DMHC Drops Portion of Case Against Kaiser, But Maintains $1.1M Fine
The state Department of Managed Health Care has dropped its claim that Kaiser Permanente did not provide "timely ambulance services" from a larger case alleging that the company did not provide adequate "access to care, continuity of care" and resolution of grievances connected with three patient deaths, the San Francisco Chronicle reports (Colliver, San Francisco Chronicle, 1/11). The department also dropped claims regarding Kaiser's telephone call center (Los Angeles Times, 1/11). Department head Daniel Zingale did not explain why the state had dropped the claims. DMHC officials said they do not, however, plan to reduce the $1.1 million fine they are seeking against the health plan (San Francisco Chronicle, 1/11). In May 2000, the state levied a $1 million fine against Kaiser for "systemic problems" in the HMO's emergency care system stemming from the 1996 death of a San Leandro woman. After a DMHC investigation, Zingale added two additional patients to the complaint, including a member of Senior Advantage, Kaiser's Medicare+Choice plan, and increased the fine to $1.1 million (California Healthline, 11/29/01). Kaiser is currently appealing the fine in court. DMHC spokesperson Steve Fisher said the dropped claims don't "change anything in the terms of the fine. It's just a sharpening of the case." But attorneys for Kaiser said the "changes are significant" and that the remaining allegations are "misguided." Steve Madison, who is representing Kaiser, said, "It's almost a third of the case that has been dismissed entirely." He added, "[W]e maintained consistently there was not evidence, and we had to maintain the burden of this accusation for the past several years. But we're happy the department did the right thing." The state has already presented its case in court, and Madison said Kaiser's appeal should be finished by next week (San Francisco Chronicle, 1/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.