) | — | Monica Soria: No secondary insurance on file; prior enrollment/unenrollment note from previous week could not be located; Medicare cannot set up crossover records; crossover takes up to 60 business days |
| 3:05 PM | Medicare | — | Eric Thompson: Confirmed no secondary coverage on file as of 12/31/2025 |
| 3:23 PM | Accolade/Blue Cross | — | Follow-up; physical therapy claim miscoded as “biofeedback”; Accolade stated benefit administration is UC’s responsibility; Accolade warned account would be “closed out” upon Medicare transition |
Critical admission from Medicare call: Medicare representative Monica Soria confirmed that a note showing prior enrollment/unenrollment history (found by a different Medicare representative in a prior call) could not be located: “I don’t know where she looked at that because I’m not able to find it.” This disappearing data is consistent with the batch file upload issues described by UC representatives and the systemic data integrity failures documented throughout this case.
| # | Document | Date | Proves |
|---|---|---|---|
| 1 | UCRAYS Retiree Insurance page screenshot | Current | Active enrollment, $727.48/mo premium, UC High Option Supplement, Medicare Coordination: Yes |
| 2 | Medicare.gov “Your Plans” screenshot | Current | Blue Cross of California recognized as Other Insurance, start 1/1/2026 |
| 3 | Anthem Blue Cross Plan Documents dropdown | 01/30/2026 | No plan records prior to Jan 1, 2024 despite 20+ years coverage |
| 4 | Accolade app Healthcare Services Coverage | 02/01/2026 | “0 Services Available” despite active premiums and prior authorization |
| 5 | UCRAYS RASC messages (Farzana & Jeanine) | 01/30/2026 | Coverage change planned for 04/01/2026; Via Benefits transition |
| 6 | Verification of UCRP Income | 01/13/2026 | Gross pension $2,916.21/mo ($2,286.99 + $629.22 COLA) |
| 7 | UCRAYS Payee Tax Withholding | Current | Tax status change date: 06/01/2015; 0% withholding |
| 8 | SMIL Patient Responsibility Estimate | 11/22/2025 | Pre-service estimate: $4,123.36 with $30 copay |
| 9 | Accolade Prior Authorization #8749806 | 11/25/2025 | Procedure approved as medically necessary |
| 10 | UNIFY Financial CU bank statement | 12/02/2025 | $30.00 copay paid at time of service |
| 11 | Accolade claims — CPT 78815 detail | 12/23/2025 | $7,211 patient responsibility, $0 insurance paid |
| 12 | Accolade claims — A9595 detail | 12/23/2025 | $2,725.16 patient responsibility, $7,441.80 insurance paid |
| 13 | SMIL collection text messages (2) | 01/25 & 02/01/2026 | Active collection for $2,725.16 |
| 14 | December 31, 2025 call log screenshot | 12/31/2025 | 8 calls to 4 entities in one afternoon |
| 15 | December 31, 2025 call transcripts (6) | 12/31/2025 | Institutional admissions re: coordination of benefits, disappearing data |
| 16 | Email to SMIL re: $30 copay quote | 11/27/2025 | Contemporaneous written documentation of verbal cost representation |
| 17 | Accolade contact record (phone) | 12/31/2025 | 9m 25s call duration documented |
| 18 | Accolade December 2025 claims list | 02/01/2026 | All other Dec claims processed normally; selective failure pattern |