Los Angeles Times Editorial Criticizes Kaiser Permanente’s Legal Actions Against DMHC

Kaiser Permanente's attempt to overturn a $1.1 million fine levied by Department of Managed Health Care Director Daniel Zingale is "pure intimidation and should be thrown out of court," a Los Angeles Times editorial today says. The DMHC fined Kaiser after the 1996 death of a 74-year-old Bay area woman who waited an hour to receive care at a Kaiser facility before dying as a result of an aortic aneurysm. Kaiser lawyers will argue at a federal hearing in Los Angeles today that Zingale should be held in contempt of court because he "exceeded his regulatory authority" by using the death of another Kaiser patient who was enrolled in Kaiser's Medicare HMO, Senior Advantage, to "show a pattern of misconduct and justify the fine." Kaiser attorneys say that the DMHC, as a state agency, does not have the authority to oversee federally regulated Medicare+Choice plans. The Times states that this argument is "invalid" because "Zingale did not fine Kaiser for the Medicare patient's death," but instead "only cited it as a example of systemic problems" at Kaiser. Further, the Times says, Kaiser attorneys argued in a state court hearing last week that if "any errors contributed" to the woman's death, "they would have been the fault of the doctors working for Kaiser, not of the health plan itself." But the Times contends that this argument is belied by Kaiser advertisements that state, "Teamwork and quality set us apart, because we're a physician-led health plan, not an insurance company." The editorial concludes, "Zingale has turned out to be an effective, thoughtful regulator, just what the state needed. Surely he won't be thrown in the slammer because he dares to do his job" (Los Angeles Times, 12/10).