Zingale to Face Contempt Charges for $1.1M Fine Levied Against Kaiser Permanente

A federal court has ordered Department of Managed Health Care Director Daniel Zingale to appear on charges of contempt after the department last year levied a $1.1 million fine against Kaiser Permanente based in part on the death of a Medicare beneficiary, which may have violated federal law, the Sacramento Bee reports (Rapaport, Sacramento Bee, 11/29). Zingale will appear in U.S. District Court in Los Angeles Dec. 10 (Coleman, AP/San Diego Union-Tribune, 11/29). 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 (San Francisco Chronicle, 11/29). 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 (Sacramento Bee, 11/29). However, a federal court ruled in August in a case filed by the California Association of Health Plans that the state could not impose some rules on health plans "as they relate" to Medicare beneficiaries (AP/San Diego Union-Tribune, 11/29).

Zingale, who could face jail time for contempt, said that the DMHC only used a Medicare beneficiary's "experience to show a systemic problem" with an HMO (San Francisco Chronicle, 11/29). He added that state law allows him to "use complaints from Medicare and non-Medicare members to show" a "pattern of poor care." The Bee reports that the contempt case will likely determine whether the state's 1.5 million Medicare+Choice members can "expect state help resolving health plan disputes" and whether state officials can use Medicare complaints as the "basis for actions designed to protect all state HMO patients" (Sacramento Bee, 11/29). Kaiser has appealed the $1.1 million fine -- the largest ever issued against an HMO in California -- and will argue the case in the state Office of Administrative Law in Oakland Tuesday (San Francisco Chronicle, 11/29).