Authorities are investigating a medication error that led to the death of a baby at Kaiser's Santa Clara hospital. The article cites three medication error deaths at Kaiser Santa Clara since 2004 - this number seems low to me, so I'm wondering what Kaiser does to re-catagorize other deaths. Here's another article.
To give an example of how far Kaiser is willing to go, check out the case of Lehna Jordann Brewer, in which Kaiser pursues evidence manipulation and cover ups galore. Lehna's father recently spoke out about Kaiser's HealthConnect debacle - the L.A. Times article mentions problems caused by outages in the Neonatal ICU.
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In other news, Kaiser is dumping Martinez for the more upscale suburbs of Walnut Creek and Antioch. Kaiser's Modesto project is waiting on a full deployment of HealthConnect. That's going to be a loooong wait - lol. The California Deptartment of Managed Health Care still claims to be investigating the problems with Kaiser's EMR.
Kaiser Thrive has also posted a visual aid for Kaiser nepotism. Among the many complaints about Kaiser HR is they look the other way as high level managers hire their friends and family.
ROTFLMAO: For some unexplained reason, Kaiser has rejected my application for Culture Change Leader. :D
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The police are investigating whether a Kaiser surgeon hastened a man's death to get his kidney. I don't even know what to say to that.
Kaiser whistleblower Justen Deal has published an article about patient safety at Kaiser in The News is Now Public. If you think these issues are important vote for the article on Digg here.
I'd like to shout out a thank you to Matthew Holt for his recent help. I look forward to meeting him at the Healthcare Blogging Summit.
ROTFLMAO Update! Should I apply for this Kaiser job? Leave it to Kaiser to stomp on and priggishly ignore their critics while creating a new bureaucratic position to pretend like they're taking action. What Kaiser doesn't get is that Doing the Right Thing starts with...actually Doing the Right Thing. Further Update: Kaiser blocked and email-bounced my application for Culture Change Leader. Should I interpret this as Kaiser symbolically blocking culture change? :D
Here is the text from some recent Kaiser memos attempting to shape public perceptions of their EMR project. Is it possible to overdose on Koolaid? I'm not posting pdfs of the originals because I received them as text.
Important Announcement from George Halvorson, CEO Chief Information Officer (CIO) Appointment
February 26, 2007
I am pleased to announce that Philip (Phil) Fasano has joined Kaiser Permanente as Senior Vice President and Chief Information Officer, effective immediately. As the leader of KP-IT, he will focus on the service, products and people essential to the success of KP’s technology agenda. Phil will be a member of the National Leadership Team and will report directly to me.
Sincere Thanks to Bruce Turkstra
I want to thank Bruce Turkstra for his excellent leadership during his tenure as interim CIO. As you know, Bruce also did a wonderful job overseeing the KP HealthConnect roll-out and advancing our electronic health record to where it is today. His valued contributions throughout the KP HealthConnect project and during his recent work in IT are greatly appreciated. Bruce will be working with me to develop and execute a transition plan.
Phil Comes to KP With an Impressive Background
Throughout his career, Phil has managed teams and organizations whose scope and complexity are very similar to our IT organization. His proven ability in a number of settings to interrelate system support and the overall strategy of the organization will be of great value to us. Kaiser Permanente will benefit from his business acumen, strategic approach and deep technical skills.
Phil has more than 20 years of corporate experience as a business leader and has successfully served as CIO for several companies including Deutsche Financial Services, JP Morgan Chase and Capital One. With each opportunity, he brought a transformational vision that was key to the evolution of the company’s business strategy and success.
Most recently, Phil was President and CEO of Capital Sourcing Group, Inc., in McLean, Virginia, where he provided advice, consulting and services to Fortune 500 companies and the U.S. Department of Homeland Security.
Phil received an M.B.A. from Long Island University, and a B.S. in Computer Science from the New York Institute of Technology. He and his wife, Judy, have five children. They will relocate to the SF Bay area in the near future.
Please join me in welcoming Phil to KP, and in thanking Bruce for his strong performance. I am confident that we will all support Phil in our ongoing efforts to drive an effective technology agenda that enables optimal care for our members.
This is a broadly distributed message. Please do not reply.
Please share this message broadly with your peers.
A message to KPSC managers and physician leaders from
Benjamin K. Chu, MD, president KFHP/H, Southern California, and
Jeffrey A. Weisz, MD, executive medical director, SCPMG
The February 15 edition of the Los Angeles Times reported on concerns with the implementation of our Kaiser Permanente HealthConnect TM system, and questioned its safety.
Many of you have wondered where the reporter from the L.A Times received his information. He interviewed numerous people within KP including CEO George Halvorson and other national leaders. We also hosted him for a full day at Baldwin Park Medical Center, where he spoke with two of our physicians closely involved with KP HealthConnect. He also talked with nurses and other staff, and we gave him unrestricted access to our hospital and clinics with KP HealthConnect. While many spoke candidly of some of the earlier challenges, nearly everyone commented on the benefits the system provides to enhance care for our members.
We know, and the article acknowledges, that Kaiser Permanente has already improved the care for our members because of KP HealthConnect. After mastering the system, the overwhelming majority of our doctors and nurses agree that KP HealthConnect has improved their ability to deliver the highest quality of care.
No comparable scale electronic health record has ever been deployed so rapidly. With a project this large and an organization as diverse as Kaiser Permanente, we have had to overcome our share of obstacles. For the first time, all eight of our regions are operating on a common technology platform through KP HealthConnect. A change of this magnitude required significant IT infrastructure upgrades, as well as a level of cross-regional collaboration that had not been required to date.
This conversion also has had a profound impact on the day-to-day work of our physicians, clinicians, and staff. More than moving from paper to electronic processes, we did extensive examinations of workflows and care practices to optimize the care our members receive throughout our system. This has required significant training and support.
We have always been forthcoming regarding the challenges we have faced and overcome, as well as the success. We expected these challenges in infrastructure, deployment, and adoption given the size and scope of our implementation and we are pleased with our progress to date.
We thank all employees and physicians whose tremendous work has advanced us to this point in our system’s implementation. Your efforts, professionalism, and results make the difference in our ability to deliver and meet our members’ and patients’ needs in the 21st century.
Because you may receive questions about the article from members, family and friends we have provided a brief overview and a link to a Q & A regarding questions about KP HealthConnect below.
Sincerely,
Benjamin K. Chu, MD, MHA Jeffrey A Weisz, MD
President, Kaiser Foundation Health Plan, Hospitals Executive Medical Director, SCPMG
KP HealthConnect Facts
KP HealthConnect is Improving Care Delivery
KP HealthConnect's built-in treatment guidelines are helping us improve the management of common/chronic conditions such as diabetes and hypertension. We are also improving patient safety by increasing the accessibility of the patient medical record. Industry studies show that a paper medical record is missing up to 30 percent of the time for an office visit and paper medical records are almost never available for patient care in an emergency room. With KP HealthConnect, the electronic health record is available when and where it is needed.
Because KP HealthConnect includes more comprehensive patient information, it is helping caregivers address multiple problems or the provision of multiple services in a single visit. This reduces the need for additional follow-up appointments.
Our new online features, such as secure e-mail to your doctor’s office, will bring our members unprecedented access to Kaiser Permanente care.
By logging on to kp.org, members now have the ability to address some of their needs online, instead of coming in for an office visit or spending time playing phone tag. Preliminary surveys show high satisfaction with these opportunities to save both time.
System Availability is Close to Our Goal
Our goal is to have KP HealthConnect available for use everywhere and every time it is needed to provide care and service to our members. Our goal for system availability is 99.7 percent. We currently average 99.2 percent and we are aggressively working to meet our ultimate availability goal.
We’re Continuing to Move Forward
The world recognizes the KP HealthConnect project as a groundbreaking tool that will allow us to set ever higher standards of health care. The dedication of our many outstanding professionals who deploy, support, or use it every single day ensures that we will meet the challenges ahead of us, and distinguish Kaiser Permanente as the best place to receive quality and compassionate care.
For Answers to Additional Questions
Go to the KP HealthConnect Web site for answers to additional questions.
How to Get Kaiser Permanente’s Side of the Story
Ever wish you could go online to get Kaiser Permanente’s side of the story when KP appears in the news? Kaiser Permanente’s Brand Strategy, Communications and Public Relations Department launched an external Web site accessible from KP.org on February 1 so that you can do just that.
The new Web site, KP News Center, highlights the latest news and commentary from across the Program and provides a channel for Kaiser Permanente leadership to tell KP’s side of stories that appear. For example, the feature story on the site today responds to an LA Timesnews article that describes KP’s electronic health record efforts.
The site is designed to inform audiences such as KP members and potential members, KP employees, legislators, purchasers and customers, and the media with facts and information. We are working to identify the best way to make the public aware of the news Web site.
The site also features stories on a variety of topics including Health Research, KP HealthConnect™, Community Benefit and Clinical Excellence. In addition to our own news features, the site includes links to other news sources, health resources on KP.org and Kaiser Permanente podcasts. Readers can also subscribe to news and receive regular updates through an RSS feed. Bookmark it now: http://xnet.kp.org/newscenter/index.html
Please be sure to check this site regularly for ongoing updates and information.
Thank you,
Diane Gage Lofgren
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Holy cats - I look away five seconds and Kaiser accelerates its bad karma spree! First of all I'm going to direct everyone to Kaiser Thrive to read excerpts from articles that require registration, and I will link to the Kaiser Thrive posts in appreciation of all the work they do.
First, the L.A. Times reports that five Kaiser hospitals are deadly for people with pneumonia. Not exactly a surprise, but I'm glad the L.A. Times is continuing to buck the Kaiser-payola situation in California.
Second, Bruce Turkstra got dumped from the interim CIO position. The scuttle is that Turkstra made a number of changes based on the expectation he would keep the job, so I'm sure mucho membership $$$ were dedicated to his golden parachute/bribe.
Here's yet another Kaiser employee telling it like it is. I'm still waiting for a sign that Kaiser is actually getting the message. What Kaiser does to its own employees is unacceptable, and this mistreatment trickles down to sabotage patient care. Moreover Kaiser's practice of destroying evidence and choosing to manipulate perceptions over fixing the problem effects both employees and patients. It's a cultural problem, and this tone is being set by Halvorson and his team. UPDATE: The HealthConnect Corruption Scandal seems to be on fire!
In support of the letter posted by the Kaiser employee, I heard similar sentiments expressed about the situation from a completely different source. I think the abusive managers are going to have a tough time talking their way out of this one. And, once again, SHAME ON KAISER HR, for letting this sort of thing go on and for punishing the employees who try to seek help.
Congratulations to Justen Deal for being named Health Care IT's 2006 Industry Figure of the Year by the Hissies! ROTFLMAO!!!
Another ROTFLMAO - Kaiser sends out the PR panzer division in an attempt to roll over the L.A. Times expose of HealthDisconnect. Here is the internal Kaiser koolaid memo.
BizJournals ran an article on Kaiser's blogging strategy. Or anti-blogging strategy: it's just more gross attempts to manipulate the media. The article covers how Kaiser chickened out of the Health Care Blogging Summit once it found out critics would be on the same stage. The conference organizer pointed out that this is part of Kaiser's larger transparency problem.
I need a breather, but if there's recent Kaiser stupidacity that I missed, please post a comment, and I'll be happy to add it here.
Update: I almost forgot the funniest thing of all! Some Northern California Kaiser employee tried to hack into Kaiser Thrive yesterday! How lame! But also ROTFLMAO because the attempt is pretty bad.
Update2: Wow, my blog is under visitor seige right now! Hi to all newcomers. If anyone is so inclined, I'm trying to raise money so I can represent patient advocates at the Health Care Blogging Summit in April. You can chip in here. This blog has no advertising or sponsorship, and I don't work regularly myself (thanks to Kaiser). I would appreciate any help.
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An article in the front page times details the myriad problems with Kaiser's over-hyped and under-performing EMR. There have been many incidents putting patients at risk, including an infant in the NICU, and I hope this article helps patients understand why the technology issues are directly relevant to them.
However, what did the TV news report this morning? They parroted a Kaiser press release about their intention to launch the quote unquote "BIGGEST" health care study on diet and genetics. Don't the TV news editors even GLANCE at what's in the newspapers? This BIGGEST member survey is blatantly timed to distract people from and/or preempt the L.A. Times article. What a coup for the Kaiser PR people who had a hotline to the ABC news room, where the same pseudo-story about Kaiser's BIGGEST member survey has mentioned three times so far this morning, while the revelations of the L.A. Times article have not been mentioned at all.
Update: Kaiser's decoy story has now been added to the rolling headlines on the bottom of the screen! This is usually reserved important news alerts that need to continue to be communicated even when the reporters are talking about something else.
Once again Kaiser has chosen to exercise low PR tactics instead of addressing the problems. And once again the mainstream media has gone slithering after the money instead of bothering with the hassle of investigative reporting.
Kaiser must not be allowed to get away with putting PR before patients. To bring home how important it is to not let Kaiser substitute "thriviness" for problem-solving: I found out this morning that the Roseville cancer patient mentioned in my previous post DIED this morning. Even though the patient could eat, Kaiser withheld all medication except for morphine. Kaiser representatives claimed that the patient didn't need medication (for diabetes and a heart condition) because "his brain would take over". Two family members with M.D.s tried to intervene. One was allowed to speak to the attending physician, but no one was allowed to see the medical records.
The saddest part of all this is that Kaiser sowed dissension in the family by asserting that if the family moved the patient to another hospital, they would be stuck with a bill they could never pay off. Who knows what options the family would have found if they looked, but while they were trying to figure everything out, the patient died.
In other news, Kaiser lost another laptop containing the medical information of as many as 22,000 people. Why isn't this being reported instead of Kaiser's strategic deployment of the word "BIGGEST"?
For People Leaving Comments: An emergency came up, and it's hard for me to get to a computer to approve the comments. Please do leave your comments - I care about them a lot, and I think it's important for Kaiser to hear a community of voices. I will get to the comments as quickly as I can, and I will reply at some point during the day.
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First, I want to thank everyone who has chipped in for my participation in the Health Care Blogging Summit. A few dollars from a lot of people builds up fast, and I'm now confident I'll have the money by the end April. :D
Now on to the horrific example of Kaiser Thrivicide that's currently being discussed everywhere. The patient had been going to Kaiser (Northern California - Roseville) for NINE YEARS, with the complaint that he had lost his sense of smell. The doctors I know say that any third year medical student would immediately consider the possibility of a frontal lobe brain tumor. However, as usual, Kaiser avoided doing the brain scan that's required to rule out that diagnosis (i.e. Kaiser didn't want to spend the money on the necessary test.)
After nine years, a Kaiser doctor finally ordered the tests, and of course the patient had a frontal lobe brain tumor.
Since brain tumors are expensive to treat, Kaiser elected not to consult with the person who had his Power of Attorney for the patient's health care, or anyone else: Kaiser sent the patient directly to a hospice without ordering any further tests or treatment!!!
When his family got to the patient, he was being pumped full of IV Morphine, though he had no pain symptoms! Apparently, even the costs of maintenance without treatment are too much for Kaiser. Suppressing respiration with Morphine will hasten death. And both the hospice move and what looks to me like attempted murder reduced the chances of the patient going to REAL doctors who might try to treat, or even cure this disease.
The patient's family (who have his Power of Attorney) want to move him to a hospital where he can be treated, but Kaiser has been trying to play the family members off each other instead.
The advocacy community is outraged because this is TYPICAL for Kaiser! The doctors at Kaiser avoid diagnosis of an expensive disease, and when its presence becomes impossible to deny, they declare it incurable without proper testing, and then rush them off to "Hospice" to initiate involuntary euthanasia.
This is NOT negligence! This appears to be a premeditated PLAN to save money at the expense of patient lives!
Yet Kaiser rates continue to skyrocket. Patients are paying $$$ for Kaiser's PR thriviness instead of health care!
I've pieced together the story from a number of emails - most of the above is paraphrased or directly quoted from my source. If I've misunderstood anything, I welcome corrections and will act quickly on them.
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Kaiser leadership recently distributed a memo on ethics to their organization, which you can read here. Since Kaiser hasn't taking any action whatsoever to address the incidents where people have suffered because of their ethical malfeasance, this memo is just blowing a lot of smoke. The disturbing part, though, is that memo tells employees they have a duty to report ethics violations. However, anyone who works for Kaiser knows that HR has a mandate to back managers under any circumstance, so managers will preemptively move to fire or otherwise retaliate against employees who even hint that there's an ethics problem. Kaiser needs to fix the HR problem first before ordering rank-and-file employees to put their jobs on the line.
In other news, the Labor Panel went very well, and hopefully whatever aired on local TV will soon be available online. I met Justen Deal for the first time in person, and we compared notes on our experiences. I still have hope that Kaiser will review the stance they took toward him, because putting him on unpaid leave for months for a well-intended criticism just makes them look like jerks who put political kowtowing before the good of anyone else - including patients as well as employees.
I have been invited to participate in a panel for the Healthcare Blogging Summit. This summit has brought to light the way corporate interests infiltrate and dominate the public voice - thus silencing, isolating, and delegitimizing critics. Corporate bloggers are paid: they are funded to attend conferences, and when they serve on panels they become known as "professionals" to be taken seriously. There are even corporate sponsorships for people attending the conference, so the HMO and Insurance industries actually *become* the blogosphere. Many corporate critics don't even have ads to support their blogs: everything they do is on their own time and out of their own pocket.
I was honored to be invited to be on a panel of the Healthcare Blogging Summit, and I hope my one determined voice won't be utterly swamped by the sea of corporate stooges. Interested parties can show their support in part by recognizing how some of the rising professional bloggers are being subsidized by corporate interests.
Lastly, somehow I missed that David Merlin settled his lawsuit against Kaiser last month. I'm sure there's a gag order involved, so this is a real loss to the public's right to know about what really happened during the kidney transplant scandal. :-(
Update: At the suggestion of a community participant below, I've set a ChipIn account to raise money for the Healthcare Blogging Summit. For anyone who makes a donation, thanks in advance for your support and please feel free to email me if you need help with a Kaiser-related problem.
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On Saturday, February 3 at 2:00pm there will be a free public forum on The Kaiser Crisis in San Francisco. It will be held at the Community Room on 630 Valencia St./17th St. Here's the description of the event:
Kaiser Permanente, which covers millions of people in California, has been facing one crisis after another from the cover-up of their kidney dialysis unit to the firing of workers who stand up for proper heathcare and health and safety. This forum will have speakers from the trenches at Kaiser who have seen how it operates from the inside and how the system really operates inside and outside. Who is regulating Kaiser and where is Kaiser going?
Join with Kaiser workers, consumers and healthcare advocates:
Dina Padilla, for Kaiser SEIU 250 shop steward and Voices CA Chapter Pres. B.E.S.T.
Dr. Charles Philipps, Former Kaiser Doctor, author and critic Of managed care
Sharon Rushford, Fought a legal battle for her husband who was a patient of Kaiser
April Gottman, Ex SEIU 250 Kaiser employee and researcher
And...[drumroll]...ME as a Former Kaiser web worker and activist for Kaiser transparency.
Sponsored by VOICES CA, B.E.S.T.
California Coalition For Workers Memorial Day
Labor Video Project
I believe this is going to be televised on local Bay Area TV - will get back to you all on that.
If you attend or see it on TV, please feel free to post a shout out here!
I apologize for not being able to update for a few weeks. I've had a lot going on. This doesn't mean there's a lull in Kaiser misdeeds: I just have to play catch-up reporting on it. I'm going to post an update asap.
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Here's a quick review of recent Kaiser follies:
Mary Ann Thode, long time President of Kaiser's Northern California region, is the latest to take the fall for Kaiser's recent troubles. Hopefully anyone watching will realize a few executive resignations don't make up for all the people who DIED after being bumped from the kidney transplant list.
Kaiser is putting even more emphasis on sales and marketing. Kaiser has also been buffing up marketing in Hawaii. When is Kaiser going to give up on the not-for-profit charade?
Matthew Holt notes Kaiser was caught with its hand in the cancellation cookie jar and offers some context for one of the most horrific aspects of the current health care crisis. More on the possibility of State oversighe here.
An anonymous source pointed out that Kaiser bigwigs are involved in what amounts to money laundering for supposedly non-profit health care executives. The Connecticut Attorney General has sanctioned the "Healthcare Research and Development Institute, LLC," fined it $150,000, and forced its closure.
The supposed "Institute" would funnel large sums of money from companies to healthcare executives. Kaiser participants include Dr. Thomas Chapman, the only "independent" Kaiser Foundation Health Plan director remaining who was involved in the hiring of George Halvorson and Dr. Benjamin Chu, the Halvorson hand-picked president for Southern California. Apparently, executives like Dr. Chapman and Dr. Chu were given tens of thousands of dollars and put up in luxurious hotels to entertain business opportunities from the pay-for-play business executives.
If someone has any idea how much Dr. Chapman and Dr. Chu received, please let me know. One thing is for sure: the Kaiser Foundation Health Plan Board will actively ignore these ethical lapses, like they have the Halvorson-HealthPartners and "Compliance Officer" Garcia affairs.
That about wraps it up. Someone let me know if I left any important Kaiser news out.
Update: I left out this important article about how EMR "documentation" can easily turn into lying about the patient encounter. This is one of my biggest issues, and I hope more physicians will start to write about this issue. The EMR is not a panacea...in fact, it could amount to a lethal annihilation of patient rights.
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Kaiser's California credentialing department (responsible for tracking physician board certification, continuing education, etc.) has been demanding that the professional staff sign and fax back the following statement:
I AGREE TO BE BOUND BY THE BYLAWS and RULES & REGULATIONS OF THE PROFESSIONAL STAFF for KAISER FOUNDATION HOSPITAL EAST BAY, OAKLAND/RICHMOND CAMPUSES AS NOW ADOPTED AND AS AMENDED IN THE FUTURE, and THE LAWS & REGULATIONS OF THE STATE OF CALIFORNIA
No one I've talked to has ever seen anything like this before. Moveover, no copy of the BYLAWS and RULES & REGULATIONS, which may change at any time, were circulated with the signature-required form. Therefore Kaiser expects people to sign off when they have no way of knowing whether they are in compliance: this is what Kaiser did with HIPAA (patient privacy) training, too.
In speaking of privacy, if you ask Kaiser to restrict your medical records, they have a policy to ignore your request. This policy seems pretty silly given that one of the main justification's of Kaiser's 3-4 billion dollar (and counting) Electronic Medical Records (EMR) project is to create centralized access to patient data. I.E., the patient data shouldn't "reside in many locations" anymore. Also, people should keep this article in mind the next time a Kaiser doctor suggests they try a "free" therapy appointment before proceeding with any diagnostic tests.
Kaiser has already started to share medical records with the State for law enforcement purposes. If this gets to the point where patients are afraid to trust doctors with their medical problems, what will the alternative be? Will there be two medical establishments - the "official" establishment that constitutes a form of surveillance, and an underground medical system where actual treatment and care happens? By the time we have universal health care, it may not even matter in terms of where people actually go for help!
In other news, Kaiser PR is still busy trying to retroactively demote whistleblower Justen Deal to a mere peon shuffler of brochures, fliers and posters. I predict that when Justen eventually gets the paperwork converting him to unpaid leave, he will find out he's been the janitor of the lowest level of the parking garage all along!
Update: Someone just pointed out to me that the signature-form might actually be related to Kaiser sharing medical records with the State - i.e., physicians are being put on notice that they have to comply.
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Late Friday evening, Justen received an email from HR leader Wayne Cassard of Kaiser Foundation Health Plan that attempted to bully him into an interrogation "investigative interview" without the benefit of counsel or a written record. This email THREATENED to convert Justen to unpaid administrative leave if he didn't comply.
Note that Justen does not actually work for KFHP (he works for the Southern California Permanente Medical Group which contracts with KFHP), and the email was issued late Friday with a Monday deadline in a blatant attempt to reduce the time Justen would have to seek advice.
Justen opted not to participate in this ham-handed attempt at a set up, and thus he was placed on "unpaid leave" yesterday (Tuesday, Dec. 19). Unpaid leave is an interesting concept: if Kaiser retains any authority to compel him, does that constitute slavery? If Kaiser is no longer acting as Justen's employer, then he has been effectively terminated and should have an iron-clad wrongful termination claim, given Kaiser's published "non-retaliation" policies.
Justen has now issued a statement about his experience with Kaiser's faux investigation procedures. The most interesting revelation is that Kaiser CEO George Halvorson pushed to retaliate against Justen immediately, but Justen's employer demurred and attempted to insulate itself from the wrongful termination issues. Halvorson's crew then put together their own investigation so they could circumvent and preempt SCPMG's HR procedures. In Justen's words:
On November 3, George Halvorson demanded that I be terminated immediately. In an attempt to limit its legal liability, my employer, SCPMG refused. Instead, KFHP is now taking advantage of essentially-complete leeway to attempt to threaten and coerce my "compliance" with a process that I have reasonably objected to and that, I believe, is being conducted with little integrity and even less objectivity.
...It is clear to me that it is time for our organization to ensure that the interests of Kaiser Permanente are being protected, not the interests of George Halvorson.
...If you believe, as I do, that my employer, the Southern California Permanente Medical Group, must ensure that this process is conducted thoroughly, accurately, and objectively, with integrity and honesty, then please, share your concerns with the SCPMG Board of Directors, and please ask them to step in to ensure these problems are immediately corrected. Please email Dean Chang, secretary of the SCPMG Board of Directors, or call his office at 626 405-6287.
I would like to point out that Justen's experience with Kaiser are COMMON and WIDESPREAD. Kaiser's efforts to wear Justen down by drawing out the investigation process, to isolate Justen and game his disadvantages, to retaliate against Justen and whip out the overt threats when more discreet attempts at bullying failed - these tactics have all been experienced by many other workers AND patients who are subjected to Kaiser's rigged arbitration system. This persistant bad behavior of Kaiser's is what is fueling the complaints, the blogging, and the desperate attempts to put aside arbitration and file real lawsuits against Kaiser.
I hope Justen's brave decision to allow the email from Cassard to be published and present his own account of Kaiser's bully tactics over the past two months will raise public awareness about these problems. Better yet, I hope the public is stirred to OUTRAGE as they finally realize how Kaiser's organizational problems damage patient care and drive up the cost of health care for everyone.
Update: Kaiser is responding to media questions about the retaliation against Justen with lame prepared statements.
Update 2: In light of the IRS questions being raised, Kaiser employees who have access to accounting-related evidence might want to think about whether they're in a position to bring a qui tam suit. Just recently another Kaiser employee got $225,000 out of a qui tam action.
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I just read a recent case of Kaiser legal harassment of an injured employee. The issues involved in Donna Yee-Sanchez vs. Permanente Medical Group are so crucial that it's listed under the significant panel decisions on the Workers' Compensation Appeals Board web site. Since anyone can read the background and the legal opinion regarding this case, I'm just going to cover some of the slimy Kaiser tactics revealed here.
* The worker didn't have a lawyer and could have been tricked by Kaiser into doing something that was only in their interest and might have deprived her of her rights at any time.
* Kaiser didn't accept the initial diagnosis of a qualified physician, and they demanded a "redo" in which they forced the injured worker to choose from three Kaiser-approved physicians.
* When the second physician confirmed disability, Kaiser went into legal-harassment mode.
* The injured worker refrained from submitting to a deposition because Kaiser hadn't filed the necessary application to initate procedures with the Worker's Comp board (i.e., Kaiser was trying to be legalistically intimidating without any judicial oversight in play).
* Kaiser managed to get a deposition out of the diagnosing physician even through they didn't have any right to it.
* Kaiser continued to try to squirm out of initiating formal procedures: i.e., they wanted to get away with legal-esque intimidation without adhering to any rules or procedural oversight.
* If I'm reading this correctly, the diagnosis of the second doctor may have entitled the worker to higher disability compensation - but Kaiser, after putting the worker through the hassle of the second diagnosis, was still paying the original rate.
* The only thing this Worker's Comp board decision does is offer the remedy to address Kaiser's sleazy tactics: the worker can apply to initiate the WCAB process herself - and then there would be some oversight with the power to sanction Kaiser's bad behavior. While the injured worker might be worried about engaging with this process without an attorney, the board notes that sanctions might cover attorney fees. Still, since it's an adversarial process, it's not a sure thing that attorney fees would be covered. I'm curious about what the worker decided to do.
The Workers Comp board provides an excellent summary of the whole tangle:
...it appears (without actually deciding the question) that PMG far overstepped the bounds of proper and non-compelled investigation and ventured far into the realm of unquestionably unlawful pre-application discovery....[I]t is only the jurisdiction and authority of the WCAB that permits depositions to be noticed and taken (and subpoenas to be issued) in workers’ compensation matters....Accordingly, once an application is filed (if one has not been filed already), the PWCJ (or any other WCJ ultimately assigned to the case) should consider exercising the post-application remedies discussed above, including but not limited to monetary and evidentiary sanctions, for PMG’s apparent pre-application abuses of discovery.
Gee, this sort of reminds me of Kaiser spending two months investigating me after the Office of Civil Rights gave them my name as a whistleblower, without ever checking the prominent telltale dates on the documents involved or attempting to contact me for clarification.
Basically, Kaiser can afford lots of lawyers, so they can afford to game the system and bully people with just the threat of a lawyer attack (implied by interrogations depositions).
A further issue in the San Francisco Bay Area (i.e. Kaiser Territory), just about every lawyer who even touches on health care in the course of their practice has accepted work from Kaiser - making it very difficult for any individual who is trying to defend themselves to obtain a lawyer even if they can afford $300-$500/hr. (because conflict of interest could get the lawyer disbarred). Even if your case has nothing to do with health care, the "health care angle" (and Kaiser's deep pockets) will scare off lawyers who pursue other specialties.
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Did anyone else notice that the Business Times is now speculating on Kaiser's potential financial insolvency?
And here's another article on Kaiser turning tail when the going gets rough for patients. This time the victim is a boy with brain cancer.
In other news, Kaiser embezzler, political bribe-taker, and apparent massage-addict Leland Wong failed to overturn his indictment. Dear Kaiser Honchos - this sort of malfeasance TRICKLES DOWN FROM THE TOP!!!
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Kaiser Thrive pointed out that Kaiser has lost its good standing with UNOS (United Network for Organ Sharing) for "effectively denied patient access to kidney transplantation and threatened safety for patients on its waiting list." The L.A. Times article quotes Dr. Sue V. McDiarmid, president of UNOS:
At the time [of heavy press coverage], a top official of the HMO publicly apologized for the problems. But during the closed-door hearing Wednesday, Kaiser representatives struck a different tone...."I wouldn't characterize their position to us as acknowledging major errors," McDiarmid said. At times, she said, Kaiser officials actually denied that there had been serious lapses.
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More Kaiser EMR outages are detailed in this article. After asserting that Kaiser physicians don't care about improving the EMR as much as he does, Kaiser's Interim CIO Turkstra lowers his goal for EMR uptime to 99.7% (in the talking points document Kaiser circulated about Justen, the goal is held to be 99.9%). 99.7% is actually pretty low - remember, incidents don't "average out" - an average of 4 minutes a day could mean half an hour during the week.
The article describes several "critical patient issues", including a baby endangered in the NICU (neonatal intensive care unit), but Turkstra dismisses the wording of the incident report as "dramatic". Yep, those tech support folk are some of the most drama-prone people in the working world. Every time someone loses an email at Kaiser, 15 guys run in little circles, screaming and tearing their hair out. ;-)
In other news, a doctor describes frustrations with the Kaiser system from the patient point of view:
Dr. Min Su said he found it hard to believe when patients expressed frustrations in dealing with the health system for which he worked. This week, the Modestan found himself in those patients' shoes, battling the system after an insurance flap caused his premature twins to be split between two hospitals [Kaiser wanted the weaker of two twins to be moved to a Kaiser hospital]....The Kaiser health system did not literally "require" the transfer, but a case manager said the parents would have to pay for the charges [if one of the twins remained at an outside hospital]...
..."I heard a lot of patient complaints about Kaiser," Su said. "Now, I realize they provide good care for the healthy patients, but when the big one comes, they don't care. They just care about saving money."
...As a former physician for Kaiser, Su said, he was able to appeal to officials in Kaiser management to resolve the issue, something that is rarely possible for regular patients...."I got nowhere going through normal channels," he said. "I can see it is frustrating for people who are looking for help and don't know where to go."
Lastly, has anyone been reading the story of Abu Ghraib whistleblower Joe Darby? This poor guy can't even go back to his own hometown because everyone thinks he's a rat who betrayed his buddies for handing over PICTURES OF PEOPLE BEING TORTURED FOR KICKS. What is wrong with this country? Silencing whistleblowers (including discouraging them through loud humiliation and abuse) and hiding such atrocities helps perpetuate them. And this isn't just about a few people who were unluckily subjected to torture - though that should be reason enough in a civilized society - it's about whether we want the respect and admiration of the rest of the world. That respect and admiration has to be earned: the world is not a high school where Americans automatically get the privileges of being pretty and popular just because they can afford a nose job and a new car.
Update: A little birdy pointed out that the Business Times included a wonderful wrap-up of the mystery of the phony press release on Friday.
If it turns out to be a complete con job, it's a darn good one: Not only did the writer capture PR-speak perfectly -- he/she also knows an awful lot about Kaiser. All of the names and titles check out. Korn/Ferry, the search firm listed, is the one Kaiser used last time its top job was open. The media contact number listed is the real one. And Kaiser frequently uses PR Newswire to pump out its actual news releases.
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Tonight a Kaiser patient asked the world how to deal with a violation of patient privacy:
I received in the mail the results of my blood tests and in the same envelope were 6 other people's test results...all from Kaiser. Where should I go to bring to someone's attention at Kaiser? Member services, the doctor that it all came from, the receptionist?
I know all their names, addresses, medical numbers and private info. about their tests.....
Isn't it amazing how difficult it is for the average citizen to figure out what to do when they find Kaiser's patient privacy violations? A lawyer from the California Dept. of Managed Health Care once scolded me for not bringing the web site where Kaiser was posting patient info to the DMHC's attention first. I pointed out to them that Kaiser's own policy on the subject (which was very hard to find in the first place) instructed people to report HIPAA violations to the Office of Civil Rights (DHHS - the feds) - which I had promptly done. Nowhere did anything say anything about the DMHC. How was I supposed to know that the DMHC had taken it upon themselves to pursue HIPAA violations? (Though later it turned out that the DMHC had actually taken upon itself martial law powers to patrol the Internet for anything that *might* be dangerous - all hail Absolute Dictator Cindy Ehnes!).
A couple weeks ago I came across another case where screenshots of Kaiser patient info had been posted on the Internet - this time by a former Kaiser employee. Since the phone numbers given for the patients were local, I called one to verify whether this was real patient info. Of course it was, and the woman I talked to was totally freaked out.
(Clarification: Info for a number of Kaiser patients was posted online - I only called one.)
This discovery created quite a dilemma for me. The woman said she would report the breach to Kaiser, but what if she couldn't reach the right person or the information somehow got garbled? I needed to report it somehow myself. However, I didn't want to talk to anyone I'd previously dealt with - the DMHC, the OCR, or Kaiser itself. These people had all screwed up my life: why should I risk letting any of them screw up my life yet again? For God's sake, I've already been publicly denounced and sued by Kaiser's corporate lawyers just for surfing the Internet and mentioning what I found.
Instead I consulted with people I trusted. One friend agreed to put together a packet of evidence and fax it to the DMHC. Another friend agreed to try to contact the person who posted the web site. Despite their efforts, the web site was still online for another week. Goodness knows what the poor woman I had called was thinking the whole time.
My point is that one of the problems with punishing people for finding HIPAA violations is that it greatly discourages them for ever reporting such incidents again. Is it really in the public interest if the person who finds the info has learned the lesson to stay quiet and walk away? Do people really want to risk leaving their medical information out in public for years because people like me are afraid to report it?
I thought not. I hope this latest breach of Kaiser patient information gives everyone pause to think and revisit how the public treats whistleblowers.
Update: Huh. There's now a California Office of HIPAA Implementation. It probably would have been good to report the web site HIPAA violation to these people - except I didn't know they existed. And neither did anyone I talked to.
IMPORTANT Upate: Justen Deal - the employee Kaiser placed on administrative leave for merely sharing his concerns with other employees - has posted his response to many questions on his blog.
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An Australian court has issued an arrest warrant for Jayant "Dr. Death" Patel.
A government inquiry found that Jayant Patel of Portland may have contributed directly to 13 deaths due to an "unacceptable level of care" at Bundaberg Base Hospital in the state of Queensland while he was director of surgery there from 2003 to 2005....Patel was a surgeon at Kaiser Permanente in Portland from 1989 to 2001. After an internal investigation, Kaiser restricted him from doing complex operations in 1998. The Board of Medcical Examiners disciplined him for negligence in 2000. He was sued for malpractice or wrongful death eight times during his time at Kaiser. Kaiser settled five of those suits, paying out $1.8 million in two.
More at http://www.kaiserthrive.org
Here's another fairly recent (2002-03) KP LAWYER WATCH case. In 2001, a Kaiser cytotechnologist sued Kaiser Permanente for wrongful termination. Kaiser had given four slide misreadings as their reason for termination, but they had scraped these together from before 1998 and disregarded that employee's performance had been up to snuff since then. An arbitrator restored the employee to her job, but didn't restore backpay as a retroactive punishment for her pre-1998 mistakes. The employee then filed a lawsuit, arguing that her Union representative should never have allowed the introduction of the old slide misreadings. She also wanted statistics on other terminations to see if Kaiser had been allowed to reach into the past to use (corrected) mistakes to file other people.
Kaiser then filed for sanctions against the employee's LAWYER - and the District Court (Central District of California) sanctioned him $4,945 to cover Kaiser's fees! Kaiser won this sanction by hair-splitting:
Even if all the allegations are taken as true, the facts do not support a breach of the duty of fair representation under established Supreme Court precedent....the Union’s failure to argue...could not constitute a breach of the duty of fair representation....the Union succeeded in obtaining reinstatement for her based on its interpretation of the Agreement....[C]ounsel says that those paragraphs in the complaint meant only that no Permanente employee had ever been terminated for errors that were more than one year old, not that no Permanente employee had ever been terminated for misreading slides.
The lawyer appealed, and the appeals court vacated the sanctions and suggested that the District Court had folded outsided considerations into their decision and was acting on a grudge against the lawyer:
As part of its justification for the sanctions order, the court also referred to counsel’s "history of prior sanctions, particularly his (mis)representations as to the scope and nature of that history"....Although the district court occasionally distanced itself from explicitly relying on such past conduct, the lengthy discussion of the parties’ history implies that past conduct may have contributed to the reasoning behind the sanctions award.
The lawyer asked to re-argue the case before the District Court. HOWEVER, in 2003, the District Court replied that they had already heard everything and then AGAIN sanctioned the lawyer, ordering him to PAY KAISER $3,055 - apparently just for appealing their original sanctions and trying to represent his client to the best of his ability. Since the District Court ordered both the first and second sanction, dare I suggest this was petty sour grapes on the part of the judges? I noticed elsewhere they actually ordered a levy of the fees the lawyer had received from the Dept. of Fair Employment and Housing for representing the Kaiser employee.
So think about it...how many lawyers are going to be willing to represent Kaiser employees in wrongful termination cases if Kaiser has been successful in inflicting monetary sanctions on them? And what's up with these judges? We really need to start shining a spotlight on the court system here.
Comment received via email: One wonders whether they [the judges] are looking forward to a life of ease in retirement, serving as Kaiser "neutral" arbitrators, and they're just showing their mala fides to their potential employer. It would be a serious problem if the corruption of the Kaiser arbitration system seeped in this way into the court system!
Error Correction or Revisionist History? Several news reports this morning said Kaiser could have prevented a woman from being beaten to death with a baseball bat if they had admitted her psychotic son. However, several hours later, Kaiser was scrubbed from some of the articles: "a Kaiser Permanente hospital" has been changed to "a hospital". Here's the proof. Is this CBS correcting an error or Kaiser PR buying/pressuring for revisionist history?
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Bruce Friedman of Lab Soft News has his finger on the pulse of the EMR game. I'm sure it's mere coincidence that his scenario covers the highlights of the recent Kaiserpocalypse. I just saw a comment that pointed out that the Department of Defense has been wasting $5-$6 billion dollars of the taxpayer's money on an even bigger EMR disaster. And, quel surprise, the honcho in charge, William Winkenwerder Jr., comes from the Kaiser ranks. This perhaps explains why he tried to fix the EMR's problems by changing the name/acronym from CHCS II to AHLTA. ;-)
I wonder how much Kaiser is paying this guy?
Today's KP LAWYER WATCH is a sordid story of what happens when Kaiser doctors, who enroll their families in the Kaiser system, get tumbled into the arbitration system. A Kaiser doctor's wife suffered renal failure, and he determined it was because she had been given the wrong drug. Being a doctor, he thought he could just point this out to the arbitrator. However, the Kaiser lawyers argued that his specialty didn't cover his wife's condition, so he couldn't qualify as a medical expert. For some strange reason the arbitration judge bought the doctors-don't-know-anything-beyond-their-narrow-specialty argument, so the doctor then went to the regular court system to try to address the unfairness of the arbitration process. It looks like he didn't hire a lawyer - probably because he figured the judges in the regular court system would notice he had a medical degree and quickly order a new arbitration. The plaintiffs evidently lost their court case - the document below is from their appeal, which concluded just a couple of weeks ago.
Considering that the judges admit that they refused to look at certain evidence and could only act within a very narrow sphere and are supposed to give pro per plaintiffs the maximum latitude, this judicial opinion is incredibly mean-spirited and rude. Also keep in mind the plaintiffs were paying to be trashed - the court system is ridiculously expensive even without a lawyer. I think the plaintiffs should speedily complain to the nearest judicial oversight commission (though they will probably just stick up for their brother-in-robes, too).
I'm going to highlight in bold where the judges turn "judgmental", despite the fact their own point is they don't really know what happened. Click on the link below to get the full text (it's long - practically the whole document):
( Check out the Judges-Turned-Mega-Jerks... )
For people who have never been through Kaiser's arbitration process, this might look like a situation of he-said she-said that somehow defaults to support the arbitration judge. However, once you talk to a few people who have actually been through Kaiser's arbitration process, you will find the same issues coming up time and time after time: Kaiser doctors lied, Kaiser lawyers played dirty tricks, and the arbitrator showed favoritism toward Kaiser by refusing to acknowledge or address these problems.
To give a specific example from an arbitration that's going on right now: I know a woman who was the victim of a blatant HIPAA violation by Kaiser - and she has the evidence to show that Kaiser's lawyer lied about how the violation happened, too. However, par for the course, neither the Feds or State agencies are addressing the matter swiftly. When she attempted to complain to the Bar Association, she was told "the matter does not warrant disciplinary action." The problem is that this HIPAA violation has corrupted the arbitration process, and the woman, who was abandoned by a slacker lawyer, is now stuck representing herself and the arbitration judge isn't listening to her. So what will probably happen is that the woman will be shafted by the arbitration process, and then if she attempts to go to the regular courts, she will be treated like dirt (like the plaintiff horror story above).
In sum, judges in the regular court system seem unaware of the widespread perception of fraud and corruption in the arbitration process, supported as far as I can tell by every patient ever forced to go through that process, and in the absence of a signed confession from the arbitration judge they prefer to belittle plaintiffs.
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What could Kaiser's excuse possibly be for canceling coverage for a woman in "urgent need" of medical care and slapping her with a retroactive bill of $13,000? Apparently, even if you've been with Kaiser 20 years, the profit-mongering weenies lawyers think that assuming Kaisers much-ballyhooed EMR kept a record of your appointments is a sin of Biblical proportions. Dare you forget to report a few appointments when you switch to individual insurance and...WHAM!!! You get KAISERIZED!
Thankfully, the CA Dept. of Managed Health Care saw that Kaiser was gaming the system at the very minute when their victim patient most needed help.
[The DMHC] also said the cancellation was particularly egregious because the woman, whose name was not disclosed, couldn't afford to pay for medical treatment on her own and needed the expertise of Kaiser doctors who had treated her before.
It took two years for this woman to get the medical care she needed...and she was lucky enough to have her case "expedited". The article also states about 10 lawsuits a year are filed against Kaiser for cancelling coverage - but that number would mainly represent people who can afford lawyers, who understand they have the right to sue, and who have the time and energy to go throught the onerous process of a lawsuit. The court system itself is virulently against people who are poor, so just the fact that people are being obligated to go to the courts to defend themselves from Kaiser's lame excuses is a flashing red beacon of what's wrong with this country.
I'm glad this woman's coverage was reinstated and she ultimately received medical care, but the DMHC should have served Kaiser with a heaping big fine for this. When is the DMHC going to learn that Kaiser keeps doing this crap because they know nothing is going to happen if they get caught, but they will always get the opportunity to use their lawyers to soak anyone who dares make a peep against them.
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A former Kaiser patient sent me this email a couple of weeks ago and gave me permission to publish it:
Kaiser is screwing the senior citizens--before I got Senior Advantage I payed my monthly insurance premiums myself. Co-pay was $1 to $ 5 now with Senior (Dis)Advantage every service is $20 plus the prescription co-pay was $45 for a generic drug that I could have gotten at Costco for $18. I pay more being on Senior Advantage with all the overpriced co-pays than I did paying the insurance premiums myself. I went to the lab to pickup a test kit, and I was charged for a lab visit. When I returned the sample they said I had to make another co-pay. I said I already payed once for this test and you want me to pay for the test again...? This made me mad, and I told them to get 2 slices of bread and make themselves a sandwich before I would pay for the test again. I've been with Kaiser over 28 years now and when you need them they really try to Take SENIOR ADVANTAGE of senior citizens.
Kaiser Sucks Big Time
The follow-up email added this remark:
You might add why Kaiser makes these stupid TV ads that cost big buck to tell you Kaiser thrives - big waste of money for nothing - just cost members millions each year.
I couldn't have said it better myself.
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I have to thank Kaiser Thrive for staying on top of the Kaiser Follies for the past few weeks. There has been some truly gut-wrenching Kaiser Kraziness while I've been away:
Kaiser surgeon indicted for perjury!
"Our criminal justice system relies on the truthful testimony of witnesses, and perjury seriously undermines the integrity of that process," Kevin Ryan, the U.S. attorney in San Francisco...
Kaiser left names of 90 deceased patients on the national kidney transplant list.
Dr. Gabriel Danovitch, medical director of the kidney and pancreas transplant program at Harbor-UCLA Medical Center, said Kaiser's failure to remove patients from the waiting list pales in comparison to some of its other problems. "We know damn well that they weren't keeping up with what's going on," he said.
Kaiser being sued for racial discrimination.
12 African Americans and a Fijian-Indian working as custodians at Kaiser's Morse Avenue facility -- were fired for "the use of a non-Kaiser Permanente telephone" when checking in and out of work and taking breaks. The suit also alleges that only minority employees lost their jobs over the infraction, while "white colleagues in the ... department were not fired."
And I didn't know about this:
In 2000, Kaiser Permamente's parent company, Kaiser Foundation Health Plan Inc., settled a racial discrimination lawsuit in Cleveland for $235,000. The Federal Equal Employment Opportunity Commission had filed suit against Kaiser in support of black clerical workers who said they were discriminated against at a Kaiser hospital in Ohio.
Well, I can't let Kaiser Thrive do all the work:
Employee sexually assaulted in a Kaiser building. In CA, Kaiser an irate patient supposedly flashed a hand gun several times. (But personally I think employees should be just as scared of the managers who are overly-fond of referring to their hunting prowess).
Employee killed during Kaiser team-building exercise.
Kaiser leaves patients in the lurch with short payments to other hospitals.
Another Kaiser S.F. executive walks the plank.
More on Leland Wong (Kaiser bigwig) sex scandal.
The Governator vetoed universal health care, and put a Kaiser stooge on the task of proposing a plan that won't cover everybody. Hmmm, wonder what that will look like. Who wants to bet Californians end up footing the bill for Kaiser's Electronic Medical Record?
Kaiser's very own Dr. Death has more legal problems.
I'm sure there's more. Kaiser Thrive, consider yourself challenged!
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A little bird told me that Kaiser is raising Health Plan fees next year to make up for a 5% cut in Medicare reimbursement. Medicare provides a third of Kaiser's executive lifestyle subsidy revenue. Kaiser will be passing this loss on to non-Medicare members and then pinning on enough extra to maintain an "increase in revenue" for 2007. Lower ranking employees are being fed the "tighten your belts" bull.
Here's one I've been saving up for a while. Kaiser Senior Counsel David Armstrong has been casting about for ways to avoid paying other health care providers when patients have to seek care outside the Kaiser system (thanks again, little bird). Behold the quotes:
Quote 1: Its clear that Health Plans are precluded from paying federal program benefits to providers excluded by OIG. However, has anyone addressed payment of these same providers under other, non federal program, commercial lines of business? What about reimbursing members who have out of network benefits directly for services rendered by OIG excluded providers? Thoughts and comment on how to shut this down if possible would be appreciated. Quote 2: I would like to hear...comments and opinions regarding an HMO's rights (or lack thereof) to onsite access and concurrent review of medical records of patients admitted through the ER of non-contracted hospitals.....in particular to make efficient transfer determinations to contracted facilities upon stablization of the patient. As an alternative, are there any issues surrounding the right to demand medical records and to make retrospective determinations that deny reimbursement of days after the patient was otherwise stablized and could have been transferred to a contracted facility? Quote 3: Quick question: HIPAA and state laws generally require guaranteed issue or access in the small group market. However, what if the applicant and/or individual members of the proposed small group have a history of prior "bad acts" with your health plan such that they would otherwise fail underwriting guidelines - e.g. prior termination or rescission as the result of late pay, failure to pay or fraud? Unfortunately, I don't find any of these to meet any of the enumerated guaranteed issue exceptions. Therefore, is this a "loophole" that allows persons who would not otherwise qualify individually based upon prior history to reconstitute as a freshly minted new small group and, thereby, obtain another bite at the apple under the protection of the small group legislation? Quote 4: Does anyone have any model language that they can share that could be added to a standard MCO hospital contract to limit MCO liability for paying for care that is a result of error, omission or failure by the hospital equipment and/or personnel? Quote 5: I would like to take a survey of reimbursement policies for claims submitted by non-contracted out of network providers. Obviously the health plan has to pay for emergency services but, in the event that your state's regulations are silent on the subject, are other health plans paying charges or something else? If Usual and Customary, how are you calculating the UCR and are you experiencing push back from providers?
As for you provider reps out there, is there any reason why non-contracted providers should be entitled to reimbursement of charges to the extent that they exceed UCR and/or is there any basis for objection to UCR reimbursement?
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Okay, I had to walk away from my computer and laugh for a good ten minutes. Why does Kaiser's "Senior Counsel" need to make public inquiries about how to avoid paying their bills? What a maroon!
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Also, I've been commiserating with yet another Kaiser victim who has been subjected to the same old Kaiser lawyer strategy: avoid responding to Discovery requests, block evidence from getting in front of the Judge, and then motion for Summary Judgment before facts become part of the case. Judges have been condoning this for some unfathomable reason. If anyone has had a similar experience with Kaiser, please contact me (kaiser_scapegoat AT hotmail DOT com). I'd like to put together a packet of affadavits that could be used by all Kaiser victims so they can point to the pattern and have more leverage in getting the evidence in front of the Judge for both arbitration and court cases. My understanding is that even if you signed a settlement concerning medical treatment at Kaiser, that won't preclude you from addressing the conduct of Kaiser's lawyers.
Almost forgot: Kaiser hired a security company that cheated workers out of overtime. I wonder if this ruling also applies to temps and other hourly workers who are forced to come "ten minutes early" to warm up their computers...?
Update: Wow, Kaiser has given over a million dollars of its member's money to the California Hospitals Committee On Issues. This is a CA state lobbying group - more info here. Also, I wonder what Kaiser has against Laguna Honda Hospital...?
This makes me wonder how much Kaiser spends on lobbying at the national level. According to LobbyWatch, Kaiser spent $460,000 on lobbying firms in 2004. However, this doesn't seem to include Kaiser's own lobbying conducted by the Permanente Federation (led by Francis "Jay" Crosson). According to OpenSecrets, Kaiser only reported $240,000 last year, and 80k of that went to the Permanente Federation. That number couldn't possibly include the pay for people doing the lobbying, so somehow the base operations funding gets excluded.
Update 2: Yet another case of Kaiser destroying the evidence. Maybe I should change the Kaiser Thieves logo to Kaiser BabyKillers?
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