Kaiser Foundation Health Plan

"Cases Reveal Lapses in Kaiser Emergency Care" (Jan. 2) describes nine medical malpractice cases involving Kaiser Foundation Hospital emergency rooms [decided] in the past seven years--nine cases among more than 10 million patients treated. All of us at Kaiser Permanente wish that number was zero. We acknowledge regretfully that errors in medical judgment and in the delivery of care do sometimes occur. As the Institute of Medicine's report on patient safety and medical errors concluded, "to err is human."

A Southern California lawmaker who helped defeat legislation opposed by Kaiser is benefiting from a business relationship with the nonprofit health group. The proposal, which died in the Legislature earlier this month after a dispute over its provisions, would have required state approval for health insurers including Kaiser to raise their rates. State Sen. Ed Hernandez (D-West Covina), chairman of the Senate Health Committee, owns a corporation that leases an office building to Kaiser Permanente in Baldwin Park.

Kaiser Gets Key Accreditation: A national quality review group has awarded the Kaiser Foundation Health Plan in Southern California its highest level of accreditation. The National Committee for Quality Assurance, an independent organization that reviews managed-care programs, gave Kaiser a three-year accreditation. The NCQA approval process, which is voluntary, has become a widely sought-after indicator of quality among managed-care plans.

When word leaked out in 2005 that Nissan Motor Co. planned to move its U.S. headquarters to Tennessee, Southland officials and business leaders pitched a fit. It was another blow to the collective ego of Southern California, which has seen a disheartening exodus of corporate headquarters. Northrop Grumman Corp.'s recent announcement that it will move to Washington came on the heels of other departures, including Hilton Hotels Corp. from Beverly Hills, Computer Sciences Corp. from El Segundo and Fluor Corp.

An arbitration panel has faulted Kaiser Foundation Health Plan Inc. for contributing to the overdose death of a patient in 2005 and awarded his family $319,000. The panel found the Kaiser hospital in Harbor City "fell beneath the standard of care" and that the insulin overdose was "a substantial contributing factor" in the death of 73-year-old Peter Lakos, the panel wrote in a decision dated Jan. 30. Lakos, a Type 2 diabetic, was injected with 10 times the normal dose of insulin and went into respiratory arrest in 2005.

Re "HMO Trend Demands Eagle-Eyed State Oversight," by Jamie Court, Commentary, Jan. 15: The Kaiser Foundation Health Plan is indeed a nonprofit organization, and the "profits" Court discusses so glibly are plowed right back into the health plan to benefit the members through new technology, upgraded facilities and expanded services. According to the California Medical Assn.'s analysis of various public financial filings, Kaiser Foundation Health Plan spends 96.8% of every dollar on actual medical care--more than any other California health plan.

Humana to Sell D.C. Plans to Kaiser: The move by Humana Inc. comes after $30 million in losses this year on the plans and a disappointing second quarter for the company. It also comes as Oakland-based Kaiser Permanente, the nation's largest nonprofit operator of health maintenance organizations at 7.4 million members, is boosting its East Coast presence.

The state Department of Corporations said it has closed its investigation of Kaiser Foundation Health Plan's policies regarding the anti-impotence pill Viagra after finding that the HMO earlier this year "may have encouraged" its doctors not to prescribe the drug because of cost considerations. In April, Kaiser, the nation's largest nonprofit HMO, announced that, with rare exceptions, it would not cover the cost of the expensive treatment for sexual dysfunction.

With contract negotiations at a stalemate, the union that represents 12,000 Kaiser Foundation Health Plan employees is urging its members to reject the giant HMO's final offer and stage a one-day walkout Thursday, the day their three-year contract expires. The action appears, at least for the time being, to avert a threatened strike. Officials of the Service Employees International Union Local 399 say their members will return to work Friday while they and Kaiser attempt to resume negotiations.

A landmark court settlement has been approved in San Francisco that could provide $25 million to $50 million to about 5,000 women for in-vitro fertilization. The agreement was negotiated between Kaiser Foundation Health Plan and thousands of women who had been denied coverage for the fertilization procedure. Women will receive compensation of up to $50,000 each for the procedure, which has a 20% success rate and frequently must be repeated.

California HMO Kaiser Permanente has agreed to pay $3.75 million to resolve allegations that several of its California units submitted false bills to the federal government for treatment of Medicare and Medi-Cal patients, officials announced Thursday. The U.S. attorney's office in San Francisco contended that from 1996 through 2002, Kaiser units in California submitted bills that falsely claimed treatment had been provided by teaching physicians. In fact, the government said, the care had been provided by unsupervised residents.

One of the state's largest employers, healthcare giant Kaiser Permanente, said it would eliminate more than 1,800 positions as it struggles with drooping membership, uncertain healthcare reform and shriveling Medicare reimbursement rates. Job reductions will occur within the next few months, the Oakland-based nonprofit said Tuesday. Many of the purged positions -- just under 2% of Kaiser employees -- are temporary, on-call or short-hour. Most Kaiser medical centers in California will be affected.

An arbitration panel has faulted Kaiser Foundation Health Plan Inc. for contributing to the overdose death of a patient in 2005 and awarded his family $319,000. The panel found the Kaiser hospital in Harbor City "fell beneath the standard of care" and that the insulin overdose was "a substantial contributing factor" in the death of 73-year-old Peter Lakos, the panel wrote in a decision dated Jan. 30. Lakos, a Type 2 diabetic, was injected with 10 times the normal dose of insulin and went into respiratory arrest in 2005.

Tenet Healthcare Corp. is suing Kaiser Foundation Health Plan Inc., claiming that Kaiser failed to pay about $16 million for services provided to Kaiser patients at Tenet-run hospitals. The lawsuit was filed in Orange County Superior Court. In addition to Tenet, three dozen hospitals are also named as plaintiffs in the case. Kaiser spokesman James Anderson said Kaiser disputed the allegations, but he declined to elaborate.

Kaiser Foundation Health Plan Inc. said Tuesday that it was working with state regulators to develop standards to protect its members from unfair cancellations of health insurance, a move that the state's largest HMO hopes could lead to industrywide reforms. Kaiser's move comes as it was being fined $100,000 by state regulators for dropping a policyholder it accused of concealing his epilepsy when he applied for coverage, even though the condition had never been diagnosed by a physician.

State regulators for the first time have ordered a health plan to reinstate the insurance coverage of a patient whose policy was ruled to have been illegally canceled. In an order posted Wednesday, the Department of Managed Health Care ruled that Kaiser Foundation Health Plan illegally canceled coverage for a Northern California woman in urgent need of medical attention for large kidney stones.

Ever since anyone around here can remember, Sarah Nome has been the quintessential community gadfly, jousting with public officials in Marin County over issues big and small. Now, at 82, she's in a quixotic fight over her hospital bed. For more than a year, Nome has pugnaciously refused to budge from her fifth-floor room at Kaiser Permanente's San Rafael Medical Center. In the process, she has racked up $1.3 million in bills.

Six years ago, the California Supreme Court ruled that Kaiser Foundation Health Plan's system for arbitrating legal disputes was poorly regulated, prone to long delays and generally stacked against the best interests of Kaiser's members.