To: Dr. Rony + Catherine Shimony █████████████████████
From: Lesley Groff ███████████████████
Sent: Thur 1/18/2018 8:58:18 PM
Subject: Re: [EXTERNAL] Injectable medication

The nurse just left...they had a good talk...hoping Jeffrey will decide how he wishes to proceed soon! thanks, Lesley

On Jan 17, 2018, at 10:42 AM, Kaw, Kristine <█████████████████████████>
wrote:

Ok sounds good

From: Lesley Groff <u>rmailto</u>

Sent: Wednesday, January 17, 2018 8:11 AM

To: Kaw, Kristine

Subject: Re: [EXTERNAL] Injectable medication

Morning! Jeffrey has said yes to training tomorrow with Nurse Kristine. Do we know for sure if Jeffrey will be doing one dose a month or two? It should hopefully be one right? The nurse knows Jeffrey won't have the actual drug but says she can train without it. He has still yet to answer RE self pay or insurance.

Sent from my iPhone

On Jan 16, 2018, at 10:47 AM, Kaw, Kristine c > wrote:

Great. Just didn't want to delay the process since I know it is difficult to find time in his very busy schedule. KK

From: Lesley Groff [mailto: ]
Sent: Tuesday, January 16, 2018 10:46 AM
To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable medication

Morning Kristine! Thank you so much for following up...I am still waiting for Jeffrey's response on all of this...Hoping to hear today but he is traveling...will let you know the minute I hear something. Lesley

On Jan 16, 2018, at 10:38 AM, Kaw, Kristine <blackened out> wrote:

Good morning. Just following up regarding Mr. Epstein's decision on how to proceed. I believe the nurse is scheduled to come in this week for teaching and ideally it would be great if she can teach and observe his first medication

administration. Please let me know so I can prescribe accordingly.

KK

From: Lesley Groff <u>[rtia]</u>

Sent: Thursday, January 11, 2018 6:10 PM

To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable medication

Fii Kristine. Thank you for this! I actually sent jeffrey a note about this earlier but still ha e not heard back from him. He is been in constant meetings himself. I will ask him again however and use your much more well versed paragraph tomorrow morning early! Hope to have an answer soon. Thanks and have a great evening. Lesley

Sent from my iPhone

On Jan 11, 2018, at 6:03 PM, Kaw, Kristine <a
wrote:

Sorry for the late response. Just finished with
patients.

-Looking a labs sent from early this month, Lipids done was calculated as opposed to direct 101. Insurance companies look for the direct 101when approving medications because this is a more accurate count, therefore, representing a more accurate cardiovascular risk equivalent. When the triglycerides is high, such as in the case of Mr. Epstein, the lab cannot provide an accurate LDL count. As you can see there was no LDL value given

-If you want to proceed with insurance approval, he will need to re-take labs with direct LDL. He cannot start Repatha prior to rechecking labs because it will not be an accurate reflection of his baseline without medications.

-If he wants to self a Century Specialty Pharmacy is willing to give him a 10% discount if he purchases minimum of 6 months. They will ship the medication over as soon as it's ordered and have it virtually the next day.

-Here is the breakdown of cost: For the once a month injection $1,250/month (with 10% discount if he buys

## minimum of 6 months)

For the twice a month injection $1,150/month (with 10% discount if he buys minimum of 6 months)

Hope that answers all your questions. I will be available tomorrow if you have any questions. Please let me know what his decision is prescription to the pharmacy is pending his ok. Thanks

KK

From: <u>Lesley Groff [mailto</u>

Sent: Thursday, January 11, 2018 12:34 PM
To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable medication

Hello Kristine! I wanted to let you know I DID get Jeffrey's approval confirmed with Repatha and have been able to speak with a nurse on Jeffrey's behalf! A registered nurse is to call me within 1-2 business days to set up his training...truly hoping for next We, Th or Fri! I will be sure to let you know.

Some more questions;

-I understood from Dr. Shimony you will be contacting Jeffrey's insurance to find out about coverage and getting the $5 co-pay card?

-Once insurance approves the medication, when will Jeffrey receive his meds? Hoping he can get 3 months of the medication at a time....let me know if his insurance approves this or how many months we can receive at a time...maybe it is more!?

-will you order Jeffrey a Sharps Container? The nurse was asking me with type of injection he will be getting and I do not know...she said there are 3 different ones...

I know you are busy and will get back to me when you can!! Thank you! Lesley

## minimum of 6 months) (cont.)

On Jan 10, 2018, at 4:08 PM,
Kaw, Kristine
<██████████████████████████>
wrote:

I am so sorry if I can't respond right away since I am seeing patients with Dr. Shimony. I am on the phone now with Repatha. It must have been a misunderstanding, they need the patient, Mr. Epstein, to give permission for you to set up his appointment. Repatha needs to be called again and choose reimbursement services for Mr. Epstein to give you permission moving forward with his training. I will also be faxing you a form to fill out and for Mr. Epstein to sign. This gives Repatha permission to assist him. Are you free to talk to avoid misunderstandings? Thanks KK

From: Lesley Groff
[mailto: ]

Sent: Wednesday, January 10, 2018 2:43 PM
To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable medication

## Hi Kristine.

-1 found Erica Peltz so no worries them! :) -I called REPATHA to organize training, but they do not have him registered (which I did) and they tell me you must call them to give me permission to schedule the appointment?! Sounds like silliness to me, but what can I do!? She let me register Jeffrey so when you call give them his Acct #PP02BW57 and tell them Lesley Groff, Jeffrey Epstein's personal assistant, may coordinate the training session for him. Once

## Hi Kristine. (cont.)

you do this let me know and I
will call them back. Would
greatly appreciate it.
Thanks,
Lesley

On Jan 9, 2018, at
5:37 PM, Kaw,
Kristine

## wrote:

Great thank you. Dr.
Shimony states he
had recent labs just
don't know what his
definition of "recent"
is. Should be within
the past 30 days.
Please let me know if
any issues and
contact by email or
office number.
KK

<change><s>From:</s></change> Lesley <u>Groff</u>

Sent: Tuesday, January 09, 2018 5:27 PM To: Kaw, Kristine Subject: [EXTERNAL] Re: Injectable medication

Hi Kristine. Thank
you so much for this.
Let me find out from
Jeffrey if he has lab
work that includes
cholesterol within
past 30 days. I don't
think he does but he
has gone without me
knowing before A.
I'll call the number
below to set up
training. Have a good

## wrote: (cont.)

evening. Lesley

## Sent from my iPhone

On Jan 9, 2018, at 5:10 PM, Kaw, Kristine ███████████████ wrote:

Hi
Lesley.
Before
we get
started
with
the
process
, I need
a copy
of Mr.
Epstein’
s recent
labs
includin
g
cholest
erol
with in
the
past 30
days.
Please
let me
know if
he does
not
have
one so I
can
send an
rx to
get it
done.
We will
try to
get
approv
al for
his

## Sent from my iPhone (cont.)

## medica

tion to

avoid

paying

out of

pocket

and the

compan

y is

willing

to

provide

sample

s while

workin

g on his

approv

al.

Please

[ ]

call

## A to set

up a
training
session
and
also $5
copay
card if
medica
tion
approv
ed.
Please
let me
know if
you
have
any
questio
ns.
Thank
you
Kristine