Kaiser Donates $1 Million to Duke University Rather than Cover Cost of Experimental Treatment
In an "unexpected turnaround," Kaiser Permanente yesterday announced plans to award a $1 million research grant to Duke University rather than cover the cost of two $600,000 treatments for brothers who have a rare, incurable and often fatal illness, the San Francisco Chronicle reports. The two boys, Tommy and Hunter Bennett, ages two and four, respectively, have Sanfilippo syndrome, a disease characterized by an increase of sugar molecules in the body that destroys organs over time. The disease affects one in 70,000 children (Sarkar/Colliver, San Francisco Chronicle, 9/5). Kaiser decided to deny coverage of experimental stem cell blood transplant procedures for the boys, a procedure that the HMO said has "not been proved effective and is very risky," the Sacramento Bee reports. A state panel of three independent medical experts supported Kaiser's decision. The panel decided that the procedure, which has an estimated 30% mortality rate, "would be harmful and not helpful," according to Department of Managed Health Care Director Daniel Zingale (Evans, Sacramento Bee, 9/5). However, after an "onslaught of media coverage," Kaiser announced plans to donate $1 million to Duke University, the only facility that performs the stem cell procedure (Ornstein, Los Angeles Times, 9/5). In the grant announcement, Kaiser did not "officially tie" the $1 million to the treatment of the Bennett brothers, the Bee reports (Sacramento Bee, 9/5). "We'd like to see Duke University do research into this disease," Kaiser spokesperson Beverly Hayon said, adding, "How they choose to use that money is up to Duke." Joanne Kurtzberg, the Duke doctor who developed the stem cell procedure, said that the grant "would definitely be used to treat these kids" (San Francisco Chronicle, 9/5).
In other Kaiser news, the HMO has agreed to pay a $100,000 fine issued by DMHC for "failing to provide a terminally ill patient with sufficient home health care services," the Sacramento Bee reports (Rapaport, Sacramento Bee, 9/5). The agency cited the case of a Fairfield resident with Lou Gehrig's disease who received "inconsistent home health care services" from a Kaiser contractor between February 2001 and March 2002. DMHC said that Kaiser violated a decision by an independent panel of medical experts that required the HMO to provide 12 hours of home health care per day to the resident (Ornstein, Los Angeles Times, 9/5). The case "sparked" a DMHC investigation. In the investigation, the agency found that many Kaiser facilities "failed to properly notify patients when there was a delay or denial or modification of home health care services," Zingale said (Sacramento Bee, 9/5). He added, "The fine was magnified by the fact that it wasn't an isolated case." In addition to the fine, Kaiser has agreed to improve the system that the HMO uses to monitor contractors that provide home health care services (Los Angeles Times, 9/5). The HMO has 90 days to implement the reforms (Sacramento Bee, 9/5).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.