Apparently, insurance companies don't want to let customers cancel policies.
"Kaiser, the state’s third largest provider, doesn’t allow users to post directly to its Facebook page. It’s also where some callers complained they were receiving a pre-recorded message that ended with a dial tone when they called customer service."
Sadly, long before the new health care law went into effect, Kaiser was preventing patients from making complaints.
DMOC isn't likely to do much. There's a long history between DMHC and Kaiser.
Health Insurance Complaints Skyrocket in CA
Having trouble reaching your health insurance company? You're not alone. State regulators say in January alone, they've seen a 53% jump in complaints, in part because calls about Covered California. A little known state hotline can help
By Vicky Nguyen, Felipe Escamilla, Liza Meak, and Scott Pham
NBC News
Apr 22, 2014
The Investigative Unit has learned complaints to state regulators have skyrocketed as people find themselves unable to reach anyone at several major health insurance companies. Vicky Nguyen reports in a video that aired on April 21, 2014.
Even if you aren’t one of the 1.2 million people signing up for Covered California, chances are you’re feeling the pinch when calling your insurance company. The Investigative Unit has learned complaints to state regulators have skyrocketed as people find themselves unable to reach anyone at several major health insurance companies.
For some health insurance companies, the influx of calls is so bad, they’re hanging up on customers after a pre-recorded message, while others put callers on hold indefinitely.
“I’ve been put on hold anywhere from 15-40 minutes,” said Don Tran, a full-time grad student at San Jose State.
Tran said he wanted to cancel his individual health plan with Blue Shield of California because he was eligible for less expensive coverage through his employer. But getting in touch with Blue Shield turned out to be much more difficult than he anticipated. “It’s been over a month and a half and I still haven’t been able to reach anybody,” Tran said.
Tran's story is a familiar one to Marta Green, spokeswoman for the California Department of Managed Health Care. The agency regulates [or at least, it collects a lot of money from the taxpayers in exchange for promising to regulate] health care plans and protects consumers.
“We have seen our call volume go up quite a bit,” Green said. She attributes much of the increase to the sudden spike in health insurance enrollment due to Covered California.
The rise in complaint volume was so extreme, the department began tracking the number of complaints from people who said they couldn't even reach their insurance providers.
“It was never an issue before this year,” Green said. But the department is only tracking “can’t reach plan” complaints for customers enrolled in Covered California. Of the roughly 1,000 complaints received between January and March of 2014, 1 in 10 people said they were trying to cancel or couldn’t reach their plan.
Green said there’s little consequence at this point for health plans that aren’t responsive to consumers. “If a health care plan is found to have violated the law, they can face enforcement action…[but] there is no specific law in relation to wait times.” Green said consumers can call, email or even send postal mail to the department regarding any issues with their health insurance. She said the department is committed to helping consumers resolve their problems, a process that can take anywhere from a day to a month.
“Every complaint we receive is investigated,” Green said. She encouraged consumers to call the department’s hotline, 1-888-466-2219, where they are guaranteed to reach a human being during business hours.
Don Tran took his complaint online, joining dozens of others NBC Bay Area found on social media, who are posting pictures of their wait times and airing their complaints on Facebook and Twitter. A check of the Facebook pages for the two largest providers in California—Anthem and Blue Shield – revealed new complaints daily.
Kaiser, the state’s third largest provider, doesn’t allow users to post directly to its Facebook page. It’s also where some callers complained they were receiving a pre-recorded message that ended with a dial tone when they called customer service.
“It’s a real hassle,” Tran said, adding that Blue Shield only responded after he posted several comments on social media. Now, more than 2 months later, he finally has his cancellation notice, but didn't get a reimbursement check until a few days ago.
Blue Shield of California spokesman Sean Barry said via email the company has expanded its customer service staff, adding, “We’re committed to delivering a high-quality customer experience. We have put several measures in place to reduce the delays in resolving issues by phone, receiving new ID cards and making payments.”
He directed customers to this customer service home page with a list of contacts to help resolve issues.
Darrel Ng echoed a similar sentiment. In an emailed statement, the Anthem Blue Cross spokesman said, “At the beginning of the year, hundreds of thousands of Californians were added to the insurance rolls on Jan. 1 as our nation’s health care delivery system went through a complete transformation. Because of that, in the first two business days of January, our company received a million calls nationally. Since then, we hired and trained hundreds of additional customer service agents and reassigned hundreds of other internal assets to assist on our phone lines. Through those efforts, the average hold time for customer service was under 3 minutes in March and is down to less than 90 seconds thus far in April.”
Kaiser Permanente spokesperson Karl Sonkin emailed this statement. "Prior to the deadline for Affordable Care Act Kaiser Permanente experienced a higher volume of calls to our Member Services Call Center during peak hours than we typically receive in the first part of the year, and that had resulted in longer than normal hold times. However, now that the enrollment deadline has passed our call volumes have returned to more typical levels and we are no longer experiencing delays."
[Maura Larkins' comment: This seem to be Kaiser's way of saying that patients will be experiencing the same treatment that they received for years before the Affordable Care Act.]
Showing posts with label Kaiser complaint process. Show all posts
Showing posts with label Kaiser complaint process. Show all posts
Tuesday, April 22, 2014
Saturday, June 16, 2012
Kaiser Foundation Hospital Overtime Pay Class Action Lawsuit
Kaiser Foundation Hospital Overtime Pay Class Action Lawsuit Complaint Filed On Behalf of Kaiser Site Support Specialists
JUNE 11, 2012
A class action lawsuit has been filed against Kaiser Foundation Hospitals, Inc., a subsidiary of Kaiser Permanente (“Kaiser Hospital” or “Defendant”) in the Superior Court for the State of California , County of Sacramento (captioned Jozette Lemmons v. Kaiser Foundation Hospitals, Inc., Class Action Case No. 34-2012-00125488) alleging, among other things, a failure to pay overtime wages in purported violation of Cal. Labor Code section 510, 1194 and 1198, failure to provide accurate itemized wage statements in purported violation of California Labor code section 226 and alleged unfair competition in purported violation of California Business and Professions code section 17200, according to the Kaiser Foundation Hospital Site Support Specialist Overtime Pay class action lawsuit complaint.
The Kaiser Foundation Hospital Site Support Specialist Overtime Pay class action lawsuit complaint is reportedly brought as a class action on behalf of the following proposed class (“Class”):
All individuals who are or previously were employed by Defendant Kaiser Foundation Hospitals, Inc., as Site Support Specialists in California classified as Non-Exempt and who worked on-call hours (“CALIFORNIA CLASS”) at any time during the period beginning on October 6, 2008 and ending on the date as determined by the Court (“CALIFORNIA CLASS PERIOD”).
The Kaiser Foundation Hospital Site Support Specialist Overtime Pay class action lawsuit complaint reportedly seeks, among other things, compensatory damages, injunctive relief, restitution, and pre-judgment and post-judgment interest.
JUNE 11, 2012
A class action lawsuit has been filed against Kaiser Foundation Hospitals, Inc., a subsidiary of Kaiser Permanente (“Kaiser Hospital” or “Defendant”) in the Superior Court for the State of California , County of Sacramento (captioned Jozette Lemmons v. Kaiser Foundation Hospitals, Inc., Class Action Case No. 34-2012-00125488) alleging, among other things, a failure to pay overtime wages in purported violation of Cal. Labor Code section 510, 1194 and 1198, failure to provide accurate itemized wage statements in purported violation of California Labor code section 226 and alleged unfair competition in purported violation of California Business and Professions code section 17200, according to the Kaiser Foundation Hospital Site Support Specialist Overtime Pay class action lawsuit complaint.
The Kaiser Foundation Hospital Site Support Specialist Overtime Pay class action lawsuit complaint is reportedly brought as a class action on behalf of the following proposed class (“Class”):
All individuals who are or previously were employed by Defendant Kaiser Foundation Hospitals, Inc., as Site Support Specialists in California classified as Non-Exempt and who worked on-call hours (“CALIFORNIA CLASS”) at any time during the period beginning on October 6, 2008 and ending on the date as determined by the Court (“CALIFORNIA CLASS PERIOD”).
The Kaiser Foundation Hospital Site Support Specialist Overtime Pay class action lawsuit complaint reportedly seeks, among other things, compensatory damages, injunctive relief, restitution, and pre-judgment and post-judgment interest.
Wednesday, December 21, 2011
CalPERS Lack of Auditing of Kaiser Permanente Services
Kaiser Permanent employees labor under a draconian contract which prevents any physician or nurse who witnesses abuse or abandonment from notifying anyone of the problem.
CalPERS Lack of Auditing of Kaiser Permanente Services
Resulting in Patient Abandonment, Violation of Elder Abuse Laws
Sacramento, California
12th of Jul, 2011 by User936345
In many ways, CalPERS does an excellent job for California State retirees. However, that description does not extend to the monitoring of Kaiser Permanente, and the many systems Kaiser has in place to frustrate the reporting of retiree abuse, and abandonment. Obviously, CalPERS wants to hear good stories about Kaiser. After all, they are providing service to tens of thousands of State and local retirees. How horrible would it be for CalPERS to discover that the lack of complaints is due to the clever methods Kaiser Permanente has established for sheltering CalPERS from what they "don't need to know."
So what are these mechanisms that prevent nary a complaint from ever reaching CalPERS? They are many, including:
-A Member Services "complaint" system that can often take several weeks, a system that serves to defuse patient anger, but never results in a decision favorable to a retiree. So-called "resolutions" are simply word for word transcriptions of rationales supplied by offending physicians. There is never a meeting with a supervisor. Never a contact from the physician. The "case worker" analyzing the complaint has no medical training because she does not need any, since the finding is a foregone conclusion.
-An appeals process for Member Services "resolutions" to a nameless committee in either the San Francisco Bay Area or Los Angeles. These committees meet in secret, and the names of the attendees are never divulged to patients or their medical representatives. Again, a case worker without medical training is in charge of the paperwork, and, again, the result is a foregone conclusion. (CalPERS could well paper their offices with the stacks of denials resulting from these secret meetings.)
-RISK MANAGEMENT units: These groups are composed primarily of attorneys who are organized for one purpose only. That is, to reduce the risk to Kaiser Permanente from any patient who has been abused or abandoned. In Northern California, one may find this unit at Kaiser Plaza in Oakland. At the local level, a physician is normally assigned to a so-called MedLegal to refer patient "complaints" to RISK MANAGEMENT for burial.
-Ombudsmen: On each Kaiser campus there exists an Ombudsman. These individuals are typically either non-medical personnel or RN's who are very charming, but will tell patients immediately that they have no power to correct problems relative to medical care. Ombudsmen on Kaiser campuses are not respected by medical personnel. At best, an Ombudsman might serve as a traffic cop. However, if a patient has been abandoned, he or she will stay abandoned. If a patient has been referred to RISK MANAGEMENT, he or she will stay referred to RISK MANAGEMENT.
-THE CONTRACT: Kaiser Permanent employees labor under a draconian contract which prevents any physician or nurse who witnesses abuse or abandonment from notifying anyone of the problem. HIPAA rules and regulations having to do with medical information confidentiality are used by Kaiser in the same way as "national security" is sometimes used by the government, that is, to frustrate the ability of witnesses to have their information considered by proper authorities. In such an environment, it is unlikely that CalPERS will ever hear from all but the most persistent patients. (Illness, discomfort and other factors also play into the inability of retirees to be heard by CalPERS.)
Requesting a more aggressive CalPERS relative to Kaiser Permanente is the first purpose of this complaint. The additional purpose of this complaint is to notify CalPERS that its own systems for receiving and taking action relative to medical malfeasance are deficient. A much more immediate and less impersonal system needs to be designed. A five to ten day turnaround time for all complaints is simply inadequate. Routine surprise audits also need to be conducted by CalPERS of all Kaiser Permanente facilities. Further, the rating systems associated with CalPERS relative to Kaiser Permanente are out of date, and serve only to mislead both active and retired personnel into choosing a service that, as it is currently structured, is dollars vs patient oriented. CalPERS actions taken as a result of this NOTICE will be appreciated by all patient advocates, as well as Kaiser employees who are in positions to witness, but not to openly challenge, a system established for other than patient well being. Kaiser Permanente is not a hopeless organization. However, CalPERS, which siphons millions of dollars into Kaiser coffers every year, must be more diligent in making certain that the intentions of CalPERS and the delivery systems hired to fulfill those intentions are congruous.
CalPERS Lack of Auditing of Kaiser Permanente Services
Resulting in Patient Abandonment, Violation of Elder Abuse Laws
Sacramento, California
12th of Jul, 2011 by User936345
In many ways, CalPERS does an excellent job for California State retirees. However, that description does not extend to the monitoring of Kaiser Permanente, and the many systems Kaiser has in place to frustrate the reporting of retiree abuse, and abandonment. Obviously, CalPERS wants to hear good stories about Kaiser. After all, they are providing service to tens of thousands of State and local retirees. How horrible would it be for CalPERS to discover that the lack of complaints is due to the clever methods Kaiser Permanente has established for sheltering CalPERS from what they "don't need to know."
So what are these mechanisms that prevent nary a complaint from ever reaching CalPERS? They are many, including:
-A Member Services "complaint" system that can often take several weeks, a system that serves to defuse patient anger, but never results in a decision favorable to a retiree. So-called "resolutions" are simply word for word transcriptions of rationales supplied by offending physicians. There is never a meeting with a supervisor. Never a contact from the physician. The "case worker" analyzing the complaint has no medical training because she does not need any, since the finding is a foregone conclusion.
-An appeals process for Member Services "resolutions" to a nameless committee in either the San Francisco Bay Area or Los Angeles. These committees meet in secret, and the names of the attendees are never divulged to patients or their medical representatives. Again, a case worker without medical training is in charge of the paperwork, and, again, the result is a foregone conclusion. (CalPERS could well paper their offices with the stacks of denials resulting from these secret meetings.)
-RISK MANAGEMENT units: These groups are composed primarily of attorneys who are organized for one purpose only. That is, to reduce the risk to Kaiser Permanente from any patient who has been abused or abandoned. In Northern California, one may find this unit at Kaiser Plaza in Oakland. At the local level, a physician is normally assigned to a so-called MedLegal to refer patient "complaints" to RISK MANAGEMENT for burial.
-Ombudsmen: On each Kaiser campus there exists an Ombudsman. These individuals are typically either non-medical personnel or RN's who are very charming, but will tell patients immediately that they have no power to correct problems relative to medical care. Ombudsmen on Kaiser campuses are not respected by medical personnel. At best, an Ombudsman might serve as a traffic cop. However, if a patient has been abandoned, he or she will stay abandoned. If a patient has been referred to RISK MANAGEMENT, he or she will stay referred to RISK MANAGEMENT.
-THE CONTRACT: Kaiser Permanent employees labor under a draconian contract which prevents any physician or nurse who witnesses abuse or abandonment from notifying anyone of the problem. HIPAA rules and regulations having to do with medical information confidentiality are used by Kaiser in the same way as "national security" is sometimes used by the government, that is, to frustrate the ability of witnesses to have their information considered by proper authorities. In such an environment, it is unlikely that CalPERS will ever hear from all but the most persistent patients. (Illness, discomfort and other factors also play into the inability of retirees to be heard by CalPERS.)
Requesting a more aggressive CalPERS relative to Kaiser Permanente is the first purpose of this complaint. The additional purpose of this complaint is to notify CalPERS that its own systems for receiving and taking action relative to medical malfeasance are deficient. A much more immediate and less impersonal system needs to be designed. A five to ten day turnaround time for all complaints is simply inadequate. Routine surprise audits also need to be conducted by CalPERS of all Kaiser Permanente facilities. Further, the rating systems associated with CalPERS relative to Kaiser Permanente are out of date, and serve only to mislead both active and retired personnel into choosing a service that, as it is currently structured, is dollars vs patient oriented. CalPERS actions taken as a result of this NOTICE will be appreciated by all patient advocates, as well as Kaiser employees who are in positions to witness, but not to openly challenge, a system established for other than patient well being. Kaiser Permanente is not a hopeless organization. However, CalPERS, which siphons millions of dollars into Kaiser coffers every year, must be more diligent in making certain that the intentions of CalPERS and the delivery systems hired to fulfill those intentions are congruous.
Wednesday, November 2, 2011
Filing a complaint with Kaiser Permanente Member Services
1 800 464 4000 Member Services Call Center
(* See below if your Kaiser email isn't working.)
Kaiser Permanente makes it hard to get through, but it's actually easy to file a complaint once you get to talk to a human being. You simply have to ignore all the little tricks they use to get you to hang up.
(Actually, sometimes you get an unhelpful person on the line. In that case, just call back and get a different person. One employee flat-out refused to take my complaint. I asked to talk to her supervisor, who was very helpful. One woman told me she would only take complaints going back three months. Usually they say six months. But if it's a continuing problem, you should describe recent events, then you would probably need to go back and explain the beginning of the problem.)
(Also, you can always fill out a grievance form. )
When I called Kaiser Permanente Member Services call center today, the recording said there were "extemely high volumes and wait times." Not true!
The truth was, I waited less than a minute to talk to someone once I had gone through all the menus.
Also, don't pay any attention when the recording tells you that you have punched in an incorrect Medical Record Number and 4-digit birthdate (month and year). Just ignore it. They are trying to get you to hang up and go away.
After you punch in your Medical Record Number and birthdate, there will be another menu to listen to. Making a complaint with Member Services won't be one of the options, but stay on the line. There will be a pause in the recorded menu making you think there are no more options. But if you keep holding, you will be told to press "0" to talk to someone to make your complaint.
The toll-free number is 1 800 464 4000.
KAISER PERMANENTE EMAIL NOT WORKING?
When I called Member Services to report that my Kaiser email wasn't working, Kaiser got me to hang up by means of a recorded message that suggested that the problem could be solved by clicking on a certain button. Not so. I believe that the message was just a trick to get people to go away.
I called back and reported the problem, and lo and behold, my email was working again within a few hours. Complaining can be very effective!
(* See below if your Kaiser email isn't working.)
Kaiser Permanente makes it hard to get through, but it's actually easy to file a complaint once you get to talk to a human being. You simply have to ignore all the little tricks they use to get you to hang up.
(Actually, sometimes you get an unhelpful person on the line. In that case, just call back and get a different person. One employee flat-out refused to take my complaint. I asked to talk to her supervisor, who was very helpful. One woman told me she would only take complaints going back three months. Usually they say six months. But if it's a continuing problem, you should describe recent events, then you would probably need to go back and explain the beginning of the problem.)
(Also, you can always fill out a grievance form. )
When I called Kaiser Permanente Member Services call center today, the recording said there were "extemely high volumes and wait times." Not true!
The truth was, I waited less than a minute to talk to someone once I had gone through all the menus.
Also, don't pay any attention when the recording tells you that you have punched in an incorrect Medical Record Number and 4-digit birthdate (month and year). Just ignore it. They are trying to get you to hang up and go away.
After you punch in your Medical Record Number and birthdate, there will be another menu to listen to. Making a complaint with Member Services won't be one of the options, but stay on the line. There will be a pause in the recorded menu making you think there are no more options. But if you keep holding, you will be told to press "0" to talk to someone to make your complaint.
The toll-free number is 1 800 464 4000.
KAISER PERMANENTE EMAIL NOT WORKING?
When I called Member Services to report that my Kaiser email wasn't working, Kaiser got me to hang up by means of a recorded message that suggested that the problem could be solved by clicking on a certain button. Not so. I believe that the message was just a trick to get people to go away.
I called back and reported the problem, and lo and behold, my email was working again within a few hours. Complaining can be very effective!
Saturday, October 15, 2011
California Medical Board goes easy on Kaiser Permanente Dr. Hamid Safari
See all posts re Dr. Hamid Safari.
Last January, federal health inspectors found that if the hospital had acted on complaints and kept a closer watch over its medical staff, the two babies might still be alive.
Medical Board of California dismisses accusations against Kaiser doctor
Perinatologist Hamid Safari had been accused of negligence in the deliveries of two babies who died in 2004 and 2005. A judge found that he complied with standards of care.
February 14, 2009
Jia-Rui Chong
Los Angeles Times
After a vigorous debate among experts, the state medical board this week dismissed accusations of negligence against a perinatologist at Kaiser Permanente's Fresno Medical Center who was involved in two tragic deliveries.
The Medical Board of California had accused Dr. Hamid Safari of mishandling the procedures. One child died in the delivery room in April 2005, and the other died months after her January 2004 birth.
Kaiser Plans Start @ $75Get Free Instant Quotes. Find Affordable Kaiser Permanente Plans! KaiserQuotes.com
The Times published a front-page story about the cases in October 2007, reporting that doctors and nurses had complained repeatedly to higher-ups about Safari's medical and interpersonal skills before the deliveries, according to internal documents, a lawsuit and interviews. Federal health inspectors subsequently faulted Kaiser Fresno's medical oversight.
In the medical board case, however, "the evidence established that the respondent complied with applicable standards of care," wrote Cheryl R. Tompkin, the administrative law judge who heard the case and recommended dismissal to the board.
The case pitted two sets of medical experts against each other in a debate over what precisely constituted the standard of care in complex deliveries.
In her written opinion, Tompkin said Safari could have kept better records establishing the patients' understanding of medical risks, but she did not see "any cause for discipline of the respondent's license." The board, which has final say on the discipline of doctors, adopted the verdict Tuesday.
Safari, who has been suspended from treating Kaiser patients for the last year, was relieved and gratified by the ruling, said his lawyer Stephen Schear.
"This is a complete vindication of Dr. Safari by a neutral, unbiased judge," Schear said. "I'm extremely happy to see justice really working."
The allegations have given rise to conflicting responses. Last January, federal health inspectors found that if the hospital had acted on complaints and kept a closer watch over its medical staff, the two babies might still be alive.
Although the Kaiser hospital suspended Safari from caring for patients, the affiliated physicians group continued to pay his salary.
The Times' story from October 2007 reported that Safari repeatedly and vigorously attempted to draw out a baby boy, a twin, with a vacuum extractor in 2005. The first twin had been delivered naturally, but the second died in the delivery room because of a severed spinal cord.
The year before, The Times reported, the doctor had waited more than three hours to do a cesarean section even though a baby girl was in distress and her family said they had been pleading for the procedure.
Obstetrician-gynecologists testifying for the medical board said that Safari made "extreme departure[s] from the standard of care" in the two cases.
But experts testifying on Safari's behalf argued that in the 2004 delivery, Safari could not force a patient to undergo a procedure against her will and the cesarean section was done in a "timely" manner. The judge accepted Safari's contention that he had recommended the C-section numerous times to the patient.
In the 2005 delivery, Safari's experts said, the doctor's use of the vacuum extractor was appropriate.
"The reasoning of [Safari's] experts is found to be persuasive," the judge wrote.
It is unusual for the board to dismiss an accusation. In the last two years, only about 3% have been dismissed, according to Debbie Nelson, associate analyst at the board.
Dr. Robert L. Rusche, one of the doctors who spoke against Safari, said he was stunned by the judge's decision.
Rusche retired in 2006 shortly after reporting Safari's actions to the medical board and, with a former colleague, has sued Kaiser for alleged retaliation.
The suit is expected to be settled soon, Rusche said.
He said he was not sorry for raising an alarm, noting that federal investigators backed up his group's claims.
"I'm concerned for patients' well-being," Rusche said. "The facts of the case speak for themselves. I'm not sure the facts were really understood at the judicial level."
Safari still faces two internal hearings at Kaiser to decide if his credentials as a Kaiser doctor should be revoked and whether his suspension is fair, Schear said.
"We're hoping the medical board decision will influence them to stop what they're doing and allow Dr. Safari to go back to work," Schear said.
A Kaiser spokeswoman said the company cannot discuss the internal proceedings involving Safari under California law but said it was reviewing the medical board decision.
"At this time the Medical Board's finding will not change Dr. Safari's status at Kaiser Permanente," said spokeswoman Gerri Ginsburg, in a statement. "Our internal processes adhere to different legal standards than that of the Medical Board, and there may be no implications."
Last January, federal health inspectors found that if the hospital had acted on complaints and kept a closer watch over its medical staff, the two babies might still be alive.
Medical Board of California dismisses accusations against Kaiser doctor
Perinatologist Hamid Safari had been accused of negligence in the deliveries of two babies who died in 2004 and 2005. A judge found that he complied with standards of care.
February 14, 2009
Jia-Rui Chong
Los Angeles Times
After a vigorous debate among experts, the state medical board this week dismissed accusations of negligence against a perinatologist at Kaiser Permanente's Fresno Medical Center who was involved in two tragic deliveries.
The Medical Board of California had accused Dr. Hamid Safari of mishandling the procedures. One child died in the delivery room in April 2005, and the other died months after her January 2004 birth.
Kaiser Plans Start @ $75Get Free Instant Quotes. Find Affordable Kaiser Permanente Plans! KaiserQuotes.com
The Times published a front-page story about the cases in October 2007, reporting that doctors and nurses had complained repeatedly to higher-ups about Safari's medical and interpersonal skills before the deliveries, according to internal documents, a lawsuit and interviews. Federal health inspectors subsequently faulted Kaiser Fresno's medical oversight.
In the medical board case, however, "the evidence established that the respondent complied with applicable standards of care," wrote Cheryl R. Tompkin, the administrative law judge who heard the case and recommended dismissal to the board.
The case pitted two sets of medical experts against each other in a debate over what precisely constituted the standard of care in complex deliveries.
In her written opinion, Tompkin said Safari could have kept better records establishing the patients' understanding of medical risks, but she did not see "any cause for discipline of the respondent's license." The board, which has final say on the discipline of doctors, adopted the verdict Tuesday.
Safari, who has been suspended from treating Kaiser patients for the last year, was relieved and gratified by the ruling, said his lawyer Stephen Schear.
"This is a complete vindication of Dr. Safari by a neutral, unbiased judge," Schear said. "I'm extremely happy to see justice really working."
The allegations have given rise to conflicting responses. Last January, federal health inspectors found that if the hospital had acted on complaints and kept a closer watch over its medical staff, the two babies might still be alive.
Although the Kaiser hospital suspended Safari from caring for patients, the affiliated physicians group continued to pay his salary.
The Times' story from October 2007 reported that Safari repeatedly and vigorously attempted to draw out a baby boy, a twin, with a vacuum extractor in 2005. The first twin had been delivered naturally, but the second died in the delivery room because of a severed spinal cord.
The year before, The Times reported, the doctor had waited more than three hours to do a cesarean section even though a baby girl was in distress and her family said they had been pleading for the procedure.
Obstetrician-gynecologists testifying for the medical board said that Safari made "extreme departure[s] from the standard of care" in the two cases.
But experts testifying on Safari's behalf argued that in the 2004 delivery, Safari could not force a patient to undergo a procedure against her will and the cesarean section was done in a "timely" manner. The judge accepted Safari's contention that he had recommended the C-section numerous times to the patient.
In the 2005 delivery, Safari's experts said, the doctor's use of the vacuum extractor was appropriate.
"The reasoning of [Safari's] experts is found to be persuasive," the judge wrote.
It is unusual for the board to dismiss an accusation. In the last two years, only about 3% have been dismissed, according to Debbie Nelson, associate analyst at the board.
Dr. Robert L. Rusche, one of the doctors who spoke against Safari, said he was stunned by the judge's decision.
Rusche retired in 2006 shortly after reporting Safari's actions to the medical board and, with a former colleague, has sued Kaiser for alleged retaliation.
The suit is expected to be settled soon, Rusche said.
He said he was not sorry for raising an alarm, noting that federal investigators backed up his group's claims.
"I'm concerned for patients' well-being," Rusche said. "The facts of the case speak for themselves. I'm not sure the facts were really understood at the judicial level."
Safari still faces two internal hearings at Kaiser to decide if his credentials as a Kaiser doctor should be revoked and whether his suspension is fair, Schear said.
"We're hoping the medical board decision will influence them to stop what they're doing and allow Dr. Safari to go back to work," Schear said.
A Kaiser spokeswoman said the company cannot discuss the internal proceedings involving Safari under California law but said it was reviewing the medical board decision.
"At this time the Medical Board's finding will not change Dr. Safari's status at Kaiser Permanente," said spokeswoman Gerri Ginsburg, in a statement. "Our internal processes adhere to different legal standards than that of the Medical Board, and there may be no implications."
Kaiser doctor Hamid Safari was accused of negligence but remains on the job
'No one would listen'
A TIMES INVESTIGATION
Kaiser doctor is accused of negligence but remains on the job
October 16, 200
Tracy Weber and Charles Ornstein
Los Angeles Times Staff Writers
Late one April night, the first of Sarah Valenzuela's twins arrived with little trouble, but the second stayed put.
Though the baby was not in distress, Kaiser Permanente perinatologist Hamid Safari attached a vacuum extractor to the boy's head to draw him out. Again and again he tugged, but still the baby would not come.
He vigorously shook the vacuum, up and down, side to side, according to government documents and hospital incident reports.
It took 90 minutes and six tries -- the last with Safari on his knees, pulling. Horrified staffers -- and the boy's father -- looked on as baby Devin finally emerged. His skin was a bloodless white, his neck elongated and floppy.
His spinal cord had been severed.
Safari lashed out at a nurse. "What did you do to that baby? I gave you a good baby," he said, according to a complaint letter the nurse sent to her union representative.
Staffers at the Fresno birthing center were devastated and angry -- and not just because of the twin lost that night in 2005.
Over the years, doctors and nurses repeatedly had complained to higher-ups -- including Kaiser's top medical officer in Northern and Central California -- about problems they saw in Safari's skills and behavior, according to interviews and documents.
This is a story not just of tragic medical outcomes, but of a health plan that did not prevent them.
A year before Devin's death, the doctor had waited more than three hours to do a Caesarean section even though the baby girl was in distress and her family said they had been pleading for the procedure, according to interviews and government records. She was severely deprived of oxygen and died months later.
As far back as 2002, a physician review committee at the hospital concluded that Safari provided "inappropriate" care and that his "conduct needed significant improvement," according to a lawsuit later filed by two of his peers.
Still, the doctor continues to work at Kaiser Fresno, practicing under restrictions that staffers say have not been explained to patients.
Regulators acted only recently. This July, the state Department of Managed Health Care fined Kaiser a record $3 million for its haphazard handling of complaints and physician errors throughout the state. Officials said in an interview that the Safari matter played a significant role in their decision to investigate the HMO's practices.
Late last month, the state medical board accused Safari of gross negligence, seeking to revoke or suspend his license.
The board also has faulted Kaiser, the nation's largest HMO with 6.5 million members in California. The health plan made the board's investigation of Safari "protracted and difficult" by providing incomplete medical records, a spokeswoman said.
Kaiser did not allow senior officials to be interviewed for this story -- and warned staffers at Kaiser Fresno not to talk, several said. In a statement, hospital administrator Susan Ryan said the HMO has cooperated with the medical board and is "committed to ensuring the safety of our patients."
In July 2005 -- three months after Devin's death -- Kaiser imposed its restrictions on Safari, barring him from performing vaginal deliveries and requiring him to be monitored by another physician or an advanced-practice nurse, Ryan said. The restrictions became permanent in April 2007. Kaiser and other hospitals typically do not notify patients of such actions, officials said.
Safari, 49, declined to comment. His lawyer, Stephen D. Schear, said the accusations are "completely unwarranted" and that Safari intends to challenge the medical board's action in a hearing. Safari, he said, has the support of many at the hospital and in his department.
"If you're doing thousands of high-risk deliveries over the years, it's almost inevitable that there's going to be some unfortunate cases where children die, where things don't go right," Schear said.
"You're talking about one minute maybe where he pulled too hard to try to extract this baby. . . . Just look at his whole record, 10 years."
But doctors and other staffers allege that Devin's death was the culmination of Safari's troubles, not a fluke.
"We do not feel that our perinatologist is competent," reads an August 2005 petition signed by eight of Safari's peers, about half of the ob-gyn department. "Over and over again he put our patients at risks and most recently with the undeniably terrible outcome."
Kaiser was "misleading our patients and the public" by advertising that it had a perinatalogist on staff even though his practice was restricted, said the petition, which was addressed to the hospital's medical director.
The petition, complaint letters, depositions and other documents used in preparation of this story are part of the ongoing lawsuit by the two doctors and arbitration cases against Kaiser, or have been provided to state regulators investigating Kaiser and Safari.
A TIMES INVESTIGATION
Kaiser doctor is accused of negligence but remains on the job
October 16, 200
Tracy Weber and Charles Ornstein
Los Angeles Times Staff Writers
Late one April night, the first of Sarah Valenzuela's twins arrived with little trouble, but the second stayed put.
Though the baby was not in distress, Kaiser Permanente perinatologist Hamid Safari attached a vacuum extractor to the boy's head to draw him out. Again and again he tugged, but still the baby would not come.
He vigorously shook the vacuum, up and down, side to side, according to government documents and hospital incident reports.
It took 90 minutes and six tries -- the last with Safari on his knees, pulling. Horrified staffers -- and the boy's father -- looked on as baby Devin finally emerged. His skin was a bloodless white, his neck elongated and floppy.
His spinal cord had been severed.
Safari lashed out at a nurse. "What did you do to that baby? I gave you a good baby," he said, according to a complaint letter the nurse sent to her union representative.
Staffers at the Fresno birthing center were devastated and angry -- and not just because of the twin lost that night in 2005.
Over the years, doctors and nurses repeatedly had complained to higher-ups -- including Kaiser's top medical officer in Northern and Central California -- about problems they saw in Safari's skills and behavior, according to interviews and documents.
This is a story not just of tragic medical outcomes, but of a health plan that did not prevent them.
A year before Devin's death, the doctor had waited more than three hours to do a Caesarean section even though the baby girl was in distress and her family said they had been pleading for the procedure, according to interviews and government records. She was severely deprived of oxygen and died months later.
As far back as 2002, a physician review committee at the hospital concluded that Safari provided "inappropriate" care and that his "conduct needed significant improvement," according to a lawsuit later filed by two of his peers.
Still, the doctor continues to work at Kaiser Fresno, practicing under restrictions that staffers say have not been explained to patients.
Regulators acted only recently. This July, the state Department of Managed Health Care fined Kaiser a record $3 million for its haphazard handling of complaints and physician errors throughout the state. Officials said in an interview that the Safari matter played a significant role in their decision to investigate the HMO's practices.
Late last month, the state medical board accused Safari of gross negligence, seeking to revoke or suspend his license.
The board also has faulted Kaiser, the nation's largest HMO with 6.5 million members in California. The health plan made the board's investigation of Safari "protracted and difficult" by providing incomplete medical records, a spokeswoman said.
Kaiser did not allow senior officials to be interviewed for this story -- and warned staffers at Kaiser Fresno not to talk, several said. In a statement, hospital administrator Susan Ryan said the HMO has cooperated with the medical board and is "committed to ensuring the safety of our patients."
In July 2005 -- three months after Devin's death -- Kaiser imposed its restrictions on Safari, barring him from performing vaginal deliveries and requiring him to be monitored by another physician or an advanced-practice nurse, Ryan said. The restrictions became permanent in April 2007. Kaiser and other hospitals typically do not notify patients of such actions, officials said.
Safari, 49, declined to comment. His lawyer, Stephen D. Schear, said the accusations are "completely unwarranted" and that Safari intends to challenge the medical board's action in a hearing. Safari, he said, has the support of many at the hospital and in his department.
"If you're doing thousands of high-risk deliveries over the years, it's almost inevitable that there's going to be some unfortunate cases where children die, where things don't go right," Schear said.
"You're talking about one minute maybe where he pulled too hard to try to extract this baby. . . . Just look at his whole record, 10 years."
But doctors and other staffers allege that Devin's death was the culmination of Safari's troubles, not a fluke.
"We do not feel that our perinatologist is competent," reads an August 2005 petition signed by eight of Safari's peers, about half of the ob-gyn department. "Over and over again he put our patients at risks and most recently with the undeniably terrible outcome."
Kaiser was "misleading our patients and the public" by advertising that it had a perinatalogist on staff even though his practice was restricted, said the petition, which was addressed to the hospital's medical director.
The petition, complaint letters, depositions and other documents used in preparation of this story are part of the ongoing lawsuit by the two doctors and arbitration cases against Kaiser, or have been provided to state regulators investigating Kaiser and Safari.
Saturday, October 1, 2011
Kaiser Permanente and the bizarre saga of Dr. Hamid Safari
What does it take to get Kaiser doctors to fall in line? In my experience, most doctors and administrators at Kaiser will do what they're told even if it harms patients.
My guess is that administrators pressured doctors to sign the second letter. Why? Because Kaiser could be held liable for patient deaths if one of their doctors was found to be unprofessional. Kaiser seems to have a knee-jerk response to criticism of Kaiser doctors: deny any problem, cover it up, and don't let reason or ethics interfere with decisions.
More about this letter can be found at The Kaiser Papers.
Hamid Safari: Kaiser tried to bribe baby-killing doctor
Kaiser Permanente Thrive Exposed
March 8th, 2008
[How do you like that? Only at Kaiser can you kill two babies and endanger countless others, only to be handed $2 million of member money to quietly resign. The pattern should be glaringly obvious by now. Kaiser always tries to lie and buy its way out of a scandal, and only does the right thing when its malfeasance becomes a media event. Note that even after Safari turned down the settlement, Kaiser still would have declined to suspend him if only CMS hadn't rejected the first plan of correction (pdf).]
From the Fresno Bee:
Kaiser doctor rejected a deal
Hospital offered beleaguered Safari $2 million to resign.
By Tracy Correa
Three months before Kaiser Permanente suspended a Fresno physician at the center of a state investigation into the deaths of two babies, the hospital offered him $2 million to resign.
Dr. Hamid Safari, who treated high-risk pregnancies, said he refused the Nov. 28 offer because he wanted to continue working and believes he has done nothing wrong.
“I have spent my life to be a perinatologist and help patients, mothers and babies. The money was not my intention or my goal in life,” Safari said.
Kaiser officials acknowledged that they have discussed a settlement with Safari, but would not confirm the $2 million figure. The hospital suspended the doctor last week.
“We have considered many alternatives over time regarding Dr. Safari leaving the organization, including settlement, because we believed it was in everyone’s best interest,” Linda Monte, interim senior vice president and area manager for Kaiser’s Fresno hospital, said in a written statement.
The doctor and his lawyer, Stephen Schear, said Kaiser buckled under the pressure of bad publicity. They also criticized Kaiser for telling reporters about the suspension.
Schear said Safari was not interested in taking any amount of money in exchange for his career.
“Our counteroffer was to sit down and work things out so he could continue to treat patients at Kaiser Fresno,” he said.
Safari said a Kaiser representative showed up at his home about 5 p.m. on Feb. 29 and handed over a letter stating that he was suspended, effective immediately. He had been off that day for his deposition in a lawsuit filed by two Kaiser doctors who said they were retaliated against by hospital administration for questioning Safari’s competence.
The suspension followed months of criticism and public pressure on the doctor and Kaiser Permanente since details of the deaths — in 2004 and 2005 — became public late last year.
In September, the California Medical Board accused Safari of gross negligence — charges that could lead to loss of his California medical license. A hearing is pending.
In 2004, Safari waited more than three hours before performing a Caesarean section on a patient even though the baby was in distress, according to the accusation. The baby girl, who was deprived of oxygen, died 10 months later.
The other case occurred in 2005, when Safari allegedly severed the spinal cord of a baby boy, a twin, in what has been described by investigators in documents as a brutal delivery.
Medical staff and nurses have said they had raised questions about Safari’s competence but hospital administration failed to act.
Drs. Gilbert Moran and Robert Rusche are now suing Kaiser for retaliating against them after they complained about Safari.
Safari, in turn, accuses Moran — the former head of the OB/GYN department — and Rusche of complaining to the state medical board as part of a vendetta against him. He said they did so after he complained to superiors that one of the doctors was abusing his power on a quality review committee to go after doctors he didn’t like.
In January, federal health officials issued a critical 68-page report following an investigation into the situation. The report suggested that if Safari had been monitored more closely, the deaths might have been prevented.
Days later, Susan Ryan, the hospital’s then-top administrator, stepped down.
Schear said the bad publicity had become too much and Kaiser was determined to get rid of Safari. He also said that even though the doctor is suspended, he is collecting his Kaiser paycheck and is still entitled to due process, involving hearings and appeals, that can take months or years.
Schear said the $2 million settlement offer was an attempt to quickly disassociate the hospital from Safari and shortcut that process.
Schear provided The Bee a copy of a Nov. 28 letter from a Los Angeles law firm he said represented Kaiser. He blanked out all but one passage in the letter, which reads, “Kaiser will pay Dr. Safari $2 million, provided Dr. Safari complies with all conditions set forth herein.”
Schear said the letter also set forth conditions, including a confidentiality agreement and a pledge that Safari wouldn’t sue Kaiser.
“The essence was, you leave and we give you the money,” Schear said.
He said $2 million was a starting point and that the offer came “with indications they would pay him significantly more than that if he immediately resigned.”
Schear said he believes Kaiser moved to suspend Safari because it doesn’t think the medical board will end up revoking his license when all the facts come out.
“They just decided to throw him overboard,” Schear said.
Safari said he has performed well in recent months and that there have been no reports of any problems since 2005. He said his patient satisfaction rates are the highest they have ever been and only eight Kaiser patients have asked to be reassigned to another doctor.
“I think the action [suspension] was taken because he’s performing too well and building up a track record,” Schear said. “The longer he goes without problems, the harder it is to get rid of him.”
Safari now serves primarily as a consultant in high-risk births. Kaiser restricted Safari in July 2005 from performing vaginal deliveries and made the restrictions permanent in April 2007.
Doc’s credentials terminated due to negligence
21 October, 2010
fresnobee.com on October 18, 2010 reported that Kaiser Permanente in Fresno has terminated the hospital privileges and credentials of Dr. Hamid Safari after a nearly three-year fight by the beleaguered perinatologist to keep his job following allegations of negligence. Kaiser’s action comes despite the California Medical Board’s decision last year to clear Safari of negligence related to the deaths of two babies in 2004 and 2007.
My guess is that administrators pressured doctors to sign the second letter. Why? Because Kaiser could be held liable for patient deaths if one of their doctors was found to be unprofessional. Kaiser seems to have a knee-jerk response to criticism of Kaiser doctors: deny any problem, cover it up, and don't let reason or ethics interfere with decisions.
More about this letter can be found at The Kaiser Papers.
Hamid Safari: Kaiser tried to bribe baby-killing doctor
Kaiser Permanente Thrive Exposed
March 8th, 2008
[How do you like that? Only at Kaiser can you kill two babies and endanger countless others, only to be handed $2 million of member money to quietly resign. The pattern should be glaringly obvious by now. Kaiser always tries to lie and buy its way out of a scandal, and only does the right thing when its malfeasance becomes a media event. Note that even after Safari turned down the settlement, Kaiser still would have declined to suspend him if only CMS hadn't rejected the first plan of correction (pdf).]
From the Fresno Bee:
Kaiser doctor rejected a deal
Hospital offered beleaguered Safari $2 million to resign.
By Tracy Correa
Three months before Kaiser Permanente suspended a Fresno physician at the center of a state investigation into the deaths of two babies, the hospital offered him $2 million to resign.
Dr. Hamid Safari, who treated high-risk pregnancies, said he refused the Nov. 28 offer because he wanted to continue working and believes he has done nothing wrong.
“I have spent my life to be a perinatologist and help patients, mothers and babies. The money was not my intention or my goal in life,” Safari said.
Kaiser officials acknowledged that they have discussed a settlement with Safari, but would not confirm the $2 million figure. The hospital suspended the doctor last week.
“We have considered many alternatives over time regarding Dr. Safari leaving the organization, including settlement, because we believed it was in everyone’s best interest,” Linda Monte, interim senior vice president and area manager for Kaiser’s Fresno hospital, said in a written statement.
The doctor and his lawyer, Stephen Schear, said Kaiser buckled under the pressure of bad publicity. They also criticized Kaiser for telling reporters about the suspension.
Schear said Safari was not interested in taking any amount of money in exchange for his career.
“Our counteroffer was to sit down and work things out so he could continue to treat patients at Kaiser Fresno,” he said.
Safari said a Kaiser representative showed up at his home about 5 p.m. on Feb. 29 and handed over a letter stating that he was suspended, effective immediately. He had been off that day for his deposition in a lawsuit filed by two Kaiser doctors who said they were retaliated against by hospital administration for questioning Safari’s competence.
The suspension followed months of criticism and public pressure on the doctor and Kaiser Permanente since details of the deaths — in 2004 and 2005 — became public late last year.
In September, the California Medical Board accused Safari of gross negligence — charges that could lead to loss of his California medical license. A hearing is pending.
In 2004, Safari waited more than three hours before performing a Caesarean section on a patient even though the baby was in distress, according to the accusation. The baby girl, who was deprived of oxygen, died 10 months later.
The other case occurred in 2005, when Safari allegedly severed the spinal cord of a baby boy, a twin, in what has been described by investigators in documents as a brutal delivery.
Medical staff and nurses have said they had raised questions about Safari’s competence but hospital administration failed to act.
Drs. Gilbert Moran and Robert Rusche are now suing Kaiser for retaliating against them after they complained about Safari.
Safari, in turn, accuses Moran — the former head of the OB/GYN department — and Rusche of complaining to the state medical board as part of a vendetta against him. He said they did so after he complained to superiors that one of the doctors was abusing his power on a quality review committee to go after doctors he didn’t like.
In January, federal health officials issued a critical 68-page report following an investigation into the situation. The report suggested that if Safari had been monitored more closely, the deaths might have been prevented.
Days later, Susan Ryan, the hospital’s then-top administrator, stepped down.
Schear said the bad publicity had become too much and Kaiser was determined to get rid of Safari. He also said that even though the doctor is suspended, he is collecting his Kaiser paycheck and is still entitled to due process, involving hearings and appeals, that can take months or years.
Schear said the $2 million settlement offer was an attempt to quickly disassociate the hospital from Safari and shortcut that process.
Schear provided The Bee a copy of a Nov. 28 letter from a Los Angeles law firm he said represented Kaiser. He blanked out all but one passage in the letter, which reads, “Kaiser will pay Dr. Safari $2 million, provided Dr. Safari complies with all conditions set forth herein.”
Schear said the letter also set forth conditions, including a confidentiality agreement and a pledge that Safari wouldn’t sue Kaiser.
“The essence was, you leave and we give you the money,” Schear said.
He said $2 million was a starting point and that the offer came “with indications they would pay him significantly more than that if he immediately resigned.”
Schear said he believes Kaiser moved to suspend Safari because it doesn’t think the medical board will end up revoking his license when all the facts come out.
“They just decided to throw him overboard,” Schear said.
Safari said he has performed well in recent months and that there have been no reports of any problems since 2005. He said his patient satisfaction rates are the highest they have ever been and only eight Kaiser patients have asked to be reassigned to another doctor.
“I think the action [suspension] was taken because he’s performing too well and building up a track record,” Schear said. “The longer he goes without problems, the harder it is to get rid of him.”
Safari now serves primarily as a consultant in high-risk births. Kaiser restricted Safari in July 2005 from performing vaginal deliveries and made the restrictions permanent in April 2007.
Doc’s credentials terminated due to negligence
21 October, 2010
fresnobee.com on October 18, 2010 reported that Kaiser Permanente in Fresno has terminated the hospital privileges and credentials of Dr. Hamid Safari after a nearly three-year fight by the beleaguered perinatologist to keep his job following allegations of negligence. Kaiser’s action comes despite the California Medical Board’s decision last year to clear Safari of negligence related to the deaths of two babies in 2004 and 2007.
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