Apparently, insurance companies don't want to let customers cancel policies.
"Kaiser, the state’s third largest provider, doesn’t allow users to post directly to its Facebook page. It’s also where some callers complained they were receiving a pre-recorded message that ended with a dial tone when they called customer service."
Sadly, long before the new health care law went into effect, Kaiser was preventing patients from making complaints.
DMOC isn't likely to do much. There's a long history between DMHC and Kaiser.
Health Insurance Complaints Skyrocket in CA
Having trouble reaching your health insurance company? You're not alone. State regulators say in January alone, they've seen a 53% jump in complaints, in part because calls about Covered California. A little known state hotline can help
By Vicky Nguyen, Felipe Escamilla, Liza Meak, and Scott Pham
NBC News
Apr 22, 2014
The Investigative Unit has learned complaints to state regulators have skyrocketed as people find themselves unable to reach anyone at several major health insurance companies. Vicky Nguyen reports in a video that aired on April 21, 2014.
Even if you aren’t one of the 1.2 million people signing up for Covered California, chances are you’re feeling the pinch when calling your insurance company. The Investigative Unit has learned complaints to state regulators have skyrocketed as people find themselves unable to reach anyone at several major health insurance companies.
For some health insurance companies, the influx of calls is so bad, they’re hanging up on customers after a pre-recorded message, while others put callers on hold indefinitely.
“I’ve been put on hold anywhere from 15-40 minutes,” said Don Tran, a full-time grad student at San Jose State.
Tran said he wanted to cancel his individual health plan with Blue Shield of California because he was eligible for less expensive coverage through his employer. But getting in touch with Blue Shield turned out to be much more difficult than he anticipated. “It’s been over a month and a half and I still haven’t been able to reach anybody,” Tran said.
Tran's story is a familiar one to Marta Green, spokeswoman for the California Department of Managed Health Care. The agency regulates [or at least, it collects a lot of money from the taxpayers in exchange for promising to regulate] health care plans and protects consumers.
“We have seen our call volume go up quite a bit,” Green said. She attributes much of the increase to the sudden spike in health insurance enrollment due to Covered California.
The rise in complaint volume was so extreme, the department began tracking the number of complaints from people who said they couldn't even reach their insurance providers.
“It was never an issue before this year,” Green said. But the department is only tracking “can’t reach plan” complaints for customers enrolled in Covered California. Of the roughly 1,000 complaints received between January and March of 2014, 1 in 10 people said they were trying to cancel or couldn’t reach their plan.
Green said there’s little consequence at this point for health plans that aren’t responsive to consumers. “If a health care plan is found to have violated the law, they can face enforcement action…[but] there is no specific law in relation to wait times.” Green said consumers can call, email or even send postal mail to the department regarding any issues with their health insurance. She said the department is committed to helping consumers resolve their problems, a process that can take anywhere from a day to a month.
“Every complaint we receive is investigated,” Green said. She encouraged consumers to call the department’s hotline, 1-888-466-2219, where they are guaranteed to reach a human being during business hours.
Don Tran took his complaint online, joining dozens of others NBC Bay Area found on social media, who are posting pictures of their wait times and airing their complaints on Facebook and Twitter. A check of the Facebook pages for the two largest providers in California—Anthem and Blue Shield – revealed new complaints daily.
Kaiser, the state’s third largest provider, doesn’t allow users to post directly to its Facebook page. It’s also where some callers complained they were receiving a pre-recorded message that ended with a dial tone when they called customer service.
“It’s a real hassle,” Tran said, adding that Blue Shield only responded after he posted several comments on social media. Now, more than 2 months later, he finally has his cancellation notice, but didn't get a reimbursement check until a few days ago.
Blue Shield of California spokesman Sean Barry said via email the company has expanded its customer service staff, adding, “We’re committed to delivering a high-quality customer experience. We have put several measures in place to reduce the delays in resolving issues by phone, receiving new ID cards and making payments.”
He directed customers to this customer service home page with a list of contacts to help resolve issues.
Darrel Ng echoed a similar sentiment. In an emailed statement, the Anthem Blue Cross spokesman said, “At the beginning of the year, hundreds of thousands of Californians were added to the insurance rolls on Jan. 1 as our nation’s health care delivery system went through a complete transformation. Because of that, in the first two business days of January, our company received a million calls nationally. Since then, we hired and trained hundreds of additional customer service agents and reassigned hundreds of other internal assets to assist on our phone lines. Through those efforts, the average hold time for customer service was under 3 minutes in March and is down to less than 90 seconds thus far in April.”
Kaiser Permanente spokesperson Karl Sonkin emailed this statement. "Prior to the deadline for Affordable Care Act Kaiser Permanente experienced a higher volume of calls to our Member Services Call Center during peak hours than we typically receive in the first part of the year, and that had resulted in longer than normal hold times. However, now that the enrollment deadline has passed our call volumes have returned to more typical levels and we are no longer experiencing delays."
[Maura Larkins' comment: This seem to be Kaiser's way of saying that patients will be experiencing the same treatment that they received for years before the Affordable Care Act.]
Showing posts with label DMHC (also DOMHC). Show all posts
Showing posts with label DMHC (also DOMHC). Show all posts
Tuesday, April 22, 2014
Saturday, November 2, 2013
Do doctors help medical students by allowing them to practice on patients who are not considered important? CA issues fines against hospitals
The California Department of Public Health usually relies on self-reporting by doctors and hospitals, which happens rarely, I have observed.
Adverse Events Draw $775K in Fines at 9 CA Hospitals
Cheryl Clark
HealthLeaders Media
October 28, 2013
The most recent round of administrative penalties for hospital deficiencies constituting immediate jeopardy includes two patient falls resulting in deaths, a wrong-site surgery, and a retained surgical object.
>>>Slideshow: CA hospitals penalized for medical errors
At Sharp Memorial Hospital in San Diego, a surgical team took out a man's healthy left kidney instead of his cancerous right one because the hospital didn't make imaging studies viewable in the operating room and because the surgeon "forgot" how to log-in to see them before cutting into the patient.
At Antelope Valley Hospital in Lancaster, a patient returned to the emergency department three times before doctors realized they had forgotten to remove a 9 x 6-inch surgical device. According to state officials, the device was not included in the instrument count.
And at Community Regional Medical Center in Fresno, a surgeon left the OR after instructing a physician's assistant to finish the surgery, which the assistant was not trained to complete. The patient suffered major blood loss, cardiac arrest, and loss of oxygen to the brain. At the completion of a state investigation, the patient remained on life support.
These major adverse events in California hospitals are among 10 detailed in state documents accompanying $775,000 in administrative penalties to these hospitals, which state officials announced last week. The fines are assessed once state investigators determine that lapses in regulatory compliance caused or likely caused serious injury or death to a patient.
Since these penalties began in 2007, the state had issued 295 penalties to more than 155 of the state's 400 acute care facilities, according to a statement issued Thursday by the California Department of Public Health.
Including the latest round of penalties, the state has assessed $13.3 million in fines and has collected $10.1 million. Most of the $3.2 million not yet collected is under appeal by the hospitals that dispute the state's findings.
The funds are to be used for programs to improve healthcare safety.
In a phone interview Thursday, Debby Rogers, deputy director for the state Department of Public Health's Center for Healthcare Quality, refused to comment on any particular hospital's harmful event, but acknowledged that some incidents are more serious than others.
New regulations due to take effect by the end of the year, will allow the state to consider how much patient harm was done "and how widespread inside the hospital a particularly deficiency is."
"We feel strongly that publicizing these deficiencies helps hold these facilities accountable but it also empowers consumers to speak to their providers to put protections in place so something like this doesn't happen," Rogers said.
...At Community Regional Medical Center, Fresno, Fresno County, a patient admitted for ascending aortic aneurysm repair suffered massive blood loss, cardiac arrest, and loss of oxygen to the brain after the heart surgeon left the operating room prior to the closure of the patient's chest during open heart surgery.
The surgeon instead directed a physician's assistant "to be left in charge, an individual not qualified to be left in charge of the cardiovascular surgery."
State investigators said the patient's loss of blood "required reopening the chest and manual massage of the heart." The patient was subsequently placed on life support.
Asked for an explanation, the surgeon said he had allowed the physician's assistant "to practice above her privilege card as 'she was preparing for an advanced quality practice exam and for that, she needed so many cases with opening and closing the chest and to cannulate the heart." The surgeon said he had always been there when she did this procedure "until this time."
State investigators wrote that the incident was reported through "an anonymous complaint," suggesting that the hospital may not have properly reported the incident as required by law.
The penalty is $75,000. This is the hospital's second administrative penalty...
10 California hospitals fined a total of $675,000
August 15, 2013
By Ari Bloomekatz
Los Angeles Times
Ten California hospitals, including Ronald Reagan UCLA Medical Center and Hollywood Presbyterian Medical Center, were slapped with fines Thursday totaling $675,000 because they failed to follow certain licensing requirements that "caused, or was likely to cause, serious injury or death to patients."
The fines ranged from $50,000 to $100,000, according to a news release from the California Department of Public Health.
St. Jude Medical Center in Fullerton, for example, was fined $100,000 for its fifth administrative penalty, according to the release.
"Based on observation, interview and record review, the hospital failed to follow their policy and procedure to have relevant images and results properly labeled and displayed prior to a patient's surgery," according to documents provided by the public health department. "This failure resulted in the removal of the wrong kidney."
The penalty against UCLA's hospital was for not following the proper surgical policies and procedures that led to "a patient having to undergo a second surgery to remove a retained foreign object." The hospital was fined $50,000...
Adverse Events Draw $775K in Fines at 9 CA Hospitals
Cheryl Clark
HealthLeaders Media
October 28, 2013
The most recent round of administrative penalties for hospital deficiencies constituting immediate jeopardy includes two patient falls resulting in deaths, a wrong-site surgery, and a retained surgical object.
>>>Slideshow: CA hospitals penalized for medical errors
At Sharp Memorial Hospital in San Diego, a surgical team took out a man's healthy left kidney instead of his cancerous right one because the hospital didn't make imaging studies viewable in the operating room and because the surgeon "forgot" how to log-in to see them before cutting into the patient.
At Antelope Valley Hospital in Lancaster, a patient returned to the emergency department three times before doctors realized they had forgotten to remove a 9 x 6-inch surgical device. According to state officials, the device was not included in the instrument count.
And at Community Regional Medical Center in Fresno, a surgeon left the OR after instructing a physician's assistant to finish the surgery, which the assistant was not trained to complete. The patient suffered major blood loss, cardiac arrest, and loss of oxygen to the brain. At the completion of a state investigation, the patient remained on life support.
These major adverse events in California hospitals are among 10 detailed in state documents accompanying $775,000 in administrative penalties to these hospitals, which state officials announced last week. The fines are assessed once state investigators determine that lapses in regulatory compliance caused or likely caused serious injury or death to a patient.
Since these penalties began in 2007, the state had issued 295 penalties to more than 155 of the state's 400 acute care facilities, according to a statement issued Thursday by the California Department of Public Health.
Including the latest round of penalties, the state has assessed $13.3 million in fines and has collected $10.1 million. Most of the $3.2 million not yet collected is under appeal by the hospitals that dispute the state's findings.
The funds are to be used for programs to improve healthcare safety.
In a phone interview Thursday, Debby Rogers, deputy director for the state Department of Public Health's Center for Healthcare Quality, refused to comment on any particular hospital's harmful event, but acknowledged that some incidents are more serious than others.
New regulations due to take effect by the end of the year, will allow the state to consider how much patient harm was done "and how widespread inside the hospital a particularly deficiency is."
"We feel strongly that publicizing these deficiencies helps hold these facilities accountable but it also empowers consumers to speak to their providers to put protections in place so something like this doesn't happen," Rogers said.
...At Community Regional Medical Center, Fresno, Fresno County, a patient admitted for ascending aortic aneurysm repair suffered massive blood loss, cardiac arrest, and loss of oxygen to the brain after the heart surgeon left the operating room prior to the closure of the patient's chest during open heart surgery.
The surgeon instead directed a physician's assistant "to be left in charge, an individual not qualified to be left in charge of the cardiovascular surgery."
State investigators said the patient's loss of blood "required reopening the chest and manual massage of the heart." The patient was subsequently placed on life support.
Asked for an explanation, the surgeon said he had allowed the physician's assistant "to practice above her privilege card as 'she was preparing for an advanced quality practice exam and for that, she needed so many cases with opening and closing the chest and to cannulate the heart." The surgeon said he had always been there when she did this procedure "until this time."
State investigators wrote that the incident was reported through "an anonymous complaint," suggesting that the hospital may not have properly reported the incident as required by law.
The penalty is $75,000. This is the hospital's second administrative penalty...
10 California hospitals fined a total of $675,000
August 15, 2013
By Ari Bloomekatz
Los Angeles Times
Ten California hospitals, including Ronald Reagan UCLA Medical Center and Hollywood Presbyterian Medical Center, were slapped with fines Thursday totaling $675,000 because they failed to follow certain licensing requirements that "caused, or was likely to cause, serious injury or death to patients."
The fines ranged from $50,000 to $100,000, according to a news release from the California Department of Public Health.
St. Jude Medical Center in Fullerton, for example, was fined $100,000 for its fifth administrative penalty, according to the release.
"Based on observation, interview and record review, the hospital failed to follow their policy and procedure to have relevant images and results properly labeled and displayed prior to a patient's surgery," according to documents provided by the public health department. "This failure resulted in the removal of the wrong kidney."
The penalty against UCLA's hospital was for not following the proper surgical policies and procedures that led to "a patient having to undergo a second surgery to remove a retained foreign object." The hospital was fined $50,000...
Sunday, October 6, 2013
Patients who were harmed can join class action suit against Kaiser Permanente
Chance to participate:
On October 2, 2013 a class action suit was filed in Alameda County, California - alleging denial of timely and/or appropriate care.
Filed by Siegel, Lewitter, Malkani of Oakland, California
Contact Information: Latika Malkani
Phone Number: 510-452-5000
1939 Harrison Street, Suite 307
Oakland, California 94612
California Class Action Case RG13697775
Filing found here for your viewing: http://legalstuff.kaiserpapers.org/pdfs/Futterman-v-KFHP.pdf
[The complaint is interesting reading, discussing the investigation of the California Department of Managed Health Care (DMHC).]
This suit consists of all current and former Kaiser members who have either been denied access to mental health services, dissuaded from pursuing mental health services, provided with delayed access to mental health services and/or provided with inaccurate and confusing information from Kaiser regarding mental health services available to them from October 2, 2009 to the present.
(Violations of Business and Professions Code, Section 17200 et seq., Violations of the Unruh Civil Rights Act, Breach of the Covenant of Good Faith and Fair Dealing, Breach of Contract)
--Vickie Travis
http://kaiserpapers.org
On October 2, 2013 a class action suit was filed in Alameda County, California - alleging denial of timely and/or appropriate care.
Filed by Siegel, Lewitter, Malkani of Oakland, California
Contact Information: Latika Malkani
Phone Number: 510-452-5000
1939 Harrison Street, Suite 307
Oakland, California 94612
California Class Action Case RG13697775
Filing found here for your viewing: http://legalstuff.kaiserpapers.org/pdfs/Futterman-v-KFHP.pdf
[The complaint is interesting reading, discussing the investigation of the California Department of Managed Health Care (DMHC).]
This suit consists of all current and former Kaiser members who have either been denied access to mental health services, dissuaded from pursuing mental health services, provided with delayed access to mental health services and/or provided with inaccurate and confusing information from Kaiser regarding mental health services available to them from October 2, 2009 to the present.
(Violations of Business and Professions Code, Section 17200 et seq., Violations of the Unruh Civil Rights Act, Breach of the Covenant of Good Faith and Fair Dealing, Breach of Contract)
--Vickie Travis
http://kaiserpapers.org
Thursday, September 19, 2013
Is Kaiser Permanente in cahoots with the Department of Managed Care? NUHW Files Complaint Over Hiring of DMHC Attorney
DMHC Director (and former Kaiser counsel) Brent Barnhart
I've known for a long time that the Department of Managed Health Care (DMHC or DOMHC) was in cahoots with Kaiser. DMHC responded to a complaint I filed by saying that Kaiser fulfilled its duty by taking X-rays, and was not obligated to look at them!
DOMC's actions shouldn't come a surprise, since Brent Barnhart,the Director of DMHC, is a former senior counsel at Kaiser Foundation Health Plan.
Having one of his attorneys move to Kaiser will make everything work smoothly. Marcy Gallagher will have access to Director Barnhart, and knowledge of the inner workings of DMHC. Although I can hardly imagine that things could actually get easier for Kaiser. After all, DMHC has to disapprove of SOMETHING every once in a while, just to pretend it's regulatory agency, right?
NUHW Files Complaint Against Kaiser Over Hiring of DMHC Attorney
California Healthline
September 19, 2013
The National Union of Healthcare Workers has filed a complaint against Kaiser Permanente alleging that the company hired an attorney who previously worked at a state regulatory agency to impede an investigation into its practices, Payers & Providers reports.
NUHW filed the complaint with the California Fair Political Practices Commission (Shinkman, Payers & Providers, 9/19).
The move comes only a few weeks after NUHW filed a lawsuit to keep Kaiser from participating in California's health insurance exchange. Exchange officials have selected Kaiser to offer individual and small business policies (California Healthline, 9/6).
The union -- which represents about 5,000 Kaiser workers -- has been pressuring the organization since it lost an election earlier this year to represent about 45,000 employees, according to Payers & Providers.
However, John Borsos -- a spokesperson for NUHW -- said the complaint filed this week is unrelated.
The complaint highlights Kaiser's hiring of Marcy Gallagher, a former attorney with the California Department of Managed Health Care's enforcement division.
Kaiser hired Gallagher in 2012 while she was investigating the organization's health plan for issues related to mental health services access. She now serves as a practice leader in Kaiser's regulatory response business unit.
In a statement, NUHW said that Gallagher "reportedly trained Kaiser officials on how to answer questions posed by DMHC's investigators."
The union argues that the move violates the state's Political Reform Act, which regulates "switching sides by state officials" and "influencing prospective employment."
Gallagher, DMHC and Kaiser declined to comment on the complaint (Payers & Providers, 9/19).
Monday, June 4, 2012
The Dept. of Managed Health Care's Andrew George won't respond to a complaint--will Shelley Rouillard?
Click on image for larger view.June 4, 2012
Shelley Rouillard, Chief Deputy Director
Holly Pearson, Deputy Director and General Counsel
California Dept. of Managed Health Care
Re: Complaint 603896-STD01 and also two related Jan. 1, 2012 complaints [about VUCG problem]
Dear Ms. Rouillard and Ms. Pearson:
I have patiently worked my way up the chain of command at DOMHC [DMHC], but my complaints have not been acknowledged.
Is it DOMHC’s policy to ignore written complaints? If not, then please respond to this complaint. I described my problem in the attached letter to Andrew George and Carol Massey-McCants, but I received no response. My complaint is now threefold:
(1) the original complaint about Kaiser;
(2) the failure of DOMHC to respond adequately to the Kaiser complaint;
(3) the failure of DOMHC to respond to my complaint about DOMHC.
Yours truly,
Maura Larkins
Sunday, May 27, 2012
Kaiser Permanente settles therapy dispute with California Dept of Managed Health Care
The DOMHC has thrown Kaiser patients a small bone (see story below), but most of the time the DMHC [DOMHC] supports Kaiser's policy of making money by denying health care.
Why would the DOMHC support Kaiser's wrongdoing?
Well, let's see. Let's start by asking, "Who's in charge of the DOMHC?" None other than former Kaiser Health Plan lawyer, Brent Barnhart. Before he worked for Kaiser, Barnhart was an attorney and lobbyist for the health insurance industry in Sacramento – as legislative affairs director for Blue Cross of California, and as counsel and secretary to the Association of California Life and Health Insurance Companies.
DOMHC Director Brent A. Barnhart
This isn't the smile Brent Barnhart gives to Kaiser patients who've been injured by substandard care. DOMHC chief Brent A. Barnhart spent 13 years as senior counsel for the Kaiser Foundation Health Plan. It appears that he's still defending Kaiser in his position as overseer of health care plans. It would be interesting to learn about the cases he presided over when he represented Kaiser, but the cases are secret. Kaiser patients have to agree to binding arbitration instead of bringing their cases to the justice system.
We pay taxes to run the DOMHC Help Center, but the Help Center's goal is clearly to support Kaiser. Attorney Andrew George, an Assistant Deputy Director of DOMHC who is in charge of the Help Center, and Carol Massey-McCants, manager of the Complaint Resolution Branch, frequently ignore written complaints. Kaiser Permanente makes lots of high-profile gifts to government entities and has its own employees, in powerful positions in the DOMHC.
Dr. Bernadette Loftus, Kaiser administrator and member of DOMHC Medical Advisory Board
Kaiser, state settle therapy dispute
By Sandy Kleffman
Bay Area News Group
05/25/2012
Kaiser Permanente has agreed to reimburse some patients who were denied physical, occupational and speech therapy and paid for it themselves, state regulators announced Friday.
The HMO reached a settlement with the California Department of Managed Health Care after the state agency accused Kaiser in February of improperly refusing therapy to members who lack a "physical condition."
As a result, patients who might stutter or lisp or who had developmental delays, for example, were unable to get speech therapy, regulators said. Some people with mental illnesses also were excluded from therapy, the state said.
"The agreement ensures that Kaiser members will get the care they are entitled to under the law," said Managed Health Care Director Brent Barnhart, in a written statement.
Kaiser disputes the state's description of its policies.
"Although we continue to believe that Kaiser Permanente's approach to providing these services to our members was appropriate, we have reached an agreement with the DMHC to reimburse some members who incurred out-of-pocket expenses," said Kaiser spokesman John Nelson, in a written statement.
Under the agreement, Kaiser members who were denied medically necessary therapy since January 2009 may be eligible for reimbursement if they were named in the state enforcement action, or filed a complaint, or paid out-of-pocket for such therapy.
Members have until Jan. 31 to seek reimbursement.
[Maura Larkins comment: And what of those who could not afford to pay for their own therapy? Too bad, too sad. The DOMHC has apparently decided that they get nothing, and will simply have to live with the results of Kaiser's denial of care.]
Kaiser said it has identified nearly 90 members who may be eligible to receive payment for their out-of-pocket expenses. It will also review claims submitted by other members who are not on the list.In July, Kaiser will contact people who filed complaints.. It will also put a notice in its summer Partners in Health bulletin.
People who want more information can call the Managed Health Care Help Center at 1-888-466-2219 or go to www.HealthHelp.ca.gov.
Why would the DOMHC support Kaiser's wrongdoing?
Well, let's see. Let's start by asking, "Who's in charge of the DOMHC?" None other than former Kaiser Health Plan lawyer, Brent Barnhart. Before he worked for Kaiser, Barnhart was an attorney and lobbyist for the health insurance industry in Sacramento – as legislative affairs director for Blue Cross of California, and as counsel and secretary to the Association of California Life and Health Insurance Companies.
This isn't the smile Brent Barnhart gives to Kaiser patients who've been injured by substandard care. DOMHC chief Brent A. Barnhart spent 13 years as senior counsel for the Kaiser Foundation Health Plan. It appears that he's still defending Kaiser in his position as overseer of health care plans. It would be interesting to learn about the cases he presided over when he represented Kaiser, but the cases are secret. Kaiser patients have to agree to binding arbitration instead of bringing their cases to the justice system.
We pay taxes to run the DOMHC Help Center, but the Help Center's goal is clearly to support Kaiser. Attorney Andrew George, an Assistant Deputy Director of DOMHC who is in charge of the Help Center, and Carol Massey-McCants, manager of the Complaint Resolution Branch, frequently ignore written complaints. Kaiser Permanente makes lots of high-profile gifts to government entities and has its own employees, in powerful positions in the DOMHC.
Dr. Bernadette Loftus, Kaiser administrator and member of DOMHC Medical Advisory Board
Kaiser, state settle therapy dispute
By Sandy Kleffman
Bay Area News Group
05/25/2012
Kaiser Permanente has agreed to reimburse some patients who were denied physical, occupational and speech therapy and paid for it themselves, state regulators announced Friday.
The HMO reached a settlement with the California Department of Managed Health Care after the state agency accused Kaiser in February of improperly refusing therapy to members who lack a "physical condition."
As a result, patients who might stutter or lisp or who had developmental delays, for example, were unable to get speech therapy, regulators said. Some people with mental illnesses also were excluded from therapy, the state said.
"The agreement ensures that Kaiser members will get the care they are entitled to under the law," said Managed Health Care Director Brent Barnhart, in a written statement.
Kaiser disputes the state's description of its policies.
"Although we continue to believe that Kaiser Permanente's approach to providing these services to our members was appropriate, we have reached an agreement with the DMHC to reimburse some members who incurred out-of-pocket expenses," said Kaiser spokesman John Nelson, in a written statement.
Under the agreement, Kaiser members who were denied medically necessary therapy since January 2009 may be eligible for reimbursement if they were named in the state enforcement action, or filed a complaint, or paid out-of-pocket for such therapy.
Members have until Jan. 31 to seek reimbursement.
[Maura Larkins comment: And what of those who could not afford to pay for their own therapy? Too bad, too sad. The DOMHC has apparently decided that they get nothing, and will simply have to live with the results of Kaiser's denial of care.]
Kaiser said it has identified nearly 90 members who may be eligible to receive payment for their out-of-pocket expenses. It will also review claims submitted by other members who are not on the list.In July, Kaiser will contact people who filed complaints.. It will also put a notice in its summer Partners in Health bulletin.
People who want more information can call the Managed Health Care Help Center at 1-888-466-2219 or go to www.HealthHelp.ca.gov.
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