Kaiser Permanente is attempting to compel arbitration in the Arce vs. Kaiser autism lawsuit. Why? Because arbitration is a closed proceeding that is rigged in KP’s favor, of course! We don’t know what this would mean for the class action portion of the case, but hopefully someone with a more brilliant legal mind than ours will explain in the comments.

Warning, these are large PDF files:

• Notice of Hearing and Petition to Compel Arbitration of Kaiser Foundation Health Plan, Inc.
• Notice of Demurrer and Demurrer of Kaiser Foundation Health Plan, Inc. to First Amended Complaint’s Inarbitrable Class Claims
• Request for Judicial Notice in Support of Kaiser Foundation Health Plan, Inc’s Demurrer to Non-Arbitrable UCL Injunctive Relief Claims

What we would really like to see is a lawsuit questioning the legality of forced mandatory binding arbitration, and legislation expressly prohibiting corporations from compelling consumers to arbitrate. Why should individuals be bound involuntarily to a legal ‘remedy’ that most corporations wouldn’t agree to themselves?

According to GiveMeBackMyRights.com’s FAQ :

Do companies use binding mandatory arbitration in their own disputes with other companies?

No, most refuse to use binding mandatory arbitration in their own business dealings. As a matter of fact, car dealers were so afraid of mandatory arbitration for their own disagreements that they spent millions lobbying Congressmen and Senators to pass a federal law that prohibits automobile manufacturers from requiring binding mandatory arbitration in disputes related to dealership franchise clauses. The law passed in 2002.

The United States of America: Government of the Corporations, by the Corporations, for the Corporations…

Previously:

California attorney seeking plaintiffs for autism class action

LA Times covers Kaiser’s refusal to pay for autism treatment

In April we posted a request from California attorney Scott Glovsky, who is seeking plaintiffs for a class action lawsuit against Kaiser Permanente for refusing to cover treatments for autism as required by law. The lawsuit — which was filed on behalf of Andrew Arce, a two-year-old child Kaiser has denied treatment — alleges breach of contract, bad faith, and unfair dealing, and is seeking class action status on the third complaint. (Read the recently amended lawsuit here).

In the Sunday, July 6th Los Angeles Times, Lisa Girion tells Andrew’s story:

An explosion in the number of children diagnosed has parents, insurers and state and private institutions battling over coverage. The case of Andrew Arce is a window into the conflict.

By the time Andrew Arce was 15 months old, his parents suspected he was autistic.

He refused to cuddle, flapped his arms and stared into space a lot. On occasion, he picked at his nose until it drew blood and, with it, smeared the walls of the family’s Pasadena town house.

It was nearly a year, Guillermo Arce said, before Kaiser Permanente, the family’s healthcare provider, confirmed their fears. The diagnosis wasn’t much help, though. Kaiser refused to provide most of the treatment that specialists said Andrew needed — until the state ordered it to in April.

Read the full LA Times story.

Always true to form, Kaiser’s PRBS response not only denies all responsibility, but the creeps actually have the nerve to characterize themselves as “leaders” in the field of autism treatment after being found in violation by regulators. This is beyond disgusting, and a completely heartless and unnecessary slap in the face to the families whose children have been victimized.

Just once we would like to see Kaiser decline to add insult to injury by accepting responsibility for wrongdoing and making amends, but of course we won’t be holding our breath.

Previously:

California attorney seeking plaintiffs for autism class action

More:

From the Los Angeles Daily Journal: Families of Autistic Children, Insurers Battle Over Coverage

SAN FRANCISCO, June 5 /PRNewswire/ — Jeffery Sterman, Public Affairs Director and voice of Kaiser Permanente in San Francisco for ten years is claiming AIDS discrimination and breach of contract. A person with AIDS, Sterman is one of those who helped create the hospital’s response to HIV and AIDS.

David J. St. Louis, Sterman’s attorney, filed the action in California Superior Court in San Francisco and Kaiser Foundation Health Plan was served June 3, 2008.

The lawsuit details how Kaiser Foundation Hospital and Health Plan created a culture where employees are physically harmed and patient care compromised. Workloads are increased. Staffs are reduced. Humiliation and pressure became part of the working experience. Staffs experienced burnout from working 60 to 80 hours, often seven days a week, for an organization in constant crisis mode. Sterman’s Kaiser Permanente doctors said the hostile work environment affected his health.

They are charged with violation of Title VII of the United States Code, the California Fair Employment and Housing Act, the Americans with Disabilities Act and Article I, Section 8 of the California Constitution.

Sterman said, “The current toxic corporate culture is the antithesis of the Thrive marketing plan and the quality of patient care being compromised.”

Turnover of executives is staggering. “In nine years, San Francisco had six Senior Vice Presidents/Area Managers and two interim Senior Vice Presidents/Area Managers. Of those, three are still there, three were fired, two “retired”.

Problems with the Renal Transplant Program in San Francisco caused record fines after the California Department of Managed Care noted significant management deficiencies.

Sterman is a pioneer in the fight against AIDS. Diagnosed with AIDS in 1983, he founded Continuum HIV Day Services in 1987. He was responsible for first Congressional Field Hearing on AIDS and minorities. Joined Kaiser Permanente’s HIV Advisory Board in 1992 to bridge the gap between activists and medical center staff.

Unlike colleagues, the Americans with Disabilities Act, provides protection to speak out.

“It is unfortunate that employees are being physically harmed by Kaiser’s toxic work environment. It belittles the promise of Kaiser’s multi million dollar Thrive marketing campaign,” he said.

Our apologies for the dearth of updates lately, but by no means does our temporary silence indicate that the Kaiser Krappola hasn’t continued to hit the fan. There’s too much to post individually, so please enjoy this Kaiser Permanente News Roundup:

• Now that Kaiser has completed the nationwide roll out of the outpatient side of its HealthConnect electronic medical record, studies like this one, that exploit electronic patient health data (without your permission) will become more commonplace.
• Victim of Kaiser’s disgraced kidney transplant program, Bernard Burks, has won the right to have his lawsuit heard by a jury in a court of law, rather than in Kaiser’s rigged closed arbitration system. Besides justice for Mr. Burks, what we’re looking most forward to is the rare opportunity to spotlight Kaiser lawyer dirty tricks, which will be publicly available in the transcripts.
• Kaiserquotes(dot)com continues its paid blog post spam campaign with the intention of gaming the search engines. Google doesn’t care yet, but that will change if everyone with a Webmaster Tools account reports the paid links, which are against Google’s rules.
• According to the Wall Street Journal, KP is one of many medical facilities reusing single-use medical devices against the advice of manufacturers, who claim the instruments “pose a higher risk of failure and harm when recycled.”
• Yet another used and abused member is Sick and Tired of Kaiser Permanente!
• Members are fleeing Kaiser’s HMO for KP’s new high-deductible and coinsurance health plans. CEO George Halvorson — as usual — misses the point.
• The Los Angeles Times reports that Area Kaiser patients [are] less satisfied than many at other hospitals. Funny how that only happens when Kaiser doesn’t control the survey results.
• In Conscientious Health Insurance Company-an Oxymoron, Tam strongly reminds us why we must “QUESTION EVERYTHING FROM YOUR INSURANCE COMPANY. THEY AREN’T IN IT TO TAKE CARE OF YOU, THEY ARE IN IT FOR THE MONEY.”
• Hospital Stays Vary Less in Kaiser Permanente Hospitals than Others in California. Kaiser’s PR department thinks this is a good thing worth bragging about in a press release. We say it’s more evidence of Kaiser’s meat-market brand of one-size-fits-all medicine.
• NBC11 Investigates Mammography Violations, including several at Kaiser Novato and other Bay Area facilities.
• Kaiser’s cover up of the death of Beth Stover’s baby made the front page of the April 29th issue of USA Today. As a result of the article Ms. Stover was asked to give testimony before Congress on May 13th, as a part of Whistleblower’s Week (transcripts to follow in a later post). Thankfully, Kaiser wasn’t aware of the testimony, which prevented them from interfering. The complete story behind Lehna Brewer’s death can be found here.
• Kaiser CEO George Halvorson inserts foot in mouth.
• Kaiser Colorado opposes a bill that would stop insurers from paying doctors to switch drugs.
• Kaiser plants another visionary leader shill on a government health care advisory committee.
• Kaiser’s 1st quarter 2008 net income drops 64%, while membership remains flat.
• A Kaiser pharmacist was sentenced to six months in jail for stealing medications from Kaiser pharmacies in Maryland.
• 6000 Kaiser members have been put in the middle of a billing dispute between Kaiser Permanente and Prime Health Care. It’s almost fun to watch the two criminal organizations battling it out, but not when the only casualties are the innocent patients.
• Kaiser surgeon, Bruce Barker, has been sentenced to six months in prison for perjuring himself in the trial of a young man who was accused of illegally possessing a gun. Note that the word “former” is missing from the line about Barker’s employment at KP, which tells us that a perjury conviction isn’t grounds for dismissal. A later article claims he was only suspended. Scary.
• In If I wasn’t laughing I’d be screaming: Trying to get treated at Kaiser Permanente (Part II), Red Storm brings us up to date on her ongoing struggle to obtain necessary medical care at Kaiser.
• Anyone who still doubts that Kaiser Permanente physicians and the health plan are one and the same — which creates a conflict of interest so big you could drive an ambulance through it — should find those doubts forever put to rest by recent news that Kaiser doctors in Colorado are now making sales calls to potential members on behalf of the health plan.
• The California Department of Managed Health Care has levied a $300,000 fine, and ordered Kaiser to reinstate coverage to over 1,000 members who had their policies illegally rescinded between 2004 and 2006. As usual, Kaiser’s PRBS release attempts to make it all sound voluntary, but Jerry Flanagan of Consumer Watchdog points out that in the end, patients are still screwed.

Now this is funny. It’s rare that we post something that isn’t Kaiser related, but this extremely humorous political ad for Senator Ron Wyden’s Healthy Americans Act is about universal health care, which we strongly support.

While we would prefer a single-payer universal health care plan that cuts insurance company bureaucracy and greed out of the picture completely, we have our doubts that it is politically possible at this point in time. Wyden’s plan for guaranteed portable insurance coverage for all is a good start because it puts the “free” (as in freedom) back in free market. What universal health care opponents have long refused to acknowledge, is that there is no free market in health care when people are tied to jobs they hate just to keep their health coverage; or when they can’t change plans regardless of how poorly they are treated, because their employer only offers Kaiser.

Our sympathies go out to Kaiser employees everywhere, who not only have to work for a huge, uncaring corporate bureaucracy, but have to receive their health care there too.

For more information visit CareYouKeep.com

On 04/08/2008 a lawsuit was filed against Kaiser Permanente in Los Angeles Superior Court, on behalf of a two-year-old child that Kaiser has refused to treat for autism. The lawsuit accuses Kaiser of breach of contract, bad faith, unfair dealing, and is seeking class action status on the third complaint. As a result of the case, the DMHC is conducting a massive investigation into Kaiser’s practice of dumping all autistic children onto the government for care, and shifting its financial obligation onto taxpayers.

As one reader explained in this comment on another post:

Kaiser is required to treat Autism by statutory and contractual obligation, but on the other hand they claim not to cover any of the treatments for Autism in violation of the law. Their contract specifically provides for the treatment of Autism. However, the “treatment” that Kaiser offered the baby was two OT sessions a month, one visit with the Psychiatrist (no follow ups), and an assessment every three months. I wonder-what are they going to assess if there are no treatments offered?

All parents who feel Kaiser may have unfairly denied their child’s treatment for Autism are requested to contact attorney Scott Glovsky at sglovsky@arkinglovsky.com.

[Kaiser's PR statement about halfway through this article is interesting, as usual, because of what it doesn't say. They only stopped illegally rescinding policies in 2006 because they were caught and fined for it. The DMHC is now conducting a more in depth investigation that will reveal the illegal practice for what it is: standard operating procedure at KP and most other insurers.]

From the AP via San Jose Mercury News:

3 insurance companies to have dropped policies reviewed

By SHAYA TAYEFE MOHAJER Associated Press Writer

LOS ANGELES–Three of the state’s largest health insurance companies could be forced to reinstate thousands of dropped policies after a state regulatory agency on Thursday ordered an independent review.

The Department of Managed Health Care ordered the review of dropped policies the last four years by Kaiser Permanente, Anthem Blue Cross and Blue Shield of California.

A partial review of the three companies found that 26 people had been improperly dropped, said agency director Cindy Ehnes. Their policies were ordered reinstated immediately, and the insurance companies were also ordered to reimburse medical costs incurred after their insurance was dropped.

The cases were found in a random review of 286 cases and were “so clearly wrong that they needed to be reinstated right away,” Ehnes said.

Ten were Kaiser Permanente customers, eight from Anthem Blue Cross and eight from Blue Shield of California.

In a statement, Anthem Blue Cross said, “It is important to clarify that the survey found only a relatively small number of rescissions reviewed were improper.”

Kaiser Permanente issued a similar release, adding that the company had suspended the practice of rescissions since October 2006, and was “awaiting clear guidelines from the state.”

The California Association of Health Plans, a trade association representing 40 full-service health plans, issued a statement saying many insurers had made efforts in recent years to self-regulate.
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The trade association also noted that the threat of rescission is limited to the 2.6 million Californians who pay for their own coverage in individual plans, not those covered by their employers’ plans, Medicare, MediCal or other public programs.

Blue Shield declined further comment, saying they deferred to the trade association’s statement.

The regulatory agency’s announcement was applauded by Gov. Arnold Schwarzenegger, who pledged to work with legislators to “ensure this egregious practice is stopped.”

“It’s outrageous that innocent patients have to live in fear of losing their health care coverage,” said Schwarzenegger in a statement.

The order follows a Wednesday superior court filing by Los Angeles City Attorney Rocky Delgadillo, who said he would seek up to $1 billion in fines and restitution from Anthem Blue Cross for deceptive practices and unlawful termination of policies.

In recent months, the city attorney’s office sued another insurer, Health Net Inc., for allegedly canceling the policies of sick patients needing expensive treatment. As part of a separate suit, Health Net was ordered to pay $8.4 million in punitive damages to a woman whose policy was scrapped while she underwent treatment for breast cancer.

[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.

[Kaiser Permanente had no intention of suspending this murdering doctor, and did so only because CMS rejected Kaiser's initial plan of correction (pdf).]

From the LA Times:

Kaiser suspends accused doctor

Co-workers questioned the competency of Hamid Safari, who handled high-risk pregnancies at a Fresno hospital.

By Charles Ornstein and Tracy Weber, Los Angeles Times Staff Writers

Kaiser Permanente has suspended a physician who handled high-risk pregnancies at its Fresno hospital, more than four months after the Los Angeles Times reported that doctors and nurses there had repeatedly questioned his competence.

In a statement released late Friday, interim hospital Administrator Linda Monte said that, effective immediately, perinatologist Hamid Safari would not be able to provide care to any Kaiser member in a hospital or outpatient setting.

“Kaiser Permanente is committed to ensuring the safety of our patients, and we take this obligation to our members and patients seriously,” Monte said in the statement.

Safari allegedly botched at least two deliveries after staff members began raising concerns about his skills and demeanor, The Times reported in October. One baby died in the delivery room in April 2005; another died months after her January 2004 birth. Safari has been accused of gross negligence by the Medical Board of California.

His attorney, Stephen D. Schear, has said his client did nothing wrong. Neither Safari nor Schear could be reached Friday.

In January, federal inspectors criticized the way Kaiser responded to complaints about Safari and said that had the hospital kept a closer watch over its medical staff, the two babies might still be alive.

Days later, the hospital’s administrator stepped down.

In July 2005, three months after the second baby’s death, Kaiser imposed restrictions on Safari, barring him from performing vaginal deliveries and requiring him to be monitored by another physician or advanced-practice nurse. The restrictions became permanent last April, hospital officials said.

Since September, Safari has not performed any surgeries or caesarean sections and has served as a consultant at the hospital, they said.

Monte said the hospital decided it had to take further action “after detailed and comprehensive quality reviews during the last year.” It also was cooperating with the medical board’s investigation of Safari, she said.

Safari has the ability to appeal any discipline against him, and that process can take months. Monte said state law prevented her from “discussing publicly any peer review matters or inquiry into Dr. Safari’s quality of care.”

Kaiser still faces a lawsuit by two doctors who contend they were punished after raising concerns about Safari’s work.

[This update to the Hamid Safari case came out a few days ago. We're happy to see a resignation come from this situation, and we're hearing rumors that there might be another one that hasn't been announced yet. This is a change for Kaiser. Usually what we hear are a lot of denials, and some of the worst offenders in these scandals can end up being promoted, not fired -- especially the ones who have learned to keep their mouths shut, or are willing to perjure themselves to keep Kaiser out of trouble. We don't know if Kaiser is finally getting a clue, or if this is some kind of fluke that will never be repeated, but either way it's a good move where patients are concerned. The fact that the spokesliars didn't give the usual statement claiming the resignation was for unrelated family reasons, or that this person is "retiring" is also a good sign.]

From the LA Times:

Administrator at Kaiser’s Fresno hospital steps down

Susan Ryan’s resignation comes after a federal report faults the hospital for its slow response to complaints about a physician

By Charles Ornstein, Los Angeles Times Staff Writer

January 29, 2008

The administrator of Kaiser Permanente’s Fresno hospital stepped down Monday, days after the release of a federal report that criticized the way the medical center responded to complaints about a doctor who handled high-risk pregnancies.

In a written statement released late Monday, Kaiser said Fresno hospital administrator Susan Ryan had resigned, effective immediately.

Last week, the U.S. Centers for Medicare and Medicaid Services released a report suggesting that if Kaiser Fresno had kept a closer watch over its medical staff, two babies might still be alive.

The review was the latest in a series of critical assessments of the giant health maintenance organization, the nation’s largest with 6.5 million members in California.

The Medicare agency investigated the Fresno hospital after the Los Angeles Times reported in October that doctors and nurses had complained repeatedly to higher-ups about perinatologist Hamid Safari’s medical and interpersonal skills.

Rather than address their concerns, staffers told the newspaper, hospital leaders allowed Safari to continue handling high-risk pregnancies without restriction.

Safari allegedly botched at least two deliveries after staff members raised their concerns. One baby died in the delivery room in April 2005; another died months after her January 2004 birth. Safari has been accused of gross negligence by the state medical board; his attorney said he did nothing wrong.

Gregory A. Adams, associate regional president and chief operating officer of Kaiser Foundation Health Plan and Hospitals in Northern California, acknowledged in a written statement that the federal report was “highly critical of the Fresno hospital administration’s oversight.”

“We have reviewed the facts and taken action to address the leadership issues raised in this report,” he wrote.

Last week, in response to the federal report, Ryan defended the hospital’s quality oversight program and said officials had taken appropriate action after Safari’s alleged mishaps.

“When these events occurred, they were thoroughly investigated and corrective actions were taken,” she said in a written statement Friday. “This has led to significant improvements in our perinatal safety program.”

In July 2005, three months after the second baby’s death, Kaiser imposed restrictions on Safari, barring him from performing vaginal deliveries and requiring him to be monitored by another physician or advanced-practice nurse. The restrictions became permanent in April 2007, hospital officials said.

Since September, Safari has not performed any surgeries or C-sections and has served as a consultant at the hospital, Ryan said last week.

Ryan, who took over in August 2005, was not in charge at the time of the allegedly problematic deliveries by Safari. But a Kaiser spokesman said that “the hospital administrator has responsibility and accountability for the systems and processes in the hospital.”

Spokesman Mike Lassiter declined to say whether the hospital planned to take action against Dr. Varoujan Altebarmakian, the hospital’s physician in chief since 1999, who records show received numerous complaints about Safari.

Linda Monte, current chief operating officer of Kaiser’s South San Francisco hospital, has taken over as interim hospital administrator.