I sent this email to San Diego Kaiser Permanente's Chief Financial Officer and Chief of Records Lynette Seid today:
Dear Ms. [Lynette] Seid:
Your subordinates have come up completely empty in response to my April 7, 2014 request for radiological images.
I did receive 24 pages of paper records from my medical record today by certified mail.
So it seems that the Radiology Records department is the problem.
Sincerely,
Maura Larkins
Showing posts with label Kaiser. Show all posts
Showing posts with label Kaiser. Show all posts
Saturday, May 17, 2014
Thursday, May 1, 2014
CFO Lynette Seid and Dr. Eugene Rhee, chief of urology, at Kaiser Permanente in San Diego, are up to their old tricks
See also:
Finally, a Kaiser doctor, oncologist Jennifer Lycette, speaks out about doctors forced to allow harm to patients to increase profits--CLICK HERE
If Kaiser were telling the truth about the images of my VUCG, it wouldn't have gone to all the trouble of creating a hoax set of 7 images, with four images appearing twice and one image appearing three times, trying to pretend it's a set of 13 images! See the images here.
Lynette Seid, who is both CFO and chief of medical records at Kaiser Permanente in San Diego, and Dr. Eugene Rhee, chief of urology, told me a bizarre story to explain the absence of my digital X-rays on Kaiser San Diego's main computer, but the story has fallen apart.
Dr. Paul Bernstein and Dr. Andrew Golden started a review of this episode, but canceled the review within a week.
Lynette Seid is legally required to give me copies of my X-ray images. To avoid doing that, she created a CD which she claimed was scanned thermal paper images!
Much to the consternation of Seid and Rhee, the innocent underlings at Kaiser keep telling the truth. The technician who did my VUCG said my digital video would be uploaded to the main Kaiser computer. It never was. A clerk in Radiology records said that I could have a CD of the digital video for $10. I sent the money, but I didn't get the CD.
For some reason, doctors wanted to conceal the VUCG results. I assume that the reason is the typical one at Kaiser: saving money by denying care.
When I complained, Kaiser wrote to me that the digital video I had witnessed on the computer monitor WAS NOT SAVED--except that a few THERMAL PAPER IMAGES HAD BEEN PRINTED OUT DURING THE PROCEDURE.
In fact, the test had been done on a brand new digital fluoroscopy machine at the brand new Garfield Specialty Center in San Diego. The Center had had a grand opening one week earlier, and Kaiser Permanente's newsletter boasted that all X-rays were digital. In fact, the "thermal paper" images were simply digital images printed out on high quality paper.
This month, Ms. Seid's subordinate "SR" got caught flat-footed because she had no idea she was supposed to claim that X-rays were saved only on thermal paper in 2011. SR accidentally revealed information that Ms. Seid had gone to a great deal of trouble to conceal.
On April 7, 2014 I submitted a request to Radiology Records for the VUCG digital video.
Strangely, I was told by multiple individuals on April 7, 2014 that they had "still" images for a procedure done on me on June 16 2011. I did not have any procedure on June 16, 2011. My VUCG procedure was on June 15, 2011.
April 7, 2014
When I turned in my request at the radiology window, the young man who was sitting there immediately started preparing a CD. I asked if it was a digital video that he was preparing. He said it was a set of 13 still images from a procedure that was dated June 16, 2011. He was going to charge me $15 for the CD—from the wrong date! I said I wanted the digital video from June 15, 2011, not still images dated June 16, 2011.
The young man went to get someone else to talk to me. He went and sat at another desk and waited while a young woman named “V” sat down in his chair.
V asked me, “What are you going to play the CD on?
I was dumbfounded for a moment since this question seemed so bizarre. I was planning to play it on, and upload it to, my computer, but I didn’t understand why she was concerned about this. I figured I was free to do whatever I wanted with it, including using it as a bookmark or a Frisbee.
V asked me again, “What are you going to play the CD on?
I finally shrugged and said, “Whatever I feel like playing it on.”
Van said there was no video.
But then she started talking about VHS tapes. “If it’s on VHS…” she said, but then she didn’t finish her sentence. Perhaps eyebrows knitted and my mouth dropped open when she started talking about VHS tapes.
Van went to get J.
J, who said her title was “a senior”, said, “We don’t have moving videos.”
J said her supervisor is SR, and SR’s supervisor is Mary Hanshaw, who is the ADA for radiology files, but she refused to tell me who Mary Hanshaw’s supervisor is.
She said I should call the two names she gave me, but she didn’t give me phone numbers. Perhaps I was supposed to call out their names loudly?
I waited while J made a call. She wouldn’t give me SR’s phone number. Finally she said SR will call me.
TRANSCRIPT OF PHONE CALL FROM KAISER RADIOLOGY DEPARTMENT
SR phone call April 7, 2014
SR called me on my cell phone. She identified herself as “Manager here at Radiology Records.” I was not able to write fast enough to record every single word, but I recorded most of the conversation.
SR: Was your procedure done in urology department?
ML: Yes.
SR: What date?
ML: June 15, 2011.
SR: I have June 16, 2011. I am not aware of any moving video. I know they watch it on fluoroscopy which is like a video camera which is not actually taped.
SR: [With] fluoroscopy you can watch moving images. Those images are not saved by videotape which I think is what you are referring to. Usually they take pictures in between live video fluoroscopy. Fluoroscopy is live X-rays like a video camera. You never record moving images. For that type of procedure it’s not fully reported from beginning to end. Just spot pictures.
ML: “Spot pictures” are X-ray on a film?
SR: Correct.
ML: Do you have some films from my procedure?
SR: I’m not sure. But we don’t have moving videos. If there is anything it would be a film.
ML: Sometimes you do have plain film for people who have VUCGs?
SR: Yes, because we do it a lot on babies. I can find out if there are plain films.
ML: I’d like you to do that.
ML: So there are never any digital videos for VUCGs?
SR: For this particular exam, no. And that’s common practice, not just Kaiser. Angiograms, they tape that.
ML: You know what a VUCG is?
SR: Yes, it’s a voiding urethrocystogram.
ML: And you know for a fact that they don’t make digital videos of them?
SR: I’m 99% positive. We do babies…
ML: How about adults?
SR: I don’t even think they have the capability to do it.
ML: This is the latest technology?
SR: Correct. That’s common practice.
ML: Can you find out if anybody gets digital videos for VUCGs?
SR: I’ve been here for 20 years and it’s something I’ve never known has been done her as well as in the outside community. It’s not a standard of care.
ML: Can you find out?
SR: If it’s done at urology? I would have to call urology.
ML: You have an obligation to produce records if they exist. So you will call me when you find out?
SR: Yes, I will.
ML: Thank you. Bye-bye.
April 8, 2014
Stephanie Ritter called back.
SR: I reached out to the chief of urology and confirmed that we do not tape. You used the word video. We do not tape the full fluoroscopy for VUCGs. Your X-ray jacket is in our main warehouse up in L.A. and we’ve ordered that to be delivered and hope to have it by the end of this week so we can review if there are any images in the jacket. [Maura Larkins’ thought: why would there be an X-ray jacket if there were no images????] They can take plain film pictures between the exam.
ML: Do they use thermal paper?
[I asked this because Dr. Rhee, Lynette Seid, Andrew Golden and everyone else I talked to at Kaiser had previously told me that images from my procedure had only been saved on thermal paper. This bizarre claim was even put in writing.]
SR: No. Thermal paper hasn’t been used in a long time. Thermal paper was used in mammography more than 20 years ago.
ML: There were no digital images saved?
SR: You used the word “video”. There was no taping. That is not procedure.
ML: Are there digital images?
SR: I don’t know if they would be digital.
ML: Is there a possibility they might be digital?
SR: What do you mean by digital? [ML note: SR didn’t allow me to answer that question.] It was probably around the time we started to convert to digital in regular radiology, not necessarily in urology. Southern California, from L.A. down, did start to convert to non-film images.
ML: When you say “converting to non-film”, you mean digital?
SR: Correct. But I want to be careful about what you’re understanding. A film can be converted to digital and digital can be converted to film. [Maura Larkins’ thought: Why would anyone want to convert from digital to film????]
ML: Right now urology never uses digital X-rays or fluoroscopy?
SR: Fluoroscopy and digital are different things. We do not use video cameras.
ML: Fluoroscopy is never digital?
SR: I’m not going to say NO. Depending on type [page 6 begins here]of machine.
ML: Sometimes fluoroscopy is recorded digitally?
SR: I’m not going to answer that because it does not relate to VUCG. For a voiding urethrocystogram there is not recording of fluoroscopy.
ML: You talked to Dr. Rhee?
SR: Yes. I don’t want to mislead you.
ML: You don’t want to mislead me?
SR: Mrs. Larkins, please don’t put words in my mouth. I don’t want to miscommunicate with you.
ML: You said, “I don’t want to mislead you.”
SR: I don’t want to mislead you into something you may not understand due to dynamics of urology department.
ML: You don’t want to mislead me, do you?
SR: Mrs. Larkins, is there anything I can answer?
ML: I want you to answer this: you don’t want to mislead me, do you?
SR: I want to give you correct information. I want you to understand the dynamics of procedures. You should call Mary Hanshaw. They gave you her information.
ML: They gave me her name, but not her number.
SR: [silence]
ML: They gave me her name, but not her number.
SR: [silence]
ML: Hint, hint.
SR: Are you asking me something?
ML: I’m asking for her number.
SR: 619 528 5527. Mary is on vacation.
ML: What is her title?
SR: Director of Radiology.
ML: Who is her supervisor?
SR: Dana Gascay.
ML: What is her position?
SR: Associate Medical Group Administrator. I don’t have her information.
ML: Who is her supervisor?
SR: Jim Malone.
ML: There must be someone between her and Jim Malone.
SR: Nope, there’s not.
ML: If there is an Associate Medical Group Administrator, wouldn’t there be a Medical Group Administrator?
SR: Which is Jim Malone.
ML: I bet sometimes you don’t like your job, do you?
SR: I love my job.
ML: Surely you don’t enjoy telling me these things?
SR: I’m just telling you the truth.
ML: I hope you don’t have to do any more phone calls like this today. It really must be stressful.
SR: Well, you have a wonderful afternoon.
ML: Okay. Bye-bye.
FOLLOW-UP PHONE CALLS TO MARY HANSHAW
I called Mary Hanshaw several times at 619 528 5527.
On April 24, 2014 I called but no person or machine picked up.
On April 25, 2014 I called 619 528 5527 and talked to Elsa, who transferred me to Mary Hanshaw’s answering machine. The recorded message said, “This is Mary Hanshaw, Director of Diagnostic Imaging.”
I left this message: “This is Maura Larkins. On April 7 I submitted a request to view records. 14 days have passed and I still haven’t seen records. It’s supposed to be 5 days. Please call me...”
On May 1, 2014 I called and talked to a man, who transferred me to Mary Hanshaw’s answering machine/voice mail.
I left a message:
This is Maura Larkins. I left a message on April 25 and I haven’t heard back. I made a records request on April 7. I talked to Stephanie Ritter. She said she would check my X-ray chart [I meant to say “jacket”] but she hasn’t gotten back to me. I haven’t heard from her since April 8. Please call me... And please send the records. I believe you are beyond the legal limit for this request.
FOLLOW-UP CALL TO SR:
On May 1, 2014 I called Stephanie Ritter at 619 528 3297. Her personal greeting on her voicemail said she’s out of the office. She continued, “If you need assistance, contact the secretary at 528 5538” or the clerk at 619 528 5417.
Then the message switched to someone else’s voice:
“Sorry, the mailbox belonging to Stephanie Ritter has an extended absence greeting in place and will not accept new messages.”
EMAIL TO LYNETTE SEID:
I sent an email to Lynette Seid on April 24, 2014 telling her that her subordinates were not complying with the law. She has not responded as of May 1, 2014.
If Kaiser were telling the truth about the images of my VUCG, it wouldn't have gone to all the trouble of creating a hoax set of 7 images, with four images appearing twice and one image appearing three times, trying to pretend it's a set of 13 images! See the images here.
Lynette Seid, who is both CFO and chief of medical records at Kaiser Permanente in San Diego, and Dr. Eugene Rhee, chief of urology, told me a bizarre story to explain the absence of my digital X-rays on Kaiser San Diego's main computer, but the story has fallen apart.
Dr. Paul Bernstein and Dr. Andrew Golden started a review of this episode, but canceled the review within a week.
Lynette Seid is legally required to give me copies of my X-ray images. To avoid doing that, she created a CD which she claimed was scanned thermal paper images!
Much to the consternation of Seid and Rhee, the innocent underlings at Kaiser keep telling the truth. The technician who did my VUCG said my digital video would be uploaded to the main Kaiser computer. It never was. A clerk in Radiology records said that I could have a CD of the digital video for $10. I sent the money, but I didn't get the CD.
For some reason, doctors wanted to conceal the VUCG results. I assume that the reason is the typical one at Kaiser: saving money by denying care.
When I complained, Kaiser wrote to me that the digital video I had witnessed on the computer monitor WAS NOT SAVED--except that a few THERMAL PAPER IMAGES HAD BEEN PRINTED OUT DURING THE PROCEDURE.
In fact, the test had been done on a brand new digital fluoroscopy machine at the brand new Garfield Specialty Center in San Diego. The Center had had a grand opening one week earlier, and Kaiser Permanente's newsletter boasted that all X-rays were digital. In fact, the "thermal paper" images were simply digital images printed out on high quality paper.
This month, Ms. Seid's subordinate "SR" got caught flat-footed because she had no idea she was supposed to claim that X-rays were saved only on thermal paper in 2011. SR accidentally revealed information that Ms. Seid had gone to a great deal of trouble to conceal.
On April 7, 2014 I submitted a request to Radiology Records for the VUCG digital video.
Strangely, I was told by multiple individuals on April 7, 2014 that they had "still" images for a procedure done on me on June 16 2011. I did not have any procedure on June 16, 2011. My VUCG procedure was on June 15, 2011.
April 7, 2014
When I turned in my request at the radiology window, the young man who was sitting there immediately started preparing a CD. I asked if it was a digital video that he was preparing. He said it was a set of 13 still images from a procedure that was dated June 16, 2011. He was going to charge me $15 for the CD—from the wrong date! I said I wanted the digital video from June 15, 2011, not still images dated June 16, 2011.
The young man went to get someone else to talk to me. He went and sat at another desk and waited while a young woman named “V” sat down in his chair.
V asked me, “What are you going to play the CD on?
I was dumbfounded for a moment since this question seemed so bizarre. I was planning to play it on, and upload it to, my computer, but I didn’t understand why she was concerned about this. I figured I was free to do whatever I wanted with it, including using it as a bookmark or a Frisbee.
V asked me again, “What are you going to play the CD on?
I finally shrugged and said, “Whatever I feel like playing it on.”
Van said there was no video.
But then she started talking about VHS tapes. “If it’s on VHS…” she said, but then she didn’t finish her sentence. Perhaps eyebrows knitted and my mouth dropped open when she started talking about VHS tapes.
Van went to get J.
J, who said her title was “a senior”, said, “We don’t have moving videos.”
J said her supervisor is SR, and SR’s supervisor is Mary Hanshaw, who is the ADA for radiology files, but she refused to tell me who Mary Hanshaw’s supervisor is.
She said I should call the two names she gave me, but she didn’t give me phone numbers. Perhaps I was supposed to call out their names loudly?
I waited while J made a call. She wouldn’t give me SR’s phone number. Finally she said SR will call me.
TRANSCRIPT OF PHONE CALL FROM KAISER RADIOLOGY DEPARTMENT
SR phone call April 7, 2014
SR called me on my cell phone. She identified herself as “Manager here at Radiology Records.” I was not able to write fast enough to record every single word, but I recorded most of the conversation.
SR: Was your procedure done in urology department?
ML: Yes.
SR: What date?
ML: June 15, 2011.
SR: I have June 16, 2011. I am not aware of any moving video. I know they watch it on fluoroscopy which is like a video camera which is not actually taped.
SR: [With] fluoroscopy you can watch moving images. Those images are not saved by videotape which I think is what you are referring to. Usually they take pictures in between live video fluoroscopy. Fluoroscopy is live X-rays like a video camera. You never record moving images. For that type of procedure it’s not fully reported from beginning to end. Just spot pictures.
ML: “Spot pictures” are X-ray on a film?
SR: Correct.
ML: Do you have some films from my procedure?
SR: I’m not sure. But we don’t have moving videos. If there is anything it would be a film.
ML: Sometimes you do have plain film for people who have VUCGs?
SR: Yes, because we do it a lot on babies. I can find out if there are plain films.
ML: I’d like you to do that.
ML: So there are never any digital videos for VUCGs?
SR: For this particular exam, no. And that’s common practice, not just Kaiser. Angiograms, they tape that.
ML: You know what a VUCG is?
SR: Yes, it’s a voiding urethrocystogram.
ML: And you know for a fact that they don’t make digital videos of them?
SR: I’m 99% positive. We do babies…
ML: How about adults?
SR: I don’t even think they have the capability to do it.
ML: This is the latest technology?
SR: Correct. That’s common practice.
ML: Can you find out if anybody gets digital videos for VUCGs?
SR: I’ve been here for 20 years and it’s something I’ve never known has been done her as well as in the outside community. It’s not a standard of care.
ML: Can you find out?
SR: If it’s done at urology? I would have to call urology.
ML: You have an obligation to produce records if they exist. So you will call me when you find out?
SR: Yes, I will.
ML: Thank you. Bye-bye.
April 8, 2014
Stephanie Ritter called back.
SR: I reached out to the chief of urology and confirmed that we do not tape. You used the word video. We do not tape the full fluoroscopy for VUCGs. Your X-ray jacket is in our main warehouse up in L.A. and we’ve ordered that to be delivered and hope to have it by the end of this week so we can review if there are any images in the jacket. [Maura Larkins’ thought: why would there be an X-ray jacket if there were no images????] They can take plain film pictures between the exam.
ML: Do they use thermal paper?
[I asked this because Dr. Rhee, Lynette Seid, Andrew Golden and everyone else I talked to at Kaiser had previously told me that images from my procedure had only been saved on thermal paper. This bizarre claim was even put in writing.]
SR: No. Thermal paper hasn’t been used in a long time. Thermal paper was used in mammography more than 20 years ago.
ML: There were no digital images saved?
SR: You used the word “video”. There was no taping. That is not procedure.
ML: Are there digital images?
SR: I don’t know if they would be digital.
ML: Is there a possibility they might be digital?
SR: What do you mean by digital? [ML note: SR didn’t allow me to answer that question.] It was probably around the time we started to convert to digital in regular radiology, not necessarily in urology. Southern California, from L.A. down, did start to convert to non-film images.
ML: When you say “converting to non-film”, you mean digital?
SR: Correct. But I want to be careful about what you’re understanding. A film can be converted to digital and digital can be converted to film. [Maura Larkins’ thought: Why would anyone want to convert from digital to film????]
ML: Right now urology never uses digital X-rays or fluoroscopy?
SR: Fluoroscopy and digital are different things. We do not use video cameras.
ML: Fluoroscopy is never digital?
SR: I’m not going to say NO. Depending on type [page 6 begins here]of machine.
ML: Sometimes fluoroscopy is recorded digitally?
SR: I’m not going to answer that because it does not relate to VUCG. For a voiding urethrocystogram there is not recording of fluoroscopy.
ML: You talked to Dr. Rhee?
SR: Yes. I don’t want to mislead you.
ML: You don’t want to mislead me?
SR: Mrs. Larkins, please don’t put words in my mouth. I don’t want to miscommunicate with you.
ML: You said, “I don’t want to mislead you.”
SR: I don’t want to mislead you into something you may not understand due to dynamics of urology department.
ML: You don’t want to mislead me, do you?
SR: Mrs. Larkins, is there anything I can answer?
ML: I want you to answer this: you don’t want to mislead me, do you?
SR: I want to give you correct information. I want you to understand the dynamics of procedures. You should call Mary Hanshaw. They gave you her information.
ML: They gave me her name, but not her number.
SR: [silence]
ML: They gave me her name, but not her number.
SR: [silence]
ML: Hint, hint.
SR: Are you asking me something?
ML: I’m asking for her number.
SR: 619 528 5527. Mary is on vacation.
ML: What is her title?
SR: Director of Radiology.
ML: Who is her supervisor?
SR: Dana Gascay.
ML: What is her position?
SR: Associate Medical Group Administrator. I don’t have her information.
ML: Who is her supervisor?
SR: Jim Malone.
ML: There must be someone between her and Jim Malone.
SR: Nope, there’s not.
ML: If there is an Associate Medical Group Administrator, wouldn’t there be a Medical Group Administrator?
SR: Which is Jim Malone.
ML: I bet sometimes you don’t like your job, do you?
SR: I love my job.
ML: Surely you don’t enjoy telling me these things?
SR: I’m just telling you the truth.
ML: I hope you don’t have to do any more phone calls like this today. It really must be stressful.
SR: Well, you have a wonderful afternoon.
ML: Okay. Bye-bye.
FOLLOW-UP PHONE CALLS TO MARY HANSHAW
I called Mary Hanshaw several times at 619 528 5527.
On April 24, 2014 I called but no person or machine picked up.
On April 25, 2014 I called 619 528 5527 and talked to Elsa, who transferred me to Mary Hanshaw’s answering machine. The recorded message said, “This is Mary Hanshaw, Director of Diagnostic Imaging.”
I left this message: “This is Maura Larkins. On April 7 I submitted a request to view records. 14 days have passed and I still haven’t seen records. It’s supposed to be 5 days. Please call me...”
On May 1, 2014 I called and talked to a man, who transferred me to Mary Hanshaw’s answering machine/voice mail.
I left a message:
This is Maura Larkins. I left a message on April 25 and I haven’t heard back. I made a records request on April 7. I talked to Stephanie Ritter. She said she would check my X-ray chart [I meant to say “jacket”] but she hasn’t gotten back to me. I haven’t heard from her since April 8. Please call me... And please send the records. I believe you are beyond the legal limit for this request.
FOLLOW-UP CALL TO SR:
On May 1, 2014 I called Stephanie Ritter at 619 528 3297. Her personal greeting on her voicemail said she’s out of the office. She continued, “If you need assistance, contact the secretary at 528 5538” or the clerk at 619 528 5417.
Then the message switched to someone else’s voice:
“Sorry, the mailbox belonging to Stephanie Ritter has an extended absence greeting in place and will not accept new messages.”
EMAIL TO LYNETTE SEID:
I sent an email to Lynette Seid on April 24, 2014 telling her that her subordinates were not complying with the law. She has not responded as of May 1, 2014.
Friday, April 25, 2014
Kaiser Permanente San Diego CFO Lynnette Seid personally created a hoax CD of X-ray images
UPDATE APRIL 30, 2014:
CLICK HERE for a transcript of my bizarre adventures in the Kaiser Radiology Records Department in April 2014.
UPDATE APRIL 28, 2014:
I went to Kaiser today to get medical records that I thought might be interesting. I was not disappointed. I discovered that the last doctor I visited at Kaiser wrote this:
Is that cute or what? I don't think the doctor who wrote this meant to be quite so truthful about her inability to give an honest second opinion.
ORIGINAL POST ABOUT KAISER CONCEALING TEST RESULTS:
Lynette Seid, CFO and chief administrator
for San Diego Kaiser medical records
See also: Is Kaiser Permanente violating the California Business and Professions Code with false advertising about digitized x-rays?
Lynette Seid is not only Kaiser Permanente San Diego Area's Chief Financial Officer. She's also the chief administrator in charge of medical records.
I asked for a CD of my digital VUCG X-ray images to take to an out-of-plan doctor, and in response, Lynette Seid created a CD with the following X-ray images.
It pretends to be a set of 13 images, but it actually consists of only 7 distinct images.
Four of the images appear twice, labeled with different numbers, but with the exact same time stamp:
#1 is identical to #4;
#2 is identical to #3,
#7 is identical to #9, and
#8 is identical #12.
One image appears three times!
(#10, #11 and #13 are identical).
Some of the copies have labels added (“scout,” “voiding,” and “post-void”), but the time stamped on each image identifies it precisely.
Image #6 is of particular interest; it is the one new image that Kaiser was willing to produce for an out-of-plan doctor.
See the 13 images--or rather, 7 images--here.
Nice work, Lynette! A particularly nice touch was the high-tech CD Lynetter sent me. When I open up the bizarre images, which were first printed out and THEN were scanned, and therefore provide extremely little information, I get a rapid slide show just by moving my cursor across the images. Lynette is pretending that someone might actually be looking at these images for the purpose of discerning information about the X-rays. In fact, the images only provide information about how desperate Kaiser is to conceal information about the X-rays it took.
See all posts re Lynette Seid.
CAN BAD DOCTORS CREATE GOOD KNOWLEDGE?
I believe the answer is YES. Kaiser Permanente, for example, has guidelines that require doctors to sacrifice many patients for the purpose of increasing profits. At the same time, Kaiser collects information that helps it improve the treatment of patients who can be treated without sacrificing profits.
"IN MAY 1988, Dr Robert Pozos, a hypothermia researcher at the University of Minnesota, said he planned to analyse and republish a contemporary 56-page report on infamous Dachau experiments in which almost 300 male prisoners were placed in vats of freezing water.
"The men were observed, measured and analysed, sometimes to the point of death; sometimes they were warmed up again with boiling water. Pozos said he could learn how to treat people with hypothermia better if he understood what went on at Dachau."
This sparked off a passionate debate about the ethics of knowledge. Conferences, seminars, letters and speeches the world over have struggled with what to do about Pozos's approach. Some argued the knowledge should never be used because it was gained immorally. Others asked: "Should we not look at the pyramids because they were built using slave labour?" Eventually, Pozos used the knowledge, but the debate continues. The New England Journal of Medicine, for example, does not publish citations of the work.
Contacts and staff : Information : Nature Reviews Urology
www.nature.com/nrurol/info/info_contacts.html
Nature
Chief Editor: Annette Fenner, MBBS, PhD Acting Chief Editor: Sarah Payton, PhD Senior Editor: Melanie ... PhD; David Killock, PhD Cross-Journal Associate Editors: Tim Geach, PhD Editorial Support Manager: ... Clinical Practice & Research.
CLICK HERE for a transcript of my bizarre adventures in the Kaiser Radiology Records Department in April 2014.
UPDATE APRIL 28, 2014:
I went to Kaiser today to get medical records that I thought might be interesting. I was not disappointed. I discovered that the last doctor I visited at Kaiser wrote this:
When asked how I could help her, [Maura Larkins] states that "really I just wanted to meet you because when I asked Dr. X for a transfer to another doctor, [Dr. X] said anyone except Dr. Z". Patient felt that...I would be honest and maybe go against what my supervisor's might want me to do. Discussed with the patient that this wasn't the case at all...
Is that cute or what? I don't think the doctor who wrote this meant to be quite so truthful about her inability to give an honest second opinion.
ORIGINAL POST ABOUT KAISER CONCEALING TEST RESULTS:
Lynette Seid, CFO and chief administrator
for San Diego Kaiser medical records
See also: Is Kaiser Permanente violating the California Business and Professions Code with false advertising about digitized x-rays?
Lynette Seid is not only Kaiser Permanente San Diego Area's Chief Financial Officer. She's also the chief administrator in charge of medical records.
I asked for a CD of my digital VUCG X-ray images to take to an out-of-plan doctor, and in response, Lynette Seid created a CD with the following X-ray images.
It pretends to be a set of 13 images, but it actually consists of only 7 distinct images.
Four of the images appear twice, labeled with different numbers, but with the exact same time stamp:
#1 is identical to #4;
#2 is identical to #3,
#7 is identical to #9, and
#8 is identical #12.
One image appears three times!
(#10, #11 and #13 are identical).
Some of the copies have labels added (“scout,” “voiding,” and “post-void”), but the time stamped on each image identifies it precisely.
Image #6 is of particular interest; it is the one new image that Kaiser was willing to produce for an out-of-plan doctor.
See the 13 images--or rather, 7 images--here.
Nice work, Lynette! A particularly nice touch was the high-tech CD Lynetter sent me. When I open up the bizarre images, which were first printed out and THEN were scanned, and therefore provide extremely little information, I get a rapid slide show just by moving my cursor across the images. Lynette is pretending that someone might actually be looking at these images for the purpose of discerning information about the X-rays. In fact, the images only provide information about how desperate Kaiser is to conceal information about the X-rays it took.
Lynette Seid (Mulan7224) on Twitter
Life is truly wonderful when you love what you do and you have someone very special to share your life!
[Maura Larkins response: Seriously, Lynette? You love doing stuff like this? Do you get paid a lot to do it? And get lots of appreciation from other extremely highly-paid executives? Perhaps you are blocking out the reality that life isn't truly wonderful when one's medical records are concealed by happy folks like you.]
See all posts re Lynette Seid.
CAN BAD DOCTORS CREATE GOOD KNOWLEDGE?
I believe the answer is YES. Kaiser Permanente, for example, has guidelines that require doctors to sacrifice many patients for the purpose of increasing profits. At the same time, Kaiser collects information that helps it improve the treatment of patients who can be treated without sacrificing profits.
"IN MAY 1988, Dr Robert Pozos, a hypothermia researcher at the University of Minnesota, said he planned to analyse and republish a contemporary 56-page report on infamous Dachau experiments in which almost 300 male prisoners were placed in vats of freezing water.
"The men were observed, measured and analysed, sometimes to the point of death; sometimes they were warmed up again with boiling water. Pozos said he could learn how to treat people with hypothermia better if he understood what went on at Dachau."
This sparked off a passionate debate about the ethics of knowledge. Conferences, seminars, letters and speeches the world over have struggled with what to do about Pozos's approach. Some argued the knowledge should never be used because it was gained immorally. Others asked: "Should we not look at the pyramids because they were built using slave labour?" Eventually, Pozos used the knowledge, but the debate continues. The New England Journal of Medicine, for example, does not publish citations of the work.
Contacts and staff : Information : Nature Reviews Urology
www.nature.com/nrurol/info/info_contacts.html
Nature
Chief Editor: Annette Fenner, MBBS, PhD Acting Chief Editor: Sarah Payton, PhD Senior Editor: Melanie ... PhD; David Killock, PhD Cross-Journal Associate Editors: Tim Geach, PhD Editorial Support Manager: ... Clinical Practice & Research.
Thursday, April 24, 2014
Finally, a Kaiser doctor, oncologist Jennifer Lycette, speaks out about doctors forced to allow harm to patients to increase profits
"...Lycette’s suit states, however, that she became troubled by new Kaiser policies
after [executive Jeffrey] Weisz was brought in.
"Among her other complaints, her suit alleges she expressed concerns about a ban on referring patients to non-Kaiser specialists or clinical trials outside of Kaiser -- even though doing so would be in the best interests of patients.
"She resigned in April 2013, because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," her suit states.
"According to the website for Oregon Health & Science University, Lycette relocated to Astoria and is now working at OHSU's Cancer Care Center at Columbia Memorial Hospital..."
Former oncologist claims Kaiser Permanente pushed profits over patient care, files $7 million lawsuit
Aimee Green
Oregon Live
April 23, 2014
A former oncologist at Kaiser Permanente is suing the health care company for $7 million, claiming she had no choice but to quit her job after complaining the organization was maximizing profits to the detriment of cancer patients.
Dr. Jennifer Lycette claims quality of care took a nosedive when Northwest Permanente Medical Group hired Jeffrey Weisz as its president and executive medical director in 2011. Weisz had previously worked for Kaiser in Southern California.
"During Dr. Weisz's tenure (in California), he established a reputation as a ruthless administrator who found ways to minimize payrolls by shrinking staff while patient loads skyrocketed, often leaving the remaining staff members trying to cope with impossible patient demands which ultimately harmed Kaiser's patients," reads Lycette's lawsuit, filed Tuesday in Multnomah County Circuit Court.
In an email statement, Kaiser spokesman Michael Foley said, "The care needs of our members, patients, and customers come first. Allegations that claim otherwise are not supported by fact.
"We're reviewing the lawsuit that was filed," he addied, "and will address its inaccurate allegations through the judicial process."
The suit was filed by Lake Oswego attorney Roderick Boutin.
Lycette's suits claims that during a November 2012 meeting, Weisz ordered Kaiser's Portland oncologists to cram an initial consultation and bone-marrow biopsy of patients -- something that should take two to 2.5 hours and be done over two visits -- into one, 60-minute visit. Lycette’s suit states pain medication that must be taken orally takes 30 to 60 minutes to kick in, so a 60-minute visit would leave patients rushed and in pain.
Lycette "openly and respectfully voiced her concerns," and Weisz responded by shouting at Lycette in "a very angry and threatening manner," her suit states.
Lycette's suit also claims she complained in April 2012 to the then-chief of medical oncology, Nagendra Tirumali, about understaffing. She says patients were struggling to schedule appointments and some chemotherapy patients were only seeing their regular oncologist every two or three months.
Tirumali responded that Lycette was being “emotional,” according to a copy of an email attached to the suit. Lycette’s suit characterizes Tirumali's response as a "veiled attack" on her gender. Her suit states she later asked Tirumali whether he would have accused a man of being "emotional" over the issue of understaffing.
Lycette, 40, worked for Kaiser for about seven years -- from 2006 until she resigned in spring 2013 -- at its Interstate medical offices in North Portland and Sunnyside Medical Center in Clackamas, according to her suit. Her suit states she had the highest patient satisfaction rating, 89 percent, in her department.
Lycette’s suit alleges that before taking the job in 2006, she asked several Kaiser doctors if they thought they could care for patients without feeling that financial overhead compromised care. They assured her they could, the suit states.
Lycette’s suit states, however, that she became troubled by new Kaiser policies after Weisz was brought in.
Among her other complaints, her suit alleges she expressed concerns about a ban on referring patients to non-Kaiser specialists or clinical trials outside of Kaiser -- even though doing so would be in the best interests of patients.
She resigned in April 2013, because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," her suit states.
According to the website for Oregon Health & Science University, Lycette relocated to Astoria and is now working at OHSU's Cancer Care Center at Columbia Memorial Hospital.
Lycette is seeking $2 million in economic damages and $5 million in non-economic damages.
"Among her other complaints, her suit alleges she expressed concerns about a ban on referring patients to non-Kaiser specialists or clinical trials outside of Kaiser -- even though doing so would be in the best interests of patients.
"She resigned in April 2013, because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," her suit states.
"According to the website for Oregon Health & Science University, Lycette relocated to Astoria and is now working at OHSU's Cancer Care Center at Columbia Memorial Hospital..."
Former oncologist claims Kaiser Permanente pushed profits over patient care, files $7 million lawsuit
Aimee Green
Oregon Live
April 23, 2014
A former oncologist at Kaiser Permanente is suing the health care company for $7 million, claiming she had no choice but to quit her job after complaining the organization was maximizing profits to the detriment of cancer patients.
Dr. Jennifer Lycette claims quality of care took a nosedive when Northwest Permanente Medical Group hired Jeffrey Weisz as its president and executive medical director in 2011. Weisz had previously worked for Kaiser in Southern California.
"During Dr. Weisz's tenure (in California), he established a reputation as a ruthless administrator who found ways to minimize payrolls by shrinking staff while patient loads skyrocketed, often leaving the remaining staff members trying to cope with impossible patient demands which ultimately harmed Kaiser's patients," reads Lycette's lawsuit, filed Tuesday in Multnomah County Circuit Court.
In an email statement, Kaiser spokesman Michael Foley said, "The care needs of our members, patients, and customers come first. Allegations that claim otherwise are not supported by fact.
"We're reviewing the lawsuit that was filed," he addied, "and will address its inaccurate allegations through the judicial process."
The suit was filed by Lake Oswego attorney Roderick Boutin.
Lycette's suits claims that during a November 2012 meeting, Weisz ordered Kaiser's Portland oncologists to cram an initial consultation and bone-marrow biopsy of patients -- something that should take two to 2.5 hours and be done over two visits -- into one, 60-minute visit. Lycette’s suit states pain medication that must be taken orally takes 30 to 60 minutes to kick in, so a 60-minute visit would leave patients rushed and in pain.
Lycette "openly and respectfully voiced her concerns," and Weisz responded by shouting at Lycette in "a very angry and threatening manner," her suit states.
Lycette's suit also claims she complained in April 2012 to the then-chief of medical oncology, Nagendra Tirumali, about understaffing. She says patients were struggling to schedule appointments and some chemotherapy patients were only seeing their regular oncologist every two or three months.
Tirumali responded that Lycette was being “emotional,” according to a copy of an email attached to the suit. Lycette’s suit characterizes Tirumali's response as a "veiled attack" on her gender. Her suit states she later asked Tirumali whether he would have accused a man of being "emotional" over the issue of understaffing.
Lycette, 40, worked for Kaiser for about seven years -- from 2006 until she resigned in spring 2013 -- at its Interstate medical offices in North Portland and Sunnyside Medical Center in Clackamas, according to her suit. Her suit states she had the highest patient satisfaction rating, 89 percent, in her department.
Lycette’s suit alleges that before taking the job in 2006, she asked several Kaiser doctors if they thought they could care for patients without feeling that financial overhead compromised care. They assured her they could, the suit states.
Lycette’s suit states, however, that she became troubled by new Kaiser policies after Weisz was brought in.
Among her other complaints, her suit alleges she expressed concerns about a ban on referring patients to non-Kaiser specialists or clinical trials outside of Kaiser -- even though doing so would be in the best interests of patients.
She resigned in April 2013, because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," her suit states.
According to the website for Oregon Health & Science University, Lycette relocated to Astoria and is now working at OHSU's Cancer Care Center at Columbia Memorial Hospital.
Lycette is seeking $2 million in economic damages and $5 million in non-economic damages.
Tuesday, April 22, 2014
Health Insurance Complaints Skyrocket in CA, says DMHC (Department of Managed Health Care)
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.]
"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.]
Sunday, April 13, 2014
Kaiser Permanente pharmacists consider going on strike
See also Kaiser often denies care to paying patients, but then doles out a bit of free care to get publicity and tax write-offs.
Kaiser Permanente pharmacists consider going on strike
By ALEJANDRO CANO
Fontana Herald News
April 13, 2014
Kaiser Permanente pharmacists, including those in the Fontana medical center, voted on April 4 to authorize the Guild for Professional Pharmacists committee to call a strike, if necessary, after negotiations reached no agreement.
According to the GFPP, which represents more than 1,400 pharmacists in Southern California, the employees "overwhelmingly" authorized the committee to call a strike after Kaiser’s bargaining team did not offer better health coverage plans and retirement plans for employees who work for less than full time.
“Kaiser has, so far, steadfastly refused to do so and, instead, has sought benefits cuts that would give pharmacists even lesser benefits both wile actively employed by Kaiser and after retirement," said Robin Borden, president of GFPP. “This is outrageous and our members won’t stand for it. While I know no one wants to strike -- least all of our members, for whom patients come first -- our members will not stand by and let Kaiser undermine our economic security, including our security after retirement."
Borden added that if the strike were to be called, it could involve all or some of the following Kaiser medical centers: Panorama City, Woodland Hills, Sunset, West Los Angeles, Baldwin Park, Bellflower, Harbor South Bay, Anaheim, Irvine, Ontario, Riverside, San Diego and Fontana.
Kaiser Permanente released a statement through Jennifer Resch-Silvestri, senior director of public affairs and brand communications in the San Bernardino County area, saying that the company's first priority is “always the safety and care of our members and patients” and that pharmacists are “valued members of our professional health care team."
“It is important to note that all Kaiser Permanente health services are open and operating as usual to serve our members who should continue to come to our facilities for their appointments, lab tests, scheduled procedures, and to see their doctors," said the statement. “With the good faith involvement of all concerned, we are optimistic that we will continue to make
progress toward a contract agreement."
Kaiser Permanente pharmacists consider going on strike
By ALEJANDRO CANO
Fontana Herald News
April 13, 2014
Kaiser Permanente pharmacists, including those in the Fontana medical center, voted on April 4 to authorize the Guild for Professional Pharmacists committee to call a strike, if necessary, after negotiations reached no agreement.
According to the GFPP, which represents more than 1,400 pharmacists in Southern California, the employees "overwhelmingly" authorized the committee to call a strike after Kaiser’s bargaining team did not offer better health coverage plans and retirement plans for employees who work for less than full time.
“Kaiser has, so far, steadfastly refused to do so and, instead, has sought benefits cuts that would give pharmacists even lesser benefits both wile actively employed by Kaiser and after retirement," said Robin Borden, president of GFPP. “This is outrageous and our members won’t stand for it. While I know no one wants to strike -- least all of our members, for whom patients come first -- our members will not stand by and let Kaiser undermine our economic security, including our security after retirement."
Borden added that if the strike were to be called, it could involve all or some of the following Kaiser medical centers: Panorama City, Woodland Hills, Sunset, West Los Angeles, Baldwin Park, Bellflower, Harbor South Bay, Anaheim, Irvine, Ontario, Riverside, San Diego and Fontana.
Kaiser Permanente released a statement through Jennifer Resch-Silvestri, senior director of public affairs and brand communications in the San Bernardino County area, saying that the company's first priority is “always the safety and care of our members and patients” and that pharmacists are “valued members of our professional health care team."
“It is important to note that all Kaiser Permanente health services are open and operating as usual to serve our members who should continue to come to our facilities for their appointments, lab tests, scheduled procedures, and to see their doctors," said the statement. “With the good faith involvement of all concerned, we are optimistic that we will continue to make
progress toward a contract agreement."
Monday, April 7, 2014
Wal-Mart shoppers: Kaiser Permanente will see you now
Wal-Mart shoppers: The doctor will see you now
BY COURTENAY EDELHART
Bakersfield Californian
Apr 05 2014
Shortly after the Kaiser Permanente Care Corner clinic opened for the day in a southwest Bakersfield Wal-Mart one recent Friday, licensed vocational nurse Irene Ethridge decided to drum up some business.
[Maura Larkins' comment: Irene decided? Or she was instructed to do so?}
"Hi there. Are you a Kaiser Permanente member?" she asked a woman strolling through the store's adjacent pharmacy.
"Yes," replied Kim Klaas warily.
Ethridge brightened and explained that as such, Klaas was eligible to use the telemedicine services at the clinic, a two-year pilot project of Kaiser -- which has about 102,000 members in Kern County -- and the nation's largest retailer.
The Bakersfield telemedicine clinic is one of two that Kaiser opened in October. The other one is in Palmdale.
Kaiser members and Wal-Mart employees can walk in, no appointment necessary, and have minor ailments assessed by a health care provider via a high-resolution webcam in a private room. A registered nurse in San Diego does an initial screening, followed by an urgent care doctor in Bakersfield.
The clinic is open from noon to 8 p.m. Thursdays through Mondays. About 125 people have had exams there so far.
Klaas, 39, was feeling well on Friday, but she was intrigued. "I love the hours," said the mother of two children, ages 5 and 6. "Kids always seem to get sick at night when the doctor's office is closed, and a little ear ache isn't the kind of thing you want to go to a hospital for." Retailers have been operating clinics inside stores for years, but until recently telemedicine has largely been confined to traditional clinical settings, usually for consultations between far apart medical colleagues. Because it's efficient and convenient, telemedicine is likely to expand into all sorts of nontraditional settings, but there should be standards to ensure patients are getting good care, said Mike Harris, a principal with Harris Consulting, a Los Angeles-based healthcare consulting firm. "Of course we have to make sure we closely monitor it to be certain we're not putting patients at risk," he said. The exam at Kaiser's Wal-Mart clinic is much more than just talking to a computer screen, Kaiser notes. With a specialized stethoscope placed on the patient by the nurse at the clinic, remote doctors can actually listen to the patient's breathing and heartbeat, just as they would in a face-to-face exam. An otoscope with a camera on it also allows doctors to look deep into a patient's ears and eyes. Similarly, a special dermatoscope can transmit extremely detailed, magnified images of skin lesions. Patients with sore throats open wide for yet another camera. For routine ailments, doctors can transmit an electronic prescription that patients can fill immediately at Wal-Mart, or at another pharmacy if they choose to wait. If the condition appears to warrant an in-person exam, patients are referred to Kaiser's urgent care clinic on Stockdale Highway, where they will likely see the same doctor who was on the other end of the webcam. The partnership between Kaiser and Wal-Mart is part of an ongoing strategy Kaiser is pursuing to make health care generally more accessible. It's trying out a traditional clinic at Paramount Farms for employees of the agriculture company, and a mobile clinic that travels to outlying areas of the county six days a week. There's also a mobile phone app for making appointments and communicating with doctors. "We want to take health care beyond the traditional setting to the places where people shop and work," said Kaiser chief administrative officer Sharon Peters. If visiting the doctor is convenient, the thinking goes, patients will come in sooner and possibly avoid the health consequences and expense of more severe problems down the road.
Going to a doctor's office in the middle of the day isn't convenient for most people, but swinging through a clinic while shopping isn't too much trouble.
"This really fits in with the needs of our patients," said Kaiser medical director Dr. Julia Bae. "Millennials and the younger population, especially, don't value the traditional one-on-one office visit. They want care to fit into their busy schedules." Wal-Mart says the experiment is one more way to better serve its customers.
"We are always testing new products and services to provide our customers with affordable ways to stay healthy," said spokeswoman Danit Marquardt. "This is an example of one of those pilot programs." Customers who are not Kaiser members or Wal-Mart employees can't take advantage of the telemedicine exams, but they can use self-service options such as health research or checking their weight or blood pressure. Linda Urias, 65, doesn't belong to Kaiser but stops in at the clinic whenever she's in the store picking up groceries. On the recent Friday, she checked her blood pressure. "A little low today, but at least it wasn't high," she said. Urias also stepped on a scale to make sure her diet is still on track. She recently lost about 20 pounds, and is trying to keep it off. "I've changed the whole way I eat," Urias said proudly. It's those types of health conscious consumers retailers hope to appeal to with in-store clinics.
The partnership between Kaiser and Wal-Mart has a lot to offer both sides, said healthcare consultant MaryKate Scott of Hartland, Maine-based Scott & Co., which has had Wal-Mart as a client in the past.
The obvious benefit to Wal-Mart is the potential to sell prescription and over-the-counter medicine, but that's only part of the story, Scott said.
There are about 2,500 retail clinics in the United States. Stores like them because they generate foot traffic at a time when a growing number of consumers are shopping online.
"They want customers walking through the store with their shopping carts making impulse purchases," Scott said. Plus, health care costs are a major concern for Wal-Mart as the employer of some 1.4 million employees. If it can keep those workers healthy, that's a huge savings, Scott said. And if health care costs worry an enormously successful international retailer, how much more so for its customers, typically working-class people for whom insurance is a major expense. "If I'm Wal-Mart, I'm thinking, 'Health care is a big deal for my customers. And if it's a big deal for my customers, it better be a big deal for me,'" Scott said.
BY COURTENAY EDELHART
Bakersfield Californian
Apr 05 2014
Shortly after the Kaiser Permanente Care Corner clinic opened for the day in a southwest Bakersfield Wal-Mart one recent Friday, licensed vocational nurse Irene Ethridge decided to drum up some business.
[Maura Larkins' comment: Irene decided? Or she was instructed to do so?}
"Hi there. Are you a Kaiser Permanente member?" she asked a woman strolling through the store's adjacent pharmacy.
"Yes," replied Kim Klaas warily.
Ethridge brightened and explained that as such, Klaas was eligible to use the telemedicine services at the clinic, a two-year pilot project of Kaiser -- which has about 102,000 members in Kern County -- and the nation's largest retailer.
The Bakersfield telemedicine clinic is one of two that Kaiser opened in October. The other one is in Palmdale.
Kaiser members and Wal-Mart employees can walk in, no appointment necessary, and have minor ailments assessed by a health care provider via a high-resolution webcam in a private room. A registered nurse in San Diego does an initial screening, followed by an urgent care doctor in Bakersfield.
The clinic is open from noon to 8 p.m. Thursdays through Mondays. About 125 people have had exams there so far.
Klaas, 39, was feeling well on Friday, but she was intrigued. "I love the hours," said the mother of two children, ages 5 and 6. "Kids always seem to get sick at night when the doctor's office is closed, and a little ear ache isn't the kind of thing you want to go to a hospital for." Retailers have been operating clinics inside stores for years, but until recently telemedicine has largely been confined to traditional clinical settings, usually for consultations between far apart medical colleagues. Because it's efficient and convenient, telemedicine is likely to expand into all sorts of nontraditional settings, but there should be standards to ensure patients are getting good care, said Mike Harris, a principal with Harris Consulting, a Los Angeles-based healthcare consulting firm. "Of course we have to make sure we closely monitor it to be certain we're not putting patients at risk," he said. The exam at Kaiser's Wal-Mart clinic is much more than just talking to a computer screen, Kaiser notes. With a specialized stethoscope placed on the patient by the nurse at the clinic, remote doctors can actually listen to the patient's breathing and heartbeat, just as they would in a face-to-face exam. An otoscope with a camera on it also allows doctors to look deep into a patient's ears and eyes. Similarly, a special dermatoscope can transmit extremely detailed, magnified images of skin lesions. Patients with sore throats open wide for yet another camera. For routine ailments, doctors can transmit an electronic prescription that patients can fill immediately at Wal-Mart, or at another pharmacy if they choose to wait. If the condition appears to warrant an in-person exam, patients are referred to Kaiser's urgent care clinic on Stockdale Highway, where they will likely see the same doctor who was on the other end of the webcam. The partnership between Kaiser and Wal-Mart is part of an ongoing strategy Kaiser is pursuing to make health care generally more accessible. It's trying out a traditional clinic at Paramount Farms for employees of the agriculture company, and a mobile clinic that travels to outlying areas of the county six days a week. There's also a mobile phone app for making appointments and communicating with doctors. "We want to take health care beyond the traditional setting to the places where people shop and work," said Kaiser chief administrative officer Sharon Peters. If visiting the doctor is convenient, the thinking goes, patients will come in sooner and possibly avoid the health consequences and expense of more severe problems down the road.
Going to a doctor's office in the middle of the day isn't convenient for most people, but swinging through a clinic while shopping isn't too much trouble.
"This really fits in with the needs of our patients," said Kaiser medical director Dr. Julia Bae. "Millennials and the younger population, especially, don't value the traditional one-on-one office visit. They want care to fit into their busy schedules." Wal-Mart says the experiment is one more way to better serve its customers.
"We are always testing new products and services to provide our customers with affordable ways to stay healthy," said spokeswoman Danit Marquardt. "This is an example of one of those pilot programs." Customers who are not Kaiser members or Wal-Mart employees can't take advantage of the telemedicine exams, but they can use self-service options such as health research or checking their weight or blood pressure. Linda Urias, 65, doesn't belong to Kaiser but stops in at the clinic whenever she's in the store picking up groceries. On the recent Friday, she checked her blood pressure. "A little low today, but at least it wasn't high," she said. Urias also stepped on a scale to make sure her diet is still on track. She recently lost about 20 pounds, and is trying to keep it off. "I've changed the whole way I eat," Urias said proudly. It's those types of health conscious consumers retailers hope to appeal to with in-store clinics.
The partnership between Kaiser and Wal-Mart has a lot to offer both sides, said healthcare consultant MaryKate Scott of Hartland, Maine-based Scott & Co., which has had Wal-Mart as a client in the past.
The obvious benefit to Wal-Mart is the potential to sell prescription and over-the-counter medicine, but that's only part of the story, Scott said.
There are about 2,500 retail clinics in the United States. Stores like them because they generate foot traffic at a time when a growing number of consumers are shopping online.
"They want customers walking through the store with their shopping carts making impulse purchases," Scott said. Plus, health care costs are a major concern for Wal-Mart as the employer of some 1.4 million employees. If it can keep those workers healthy, that's a huge savings, Scott said. And if health care costs worry an enormously successful international retailer, how much more so for its customers, typically working-class people for whom insurance is a major expense. "If I'm Wal-Mart, I'm thinking, 'Health care is a big deal for my customers. And if it's a big deal for my customers, it better be a big deal for me,'" Scott said.
Saturday, January 4, 2014
Baby's Disability Blamed on Kaiser Negligence
Baby's Disability Blamed on Kaiser Negligence
By BARBARA WALLACE
Courthouse News Service
January 02, 2014
(CN) - A Kaiser hospital botched the birth of a baby girl who now has Erb's palsy, her mother claims in a court.
Charnesha Cobb sued Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and the Permanente Medical Group Inc. in San Francisco County Superior Court on behalf of her now 2-year-old daughter, Joy Barnes.
Online medical resources describe Erb's palsy as a shoulder injury that can happen during a breach delivery or when the baby's neck is overstretched during a head-first delivery. The prognosis depends upon the extent of nerve damage.
Cobb blames Kaiser for Joy's injuries, saying in her complaint that the "defendants neglected to adequately select a competent medical staff and to periodically review the competency of its medical staff and failed to adequately monitor its staff."
As a result, "Joy Barnes has been diagnosed with Erb's palsy and is permanently disabled," the complaint states.
Cobb seeks economic and noneconomic damages, past and future medical expenses, loss of future earning and earning capacity, prejudgment interest, costs of suit and a jury trial. She is represented by Thomas Donahue and Rebecca Cucu of Donahue & Horrow in El Segundo, Calif.
By BARBARA WALLACE
Courthouse News Service
January 02, 2014
(CN) - A Kaiser hospital botched the birth of a baby girl who now has Erb's palsy, her mother claims in a court.
Charnesha Cobb sued Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and the Permanente Medical Group Inc. in San Francisco County Superior Court on behalf of her now 2-year-old daughter, Joy Barnes.
Online medical resources describe Erb's palsy as a shoulder injury that can happen during a breach delivery or when the baby's neck is overstretched during a head-first delivery. The prognosis depends upon the extent of nerve damage.
Cobb blames Kaiser for Joy's injuries, saying in her complaint that the "defendants neglected to adequately select a competent medical staff and to periodically review the competency of its medical staff and failed to adequately monitor its staff."
As a result, "Joy Barnes has been diagnosed with Erb's palsy and is permanently disabled," the complaint states.
Cobb seeks economic and noneconomic damages, past and future medical expenses, loss of future earning and earning capacity, prejudgment interest, costs of suit and a jury trial. She is represented by Thomas Donahue and Rebecca Cucu of Donahue & Horrow in El Segundo, Calif.
Sunday, December 1, 2013
Kaiser, which has long claimed to practice preventive medicine, to raise rates 9.2 per cent, on reinstated policies
Apparently, Kaiser Permanente wasn't so interested in preventive medicine as it claimed. When required to provide preventive care, it raises rates.
Kaiser to raise rates on reinstated policies
The proposed 9.2% boost would cover higher costs associated with Obamacare
By Kristen Consillio
Star Advertizer
Nov 30, 2013
Kaiser Permanente Hawaii plans to boost rates by an average 9.2 percent for 11,000 individuals who were earlier notified their health insurance policies would be canceled at year's end because they did not meet the minimum requirements of the federal Affordable Care Act.
The state's largest health maintenance organization said it filed the proposed rate hike this week with the Insurance Division to cover higher projected medical expenses next year, costs associated with an aging population and taxes and fees related to the federal Affordable Care Act...
Kaiser to raise rates on reinstated policies
The proposed 9.2% boost would cover higher costs associated with Obamacare
By Kristen Consillio
Star Advertizer
Nov 30, 2013
Kaiser Permanente Hawaii plans to boost rates by an average 9.2 percent for 11,000 individuals who were earlier notified their health insurance policies would be canceled at year's end because they did not meet the minimum requirements of the federal Affordable Care Act.
The state's largest health maintenance organization said it filed the proposed rate hike this week with the Insurance Division to cover higher projected medical expenses next year, costs associated with an aging population and taxes and fees related to the federal Affordable Care Act...
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...
Saturday, October 26, 2013
Class Action lawsuit filed against Kaiser over mental health care wait times
Class Action lawsuit filed against Kaiser over mental health care wait times
By Rachel Raskin-Zrihen
Times-Herald
10/25/2013
A lawsuit served at Kaiser Permanente's Oakland headquarters Thursday alleges that Kaiser Foundation Health Plan facilities, including Vallejo's, routinely deny its members timely access to mental health services.
Kaiser officials call the suit a ploy in ongoing contract negotiations.
The Oakland-based law firm of Siegel LeWitter Malkani that works closely with the National Union of Healthcare Workers (NUHW) -- which represents Kaiser's mental health professionals and optical workers -- filed the suit earlier this month on behalf of "three named plaintiffs and thousands of other Kaiser members who have been harmed" by this alleged practice, attorney Jonathan Siegel said Thursday.
The union represents some 70 members at Kaiser Permanente Vallejo Medical Center. The firm has sued Kaiser before, Siegel said.
Kaiser officials called the suit the "NUHW's latest attempt to use inaccurate claims about our mental health care services to apply pressure in their protracted labor negotiations with Kaiser Permanente."
The union's actions do "nothing to further the negotiations that should be taking place at the table," they said.
The lawsuit alleges that Kaiser routinely violates state law by refusing to provide critical mental health services to its members within the time frame set by law.
"As a result, Kaiser members have been denied urgent services, forced to wait for long periods of time to receive needed services, discouraged from seeking services altogether, or compelled to incur out-of-pocket expenses for treatment outside of the Kaiser system," according to the suit.
The lead plaintiff, Point Richmond resident Susan Futterman, said her husband, Fred Paroutaud, killed himself after "desperate" requests for an urgent mental health appointment were delayed until his psychiatrist returned from vacation.
Los Angeles area plaintiff Megan Mortensen wound up seeking an urgent mental health appointment outside the system after Kaiser allegedly "refused" her request for a timely appointment after the loss of her brother. The third plaintiff, Acianita Lucero of Oakland, allegedly "made repeated requests for Kaiser to provide her with an urgent mental health appointment but Kaiser refused to see her within the 48 hours required by law," according to the suit.
The suit follows a report from earlier this year by the California Department of Managed Health Care which suggested Kaiser needed to reduce mental health appointment wait times. Kaiser was fined $ 4 million -- the second largest fine issued by the Department -- and issued a Cease and Desist Order to correct the problems, Siegel said.
Kaiser officials say the report did not fault Kaiser's mental health care quality or member's ability to obtain urgent or emergency mental health care.
"What was identified in the DMHC survey were some areas where our non-urgent appointment wait times and data tracking needed improvement," officials said. "We took the findings seriously, have submitted a corrective action plan to the DMHC, and have worked to correct the issues identified in the survey."
The class action lawsuit seeks compensatory and statutory damages for class members as well as an injunction requiring Kaiser to comply with the law, Siegel said.
"We're suing for Kaiser to clean up there act and provide mental health services to their clients that complies with the law," he said. "And we want damage compensation for the tens of thousands of Kaiser members who have been victimized by this."
By Rachel Raskin-Zrihen
Times-Herald
10/25/2013
A lawsuit served at Kaiser Permanente's Oakland headquarters Thursday alleges that Kaiser Foundation Health Plan facilities, including Vallejo's, routinely deny its members timely access to mental health services.
Kaiser officials call the suit a ploy in ongoing contract negotiations.
The Oakland-based law firm of Siegel LeWitter Malkani that works closely with the National Union of Healthcare Workers (NUHW) -- which represents Kaiser's mental health professionals and optical workers -- filed the suit earlier this month on behalf of "three named plaintiffs and thousands of other Kaiser members who have been harmed" by this alleged practice, attorney Jonathan Siegel said Thursday.
The union represents some 70 members at Kaiser Permanente Vallejo Medical Center. The firm has sued Kaiser before, Siegel said.
Kaiser officials called the suit the "NUHW's latest attempt to use inaccurate claims about our mental health care services to apply pressure in their protracted labor negotiations with Kaiser Permanente."
The union's actions do "nothing to further the negotiations that should be taking place at the table," they said.
The lawsuit alleges that Kaiser routinely violates state law by refusing to provide critical mental health services to its members within the time frame set by law.
"As a result, Kaiser members have been denied urgent services, forced to wait for long periods of time to receive needed services, discouraged from seeking services altogether, or compelled to incur out-of-pocket expenses for treatment outside of the Kaiser system," according to the suit.
The lead plaintiff, Point Richmond resident Susan Futterman, said her husband, Fred Paroutaud, killed himself after "desperate" requests for an urgent mental health appointment were delayed until his psychiatrist returned from vacation.
Los Angeles area plaintiff Megan Mortensen wound up seeking an urgent mental health appointment outside the system after Kaiser allegedly "refused" her request for a timely appointment after the loss of her brother. The third plaintiff, Acianita Lucero of Oakland, allegedly "made repeated requests for Kaiser to provide her with an urgent mental health appointment but Kaiser refused to see her within the 48 hours required by law," according to the suit.
The suit follows a report from earlier this year by the California Department of Managed Health Care which suggested Kaiser needed to reduce mental health appointment wait times. Kaiser was fined $ 4 million -- the second largest fine issued by the Department -- and issued a Cease and Desist Order to correct the problems, Siegel said.
Kaiser officials say the report did not fault Kaiser's mental health care quality or member's ability to obtain urgent or emergency mental health care.
"What was identified in the DMHC survey were some areas where our non-urgent appointment wait times and data tracking needed improvement," officials said. "We took the findings seriously, have submitted a corrective action plan to the DMHC, and have worked to correct the issues identified in the survey."
The class action lawsuit seeks compensatory and statutory damages for class members as well as an injunction requiring Kaiser to comply with the law, Siegel said.
"We're suing for Kaiser to clean up there act and provide mental health services to their clients that complies with the law," he said. "And we want damage compensation for the tens of thousands of Kaiser members who have been victimized by this."
Wednesday, October 23, 2013
Kaiser wants the public to know the truth about Kaiser quality. So do I.
Here it is straight from the horse's mouth: Kaiser wants the public to have more information about the quality of medical care provided by Kaiser.
I'm happy to help with this blog. Of course, I agree that Covered California should post ratings of insurers. I'd also like to suggest that the California exchange public Kaiser's treatment guidelines and those of other insurers.
The desire for openness is a big change in attitude for Kaiser, a company that usually wants to keep secrets.
Kaiser faults California’s exchange for lack of quality ratings
Chad Terhune
Los Angeles Times
Oct. 22, 2013
Healthcare giant Kaiser Permanente and two other insurers say California’s insurance exchange is withholding crucial information from consumers by not posting quality ratings alongside health plan rates.
The insurance companies said “there has never been a compelling reason to deny this information to consumers…. On this issue, Covered California has surrendered its ‘pace car’ status.”
Sharp Health Plan in San Diego and Western Health Advantage in Sacramento joined Kaiser in criticizing the state’s position in a letter sent Monday to Covered California, the state health exchange. Some consumer advocates have also urged the state to reconsider, saying any delay rewards lower-performing insurers.
Thousands of people have been shopping for coverage at the state’s website at www.coveredca.com since enrollment opened Oct. 1 under the Affordable Care Act, also known as Obamacare.
Covered California ignited this debate in August when it backed off earlier plans to include insurance company ratings in its online enrollment system.
This came as a surprise because state officials had touted the idea of consumers choosing coverage based on the overall value, combining price and quality measures.
At the time, the exchange said it reversed course because the latest state rankings examine performance from 2011, and they don’t reflect many of the new health plans and provider networks being offered for the first time under the federal healthcare law.
Major insurers such as Blue Shield of California and Health Net Inc. have offered narrower networks for some exchange policies to help lower premiums. In contrast, Kaiser and its full provider network are often more expensive.
State officials have discussed including ratings for some health plans, such as Kaiser, that are using their current network and labeling newer products as “not yet rated.” Covered California’s five-member board is expected to consider the matter at a regularly scheduled meeting Thursday.
In their letter, the three insurers also point out that other state-run exchanges, such as those in Colorado, Maryland and Oregon, are displaying quality data prominently on their websites. Colorado’s website even sorts a consumer’s options by quality, rather than just price.
“The leadership of these three state exchanges faced a choice, as California’s does now – and they chose to put consumers first,” the insurers said.
I'm happy to help with this blog. Of course, I agree that Covered California should post ratings of insurers. I'd also like to suggest that the California exchange public Kaiser's treatment guidelines and those of other insurers.
The desire for openness is a big change in attitude for Kaiser, a company that usually wants to keep secrets.
Kaiser faults California’s exchange for lack of quality ratings
Chad Terhune
Los Angeles Times
Oct. 22, 2013
Healthcare giant Kaiser Permanente and two other insurers say California’s insurance exchange is withholding crucial information from consumers by not posting quality ratings alongside health plan rates.
The insurance companies said “there has never been a compelling reason to deny this information to consumers…. On this issue, Covered California has surrendered its ‘pace car’ status.”
Sharp Health Plan in San Diego and Western Health Advantage in Sacramento joined Kaiser in criticizing the state’s position in a letter sent Monday to Covered California, the state health exchange. Some consumer advocates have also urged the state to reconsider, saying any delay rewards lower-performing insurers.
Thousands of people have been shopping for coverage at the state’s website at www.coveredca.com since enrollment opened Oct. 1 under the Affordable Care Act, also known as Obamacare.
Covered California ignited this debate in August when it backed off earlier plans to include insurance company ratings in its online enrollment system.
This came as a surprise because state officials had touted the idea of consumers choosing coverage based on the overall value, combining price and quality measures.
At the time, the exchange said it reversed course because the latest state rankings examine performance from 2011, and they don’t reflect many of the new health plans and provider networks being offered for the first time under the federal healthcare law.
Major insurers such as Blue Shield of California and Health Net Inc. have offered narrower networks for some exchange policies to help lower premiums. In contrast, Kaiser and its full provider network are often more expensive.
State officials have discussed including ratings for some health plans, such as Kaiser, that are using their current network and labeling newer products as “not yet rated.” Covered California’s five-member board is expected to consider the matter at a regularly scheduled meeting Thursday.
In their letter, the three insurers also point out that other state-run exchanges, such as those in Colorado, Maryland and Oregon, are displaying quality data prominently on their websites. Colorado’s website even sorts a consumer’s options by quality, rather than just price.
“The leadership of these three state exchanges faced a choice, as California’s does now – and they chose to put consumers first,” the insurers said.
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).
Tuesday, August 6, 2013
Patient: Kaiser Told Me 'Redheads Bleed More'
This patient was lucky that one person at Kaiser was looking out for her. This surgery might have had an even worse outcome if someone had tried to put her back to sleep when she awoke and saw a problem. I suggest an award for the staff member who insisted, "We can't give her any more medication."
Patient: Kaiser Told Me 'Redheads Bleed More'
(Click link to see documents)
By BARBARA WALLACE
Courthouse News Service
August 05, 2013
ROSEVILLE, Calif. (CN) - Kaiser staff dismissed "blood pouring uncontrollably out of" a woman's hand during surgery and "unbearable" pain afterward by saying "redheads bleed more," she claims in court.
Deborah Kossick woke up during surgery for carpal tunnel syndrome to see "blood pouring uncontrollably out of her hand and extremity, while there was chaos amongst the staff conducting the surgery, one of which kept yelling, 'we can't give her any more medication,'" she says in a complaint filed in Placer County Superior Court.
"Several days after the surgery, plaintiff was in unbearable and uncontrollable pain in her right hand," which was swollen and blackened, the complaint continues. Kossick says she "advised defendants that the pain was unbearable, and she believed that something had gone wrong during the surgery, as there was too much blood. Defendants advised plaintiff that she had nothing to worry about because 'redheads bleed more' than other patients."
At a follow-up appointment with her surgeon, Steven Hatton Ryder, M.D., a month after the operation, Kossick says she complained of continuing pain, swelling and discoloration of her hand. "Defendant showed no sympathy or concern whatsoever, and, instead, told her that there was nothing more he could do for her," the complaint says.
"To this date, plaintiff Deborah Kossick continues to be in an extreme amount of pain in her right hand, which is now permanent. The hand is also swollen and blackened, which will impact her ability to work and care for herself for the remainder of her life," according to the complaint.
Plaintiff seeks general, special and punitive damages, attorney's fees and costs of suit. Her husband, Robert Kossick, sued for loss of consortium. They are represented by David M. Poore of Brown Poore in Walnut Creek, Calif.
Patient: Kaiser Told Me 'Redheads Bleed More'
(Click link to see documents)
By BARBARA WALLACE
Courthouse News Service
August 05, 2013
ROSEVILLE, Calif. (CN) - Kaiser staff dismissed "blood pouring uncontrollably out of" a woman's hand during surgery and "unbearable" pain afterward by saying "redheads bleed more," she claims in court.
Deborah Kossick woke up during surgery for carpal tunnel syndrome to see "blood pouring uncontrollably out of her hand and extremity, while there was chaos amongst the staff conducting the surgery, one of which kept yelling, 'we can't give her any more medication,'" she says in a complaint filed in Placer County Superior Court.
"Several days after the surgery, plaintiff was in unbearable and uncontrollable pain in her right hand," which was swollen and blackened, the complaint continues. Kossick says she "advised defendants that the pain was unbearable, and she believed that something had gone wrong during the surgery, as there was too much blood. Defendants advised plaintiff that she had nothing to worry about because 'redheads bleed more' than other patients."
At a follow-up appointment with her surgeon, Steven Hatton Ryder, M.D., a month after the operation, Kossick says she complained of continuing pain, swelling and discoloration of her hand. "Defendant showed no sympathy or concern whatsoever, and, instead, told her that there was nothing more he could do for her," the complaint says.
"To this date, plaintiff Deborah Kossick continues to be in an extreme amount of pain in her right hand, which is now permanent. The hand is also swollen and blackened, which will impact her ability to work and care for herself for the remainder of her life," according to the complaint.
Plaintiff seeks general, special and punitive damages, attorney's fees and costs of suit. Her husband, Robert Kossick, sued for loss of consortium. They are represented by David M. Poore of Brown Poore in Walnut Creek, Calif.
Friday, August 2, 2013
Woman Blames Kaiser for Multi-Organ Failure
Woman Blames Kaiser for Multi-Organ Failure
By BARBARA WALLACE
Courthouse News Service
July 31, 2013
PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.
Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.
Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.
Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.
"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."
The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.
Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.
The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.
By BARBARA WALLACE
Courthouse News Service
July 31, 2013
PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.
Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.
Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.
Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.
"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."
The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.
Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.
The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.
Saturday, July 27, 2013
Infection Ate Shoulder, Kaiser Patient Claims
Infection Ate Shoulder, Kaiser Patient Claims
By TISH KRAFT
Courthouse News Service
July 25, 2013
ANNAPOLIS, Md. (CN) - Kaiser's failure to diagnose and treat a woman's oozing bone infection resulted in part of her shoulder being eaten away, she claims in Anne Arundel County Circuit Court. Billie Jo and Ron Bonolis have sued Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. and Mid-Atlantic Permanente Medical Group for malpractice and loss of consortium.
After Mrs. Bonolis had shoulder surgery, her Kaiser doctor thought she had an infection of the shoulder tissue for five months, when it actually was osteomyelitis, a bone infection, her complaint says. Within a month of the surgery, an MRI report suggested that the problem may be osteomyelitis, but no further testing was done, according to the complaint.
Three months after the surgery, and after several courses of antibiotics and attempts to clean out the surgical area, an infection consultant reported that a piece of bone used as an "anchor" during the surgery, was positive for MRSA, a "superbug" resistant to antibiotics, according to the complaint.
The infection had gone so long unchecked that it had eaten away the humoral head (the ball in the socket), and her new doctor was unable to estimate how many surgeries it would take to get rid of the painful infection, according to the complaint.
Once more of the bone had been removed to get rid of the infection, and Mrs. Bonolis was able to have her shoulder replaced, she went through a painful recovery and has suffered great mental anguish, in part due to knowing that she could have died from a superbug infection.
Mrs. Bonolis has a limited range of motion in her dominant arm and is no longer able to write normally, crochet, swim or take care of her grandchildren, among other things. Also, she needs help with personal hygiene, such as washing and combing her hair.
The new doctor told her it is unlikely that she will ever have full use of the right shoulder, the complaint says.
Roy L. Mason represents the plaintiffs, who are seeking $75,000.
By TISH KRAFT
Courthouse News Service
July 25, 2013
ANNAPOLIS, Md. (CN) - Kaiser's failure to diagnose and treat a woman's oozing bone infection resulted in part of her shoulder being eaten away, she claims in Anne Arundel County Circuit Court. Billie Jo and Ron Bonolis have sued Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. and Mid-Atlantic Permanente Medical Group for malpractice and loss of consortium.
After Mrs. Bonolis had shoulder surgery, her Kaiser doctor thought she had an infection of the shoulder tissue for five months, when it actually was osteomyelitis, a bone infection, her complaint says. Within a month of the surgery, an MRI report suggested that the problem may be osteomyelitis, but no further testing was done, according to the complaint.
Three months after the surgery, and after several courses of antibiotics and attempts to clean out the surgical area, an infection consultant reported that a piece of bone used as an "anchor" during the surgery, was positive for MRSA, a "superbug" resistant to antibiotics, according to the complaint.
The infection had gone so long unchecked that it had eaten away the humoral head (the ball in the socket), and her new doctor was unable to estimate how many surgeries it would take to get rid of the painful infection, according to the complaint.
Once more of the bone had been removed to get rid of the infection, and Mrs. Bonolis was able to have her shoulder replaced, she went through a painful recovery and has suffered great mental anguish, in part due to knowing that she could have died from a superbug infection.
Mrs. Bonolis has a limited range of motion in her dominant arm and is no longer able to write normally, crochet, swim or take care of her grandchildren, among other things. Also, she needs help with personal hygiene, such as washing and combing her hair.
The new doctor told her it is unlikely that she will ever have full use of the right shoulder, the complaint says.
Roy L. Mason represents the plaintiffs, who are seeking $75,000.
Monday, July 22, 2013
Kaiser's Obamacare rates surprise analysts
Kaiser's Obamacare rates surprise analysts
Kaiser Permanente has offered some of the highest rates in the California health exchanges next year. It denies that it is doing so to avoid treating many of the sickest newly insured patients.
By Chad Terhune
Los Angeles Times
June 12, 2013
Despite its higher rates, Kaiser Permanente said it wants to enroll a large number of people in the state exchange.
In California's new state-run health insurance market, Kaiser Permanente will cost you.
The healthcare giant has the highest rates in Southern California and some other areas of the state, surpassing rivals such as Anthem Blue Cross and other smaller competitors. The relatively high premiums from such a strong supporter of the federal healthcare law surprised industry analysts, and it has sparked considerable debate about the company's motives.
Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat. Others suspect Kaiser was worried that lower premiums would bring an influx of newly insured patients that could overwhelm its in-house roster of doctors and hospitals.
Making health insurance affordable is a crucial factor in the expansion of coverage to an estimated 5 million Californians — many of them lower-income and the uninsured — who will be eligible for a state-run exchange next year. Price will be paramount to many consumers, even for those who receive federal subsidies to help lower their costs.
In one key barometer of rates, Kaiser has the most expensive premiums for a 40-year-old in Los Angeles, Orange, San Bernardino and Riverside counties for a mid-level Silver plan. Statewide, the nonprofit company has the highest or second-highest premiums for a Silver plan in 12 of the 18 regions where it's selling HMO policies in Covered California, the state market that opens for enrollment Oct. 1.
Kaiser's Silver plan premium for a 40-year-old in southern Los Angeles County is $325 per month, 34% higher than the cheapest policy in the area, from Health Net Inc., at $242.
"Kaiser is not as low cost as many people think," said Glenn Melnick, a USC health policy professor. "They appear to be protecting themselves because the people signing up in the first year are likely to be the sickest ones."
For its part, Kaiser says it was as surprised as others were when the state announced the 13 winning health insurers and their proposed rates for 19 regions last month. These rates are scheduled to be finalized this month after a regulatory review. Individual premiums will vary based on people's age, location and family size.
Despite its higher rates, Kaiser said it wants to enroll a large number of people in the state exchange. It blamed its lackluster showing, in part, on rivals offering cheaper plans that give consumers far less choice of doctors and hospitals.
Blue Shield of California, for instance, is offering 36% of its physician network in Covered California plans.
"We were surprised to see some of the rates," said Bill Wehrle, Kaiser's vice president of health insurance exchanges. "We were surprised at what looked like very narrow networks from our competitors. We don't cut off any slice of our network."
Of course, for years Kaiser has served as a model for the limited networks other insurers are now rushing to adopt. Kaiser is a unique healthcare system because it operates its own hospitals, physician offices and insurance company for its 9 million members nationwide.
"Blue Shield or Anthem could be a little more selective in putting together a network for this new market. Kaiser is one size fits all," said Marian Mulkey, director of the health reform and public programs initiative at the California HealthCare Foundation. "The question now is will people find Kaiser attractive enough compared to their other options. This could put pressure on Kaiser to be less expensive."
Overall, Kaiser is the state's biggest health insurer with a 40% share of the market, according to 2011 data from Citigroup. Anthem Blue Cross, a unit of industry giant WellPoint Inc., was second with a 23% share of employer and individual customers.
More than 5 million Californians who don't get insurance through work are expected to participate in the state's new market. About half of those people will qualify for federal premium subsidies because they are low or moderate income.
Individuals earning up to about $46,000 a year and families making $94,000 or less will qualify for government help with their premiums. Even with that financial boost, however, most consumers are expected to look for the cheapest plans available.
"I think the lowest and second-lowest plans will really be attractive," said Lucien Wulsin, executive director of the Insure the Uninsured Project, a nonprofit research group in Santa Monica. "I'm sure being at the low end of the spectrum puts you more on the receiving end of everybody."
One of the bigger unknowns in the federal healthcare expansion is how many people will sign up initially and who will they be. Patients with preexisting medical conditions or chronic illnesses who have been denied insurance for years should be eager to enroll. Younger, healthier people may not see much reason to buy, content instead to pay a modest penalty.
Starting in January, most Americans must have health insurance or pay a fine. The penalty starts at $95 per adult or 1% of income, whichever is greater. The penalties increase over time.
"Kaiser has structured this so they don't get a lot of the poorer and potentially sicker people," said Steve Valentine, president of the Camden Group, an El Segundo healthcare consulting firm.
"Some people have been unemployed and underemployed for years, and they may have a lot of healthcare needs. There could be a lot of pent-up demand, and Kaiser may be trying to dodge that bullet," Valentine said.
For years, some consumer advocates have faulted Kaiser for not doing more for the state's poorest residents on Medi-Cal, the state Medicaid program, and for building many of its hospitals and medical offices in more affluent areas.
Kaiser defends its record of charity care and denies any effort to duck certain customers. Last year, the Oakland company said it provided care to more than 560,000 Californians enrolled in Medi-Cal and other safety-net programs.
"There is a lot of uncertainty about whether the healthy show up as well as the sick," Wehrle said. "We are very competitive on rates in some regions, which is a pretty strong indication we are not trying to avoid anything. There is no question we want to grow in the exchange, and I think we will."
Mulkey of the California HealthCare Foundation said Kaiser has regretted being the low-cost option at times in the past and being overrun by too many members at one time. Other insurers may have more flexibility to add doctors and hospitals to their network as enrollment builds.
Kaiser, on the other hand, could face the costly decision to contract with outside hospitals to absorb some of its overflow.
"We are focused on sustainable prices for the long haul," Wehrle said. "If you make a large mistake in this environment, it can be hard to recover."
Kaiser Permanente has offered some of the highest rates in the California health exchanges next year. It denies that it is doing so to avoid treating many of the sickest newly insured patients.
By Chad Terhune
Los Angeles Times
June 12, 2013
Despite its higher rates, Kaiser Permanente said it wants to enroll a large number of people in the state exchange.
In California's new state-run health insurance market, Kaiser Permanente will cost you.
The healthcare giant has the highest rates in Southern California and some other areas of the state, surpassing rivals such as Anthem Blue Cross and other smaller competitors. The relatively high premiums from such a strong supporter of the federal healthcare law surprised industry analysts, and it has sparked considerable debate about the company's motives.
Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat. Others suspect Kaiser was worried that lower premiums would bring an influx of newly insured patients that could overwhelm its in-house roster of doctors and hospitals.
Making health insurance affordable is a crucial factor in the expansion of coverage to an estimated 5 million Californians — many of them lower-income and the uninsured — who will be eligible for a state-run exchange next year. Price will be paramount to many consumers, even for those who receive federal subsidies to help lower their costs.
In one key barometer of rates, Kaiser has the most expensive premiums for a 40-year-old in Los Angeles, Orange, San Bernardino and Riverside counties for a mid-level Silver plan. Statewide, the nonprofit company has the highest or second-highest premiums for a Silver plan in 12 of the 18 regions where it's selling HMO policies in Covered California, the state market that opens for enrollment Oct. 1.
Kaiser's Silver plan premium for a 40-year-old in southern Los Angeles County is $325 per month, 34% higher than the cheapest policy in the area, from Health Net Inc., at $242.
"Kaiser is not as low cost as many people think," said Glenn Melnick, a USC health policy professor. "They appear to be protecting themselves because the people signing up in the first year are likely to be the sickest ones."
For its part, Kaiser says it was as surprised as others were when the state announced the 13 winning health insurers and their proposed rates for 19 regions last month. These rates are scheduled to be finalized this month after a regulatory review. Individual premiums will vary based on people's age, location and family size.
Despite its higher rates, Kaiser said it wants to enroll a large number of people in the state exchange. It blamed its lackluster showing, in part, on rivals offering cheaper plans that give consumers far less choice of doctors and hospitals.
Blue Shield of California, for instance, is offering 36% of its physician network in Covered California plans.
"We were surprised to see some of the rates," said Bill Wehrle, Kaiser's vice president of health insurance exchanges. "We were surprised at what looked like very narrow networks from our competitors. We don't cut off any slice of our network."
Of course, for years Kaiser has served as a model for the limited networks other insurers are now rushing to adopt. Kaiser is a unique healthcare system because it operates its own hospitals, physician offices and insurance company for its 9 million members nationwide.
"Blue Shield or Anthem could be a little more selective in putting together a network for this new market. Kaiser is one size fits all," said Marian Mulkey, director of the health reform and public programs initiative at the California HealthCare Foundation. "The question now is will people find Kaiser attractive enough compared to their other options. This could put pressure on Kaiser to be less expensive."
Overall, Kaiser is the state's biggest health insurer with a 40% share of the market, according to 2011 data from Citigroup. Anthem Blue Cross, a unit of industry giant WellPoint Inc., was second with a 23% share of employer and individual customers.
More than 5 million Californians who don't get insurance through work are expected to participate in the state's new market. About half of those people will qualify for federal premium subsidies because they are low or moderate income.
Individuals earning up to about $46,000 a year and families making $94,000 or less will qualify for government help with their premiums. Even with that financial boost, however, most consumers are expected to look for the cheapest plans available.
"I think the lowest and second-lowest plans will really be attractive," said Lucien Wulsin, executive director of the Insure the Uninsured Project, a nonprofit research group in Santa Monica. "I'm sure being at the low end of the spectrum puts you more on the receiving end of everybody."
One of the bigger unknowns in the federal healthcare expansion is how many people will sign up initially and who will they be. Patients with preexisting medical conditions or chronic illnesses who have been denied insurance for years should be eager to enroll. Younger, healthier people may not see much reason to buy, content instead to pay a modest penalty.
Starting in January, most Americans must have health insurance or pay a fine. The penalty starts at $95 per adult or 1% of income, whichever is greater. The penalties increase over time.
"Kaiser has structured this so they don't get a lot of the poorer and potentially sicker people," said Steve Valentine, president of the Camden Group, an El Segundo healthcare consulting firm.
"Some people have been unemployed and underemployed for years, and they may have a lot of healthcare needs. There could be a lot of pent-up demand, and Kaiser may be trying to dodge that bullet," Valentine said.
For years, some consumer advocates have faulted Kaiser for not doing more for the state's poorest residents on Medi-Cal, the state Medicaid program, and for building many of its hospitals and medical offices in more affluent areas.
Kaiser defends its record of charity care and denies any effort to duck certain customers. Last year, the Oakland company said it provided care to more than 560,000 Californians enrolled in Medi-Cal and other safety-net programs.
"There is a lot of uncertainty about whether the healthy show up as well as the sick," Wehrle said. "We are very competitive on rates in some regions, which is a pretty strong indication we are not trying to avoid anything. There is no question we want to grow in the exchange, and I think we will."
Mulkey of the California HealthCare Foundation said Kaiser has regretted being the low-cost option at times in the past and being overrun by too many members at one time. Other insurers may have more flexibility to add doctors and hospitals to their network as enrollment builds.
Kaiser, on the other hand, could face the costly decision to contract with outside hospitals to absorb some of its overflow.
"We are focused on sustainable prices for the long haul," Wehrle said. "If you make a large mistake in this environment, it can be hard to recover."
Wednesday, July 17, 2013
Transgender teen settles with Kaiser Permanente in landmark health case
Kaiser Permanente's motive was simple: any excuse to save money. Kaiser has narrow treatment guidelines that harm patients, not infrequently causing death, but save a fortune. This is the reason Kaiser, a non-profit company, makes billions in profits each year. Kaiser then channels these untaxed profits into its for-profit Permanente companies.
Transgender teen settles landmark health case
Posted on 17 July 2013
By Katie Kerwin McCrimmon
Healthypolicysolutions.org
FORT COLLINS — An 18-year-old college student who grew up as a girl and now identifies as a young man has settled a landmark civil rights case against Kaiser Permanente of Colorado.
In the rare case, the Colorado Civil Rights Commission found in March that there was probable cause that Miki Alexander Manigault suffered discrimination and unequal access to health care specifically because he is transgender. (Click here to read the determination of probable cause.)
On the same day, after pressure from advocates at One Colorado, Colorado’s Division of Insurance issued a bulletin and became the third state in the country to specifically bar health insurance companies from discriminating against people who are gay, lesbian, bisexual or transgender. (California and Oregon preceded Colorado. The District of Columbia also bans discrimination against LGBT patients and Vermont has since followed suit.)
Faced with charges of unequal treatment, Kaiser Permanente quietly settled Manigault’s case before it was slated to go to a hearing in June. Amy Whited, a spokeswoman for Kaiser Permanente, declined to discuss Manigault’s case. As a result of a settlement with the Civil Rights Commission, however, Kaiser, one of Colorado’s largest health insurance companies, has agreed to work with the commission to convene discussions among insurers regarding health care for transgender people.
Manigault’s case has already prompted at least one other complaint to the Civil Rights Commission and may open the doors for equal health care for LGBT patients in Colorado and elsewhere in the U.S. (Coming next week: read about Kelly Costello, another transgender person who has also filed a civil rights complaint.)
Manigault grew up as Michaela, a girl with irresistible Shirley Temple dimples who nonetheless loathed girly dresses. She has now evolved into Alex, a young man embracing the gender that he believes he was born with. It just never matched his body. Until now.
Alex finally had the chest reconstruction surgery that doctors deemed medically necessary but Kaiser previously failed to cover, according to the determination and complaint.
Alex and his family cannot discuss any details of his settlement with Kaiser. But the Colorado State University art major agreed to share his story of struggle and transformation.
Alex recently traveled to San Francisco to have an experienced surgeon remove his female breast tissue and sculpt a male chest.
They felt like tumors on my chest or phantom limbs,” Alex said of the female breasts, which he used to bind to try to flatten them.
He and his mom decided to bring the civil rights complaint and filed it in January of 2012, when Alex was just 17, because insurance companies provide all sorts of breast surgeries for other patients, including reconstruction for psychological well-being for cancer patients. It seemed fair to them that health insurance should also provide coverage that makes transgender people healthier.v “A lot of transgender people go through so much drama and so much heartache and waiting for years and sometimes decades to even talk about what it is they want and need,” said Alex. “When you can finally admit what you want and feel safe, then the insurance company tells you ‘No,’ and puts another obstacle in front of you, that’s wrong.
“I’m just as surprised as you that I’m transgender,” Alex says.
Alex credits his mom for being in his corner and pressing the case. Deborah Manigault is a civil rights law enforcement officer for the U.S. Department of Housing and Urban Development. So she knew how to file a civil rights complaint and felt it was clear that Alex deserved to win.
“These are not elective surgeries. They are medically necessary for their health, for their mental health and their medical well-being,” she said. “There are many insurance companies who are claiming to be LGBT-friendly, but they are denying coverage based on transgender status.” Alex has not decided how to proceed with what transgender people call bottom surgery. Many transgender people evolving from female to male don’t bother seeking a surgically created penis since the options are poor. Results are much better for males becoming female because an experienced surgeon can essentially tuck the penis into the body and retain sensation. Alex has been taking testosterone injections since his junior year of high school, so his voice is now deep and body hair has sprouted on his stomach and will fill his chest once it fully heals. Now a sophomore in college, he still thinks he looks somewhat feminine because of a long, graceful neck and fine cheekbones that any model would envy. But the testosterone he must inject every two weeks literally empowers him as it bulks up his muscles. In contrast to the famous “It Gets Better” campaign, http://www.itgetsbetter.org/ Alex says it doesn’t get better overnight. Still, he is no longer hiding from friends and the world, afraid to hear his own voice. At last, he is embracing his manhood. He is becoming Alex. ‘I didn’t want to be transgender’ Alex doesn’t remember a light bulb moment when he suddenly knew that he should have been a boy. Instead, growing up in Maryland and the conservative South, he remembers being a weird kid who could beat all the boys in running races, but never fit in. “I went through a long process of feeling I was different in some way and not knowing what that difference was,” Alex says. Way back, at age 2, Michaela was a flower girl in a relative’s wedding. An outgoing toddler, Michaela pitched a fit over wearing the poufy floral dress for the ceremony. At the time, Deborah Manigault attributed the tantrum to a 2-year-old’s fickle independence. Now Deborah wonders if it was an early sign that Michaela didn’t feel right in her body. As a fifth-grader, Michaela remembers once being teased by a group of classmates for not fitting in. She sought solace in a large cubby where she curled up and hid.
Transgender teen settles landmark health case
Posted on 17 July 2013
By Katie Kerwin McCrimmon
Healthypolicysolutions.org
FORT COLLINS — An 18-year-old college student who grew up as a girl and now identifies as a young man has settled a landmark civil rights case against Kaiser Permanente of Colorado.
In the rare case, the Colorado Civil Rights Commission found in March that there was probable cause that Miki Alexander Manigault suffered discrimination and unequal access to health care specifically because he is transgender. (Click here to read the determination of probable cause.)
On the same day, after pressure from advocates at One Colorado, Colorado’s Division of Insurance issued a bulletin and became the third state in the country to specifically bar health insurance companies from discriminating against people who are gay, lesbian, bisexual or transgender. (California and Oregon preceded Colorado. The District of Columbia also bans discrimination against LGBT patients and Vermont has since followed suit.)
Faced with charges of unequal treatment, Kaiser Permanente quietly settled Manigault’s case before it was slated to go to a hearing in June. Amy Whited, a spokeswoman for Kaiser Permanente, declined to discuss Manigault’s case. As a result of a settlement with the Civil Rights Commission, however, Kaiser, one of Colorado’s largest health insurance companies, has agreed to work with the commission to convene discussions among insurers regarding health care for transgender people.
Manigault’s case has already prompted at least one other complaint to the Civil Rights Commission and may open the doors for equal health care for LGBT patients in Colorado and elsewhere in the U.S. (Coming next week: read about Kelly Costello, another transgender person who has also filed a civil rights complaint.)
Manigault grew up as Michaela, a girl with irresistible Shirley Temple dimples who nonetheless loathed girly dresses. She has now evolved into Alex, a young man embracing the gender that he believes he was born with. It just never matched his body. Until now.
Alex finally had the chest reconstruction surgery that doctors deemed medically necessary but Kaiser previously failed to cover, according to the determination and complaint.
Alex and his family cannot discuss any details of his settlement with Kaiser. But the Colorado State University art major agreed to share his story of struggle and transformation.
Alex recently traveled to San Francisco to have an experienced surgeon remove his female breast tissue and sculpt a male chest.
They felt like tumors on my chest or phantom limbs,” Alex said of the female breasts, which he used to bind to try to flatten them.
He and his mom decided to bring the civil rights complaint and filed it in January of 2012, when Alex was just 17, because insurance companies provide all sorts of breast surgeries for other patients, including reconstruction for psychological well-being for cancer patients. It seemed fair to them that health insurance should also provide coverage that makes transgender people healthier.v “A lot of transgender people go through so much drama and so much heartache and waiting for years and sometimes decades to even talk about what it is they want and need,” said Alex. “When you can finally admit what you want and feel safe, then the insurance company tells you ‘No,’ and puts another obstacle in front of you, that’s wrong.
“I’m just as surprised as you that I’m transgender,” Alex says.
Alex credits his mom for being in his corner and pressing the case. Deborah Manigault is a civil rights law enforcement officer for the U.S. Department of Housing and Urban Development. So she knew how to file a civil rights complaint and felt it was clear that Alex deserved to win.
“These are not elective surgeries. They are medically necessary for their health, for their mental health and their medical well-being,” she said. “There are many insurance companies who are claiming to be LGBT-friendly, but they are denying coverage based on transgender status.” Alex has not decided how to proceed with what transgender people call bottom surgery. Many transgender people evolving from female to male don’t bother seeking a surgically created penis since the options are poor. Results are much better for males becoming female because an experienced surgeon can essentially tuck the penis into the body and retain sensation. Alex has been taking testosterone injections since his junior year of high school, so his voice is now deep and body hair has sprouted on his stomach and will fill his chest once it fully heals. Now a sophomore in college, he still thinks he looks somewhat feminine because of a long, graceful neck and fine cheekbones that any model would envy. But the testosterone he must inject every two weeks literally empowers him as it bulks up his muscles. In contrast to the famous “It Gets Better” campaign, http://www.itgetsbetter.org/ Alex says it doesn’t get better overnight. Still, he is no longer hiding from friends and the world, afraid to hear his own voice. At last, he is embracing his manhood. He is becoming Alex. ‘I didn’t want to be transgender’ Alex doesn’t remember a light bulb moment when he suddenly knew that he should have been a boy. Instead, growing up in Maryland and the conservative South, he remembers being a weird kid who could beat all the boys in running races, but never fit in. “I went through a long process of feeling I was different in some way and not knowing what that difference was,” Alex says. Way back, at age 2, Michaela was a flower girl in a relative’s wedding. An outgoing toddler, Michaela pitched a fit over wearing the poufy floral dress for the ceremony. At the time, Deborah Manigault attributed the tantrum to a 2-year-old’s fickle independence. Now Deborah wonders if it was an early sign that Michaela didn’t feel right in her body. As a fifth-grader, Michaela remembers once being teased by a group of classmates for not fitting in. She sought solace in a large cubby where she curled up and hid.
Thursday, June 27, 2013
State fines Kaiser $4 million for mental health violations
The California Department of Managed Health Care ignores almost all complaints from Kaiser patients, but this complaint came from Kaiser providers, so the DOMHC couldn't look the other way.California officials have fined healthcare giant Kaiser Permanente $4 million for problems related to patient access to mental health services.
State fines Kaiser $4 million for mental health violations
The California Department of Managed Health Care fined Kaiser Permanente $4 million Tuesday related to problems it found with patient access to mental health care.
Los Angeles Times
By Chad Terhune
June 25, 2013
California officials have fined healthcare giant Kaiser Permanente $4 million for problems related to patient access to mental health services.
The fine announced Tuesday stems from deficiencies the California Department of Managed Health Care identified in March that were found during a routine medical survey. This marks the agency's second-largest enforcement action after a $10 million fine against Anthem Blue Cross in 2008 related to improper policyholder cancellations.
"The Department's actions are a result of both the seriousness of the deficiencies and the failure of Kaiser to promptly correct them," said Brent Barnhart, director of the Department of Managed Health Care.
"The Department is taking this action to ensure that Kaiser promptly corrects these deficiencies and provides its patients with the mental healthcare promised to them by their health plan," Barnhart added.
State officials said Kaiser's problems covered a variety of issues affecting patients. It found that Kaiser needed to better track and monitor the availability of providers.
The health plan needs to ensure that appointments are offered in a timely manner and improvements to care are made when deficiencies are identified, according to the state investigation.
Regulators also said that Kaiser's educational materials and its "frequently asked questions" included inaccurate information that could dissuade a patient from seeking care.
John Nelson, a spokesman for Kaiser, said each of the state's findings "has already been corrected or is very far along toward resolution."
In light of that, the company said the "amount of the proposed penalty is unwarranted and excessive."
Agency officials said they would conduct a follow-up survey in October to ensure Kaiser has corrected the deficiencies and is complying with the law.
State fines Kaiser $4 million for mental health violations
The California Department of Managed Health Care fined Kaiser Permanente $4 million Tuesday related to problems it found with patient access to mental health care.
Los Angeles Times
By Chad Terhune
June 25, 2013
California officials have fined healthcare giant Kaiser Permanente $4 million for problems related to patient access to mental health services.
The fine announced Tuesday stems from deficiencies the California Department of Managed Health Care identified in March that were found during a routine medical survey. This marks the agency's second-largest enforcement action after a $10 million fine against Anthem Blue Cross in 2008 related to improper policyholder cancellations.
"The Department's actions are a result of both the seriousness of the deficiencies and the failure of Kaiser to promptly correct them," said Brent Barnhart, director of the Department of Managed Health Care.
"The Department is taking this action to ensure that Kaiser promptly corrects these deficiencies and provides its patients with the mental healthcare promised to them by their health plan," Barnhart added.
State officials said Kaiser's problems covered a variety of issues affecting patients. It found that Kaiser needed to better track and monitor the availability of providers.
The health plan needs to ensure that appointments are offered in a timely manner and improvements to care are made when deficiencies are identified, according to the state investigation.
Regulators also said that Kaiser's educational materials and its "frequently asked questions" included inaccurate information that could dissuade a patient from seeking care.
John Nelson, a spokesman for Kaiser, said each of the state's findings "has already been corrected or is very far along toward resolution."
In light of that, the company said the "amount of the proposed penalty is unwarranted and excessive."
Agency officials said they would conduct a follow-up survey in October to ensure Kaiser has corrected the deficiencies and is complying with the law.
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