Kaiser Permanente has been cited by the California Department of Managed Healthcare for multiple mental health care violations, including keeping two sets of records to hide lengthy appointment wait times from investigators. Definitely worth reading the entire article because it shows the deliberation with which Kaiser skimps on your care and then lies to cover it up. The sad part is that they are so rarely caught red-handed like this because the DMHC usually treats each complaint like an isolated incident, rather than evidence of the systemic fraud and malpractice that is obviously occurring. The complaints that spurred this particular investigation came from Kaiser’s own mental health practitioners, which is unusual, but it’s about time!
Government Cites Kaiser Permanente for Providing Inadequate Mental Health Care to California Patients
The California Department of Managed Health Care (DMHC) issued a report yesterday affirming the findings of an exhaustive complaint filed by Kaiser Permanente’s frontline mental health clinicians, who are represented by the National Union of Healthcare Workers (NUHW). The DMHC cited Kaiser for multiple violations that have now been referred to the agency’s Office of Enforcement, which is responsible for imposing legal and financial penalties on HMOs.
It then goes on to list some of the specific violations, and explores the serious impact Kaiser’s failure to meet state standards can have on patients.
The DMHC’s full final report is here; and the complaint from the clinicians – with the assistance of the National Union of Healthcare Workers – can be found here. This is a very well put together complaint, with all of the data to back it up.
How convenient for KP Southern California’s bank account that this man’s father was “accidentally” disconnected from his ventilator, only hours after his doctor failed to talk the man’s son into doing so on purpose! You have to ask yourself — is your Kaiser Permanente doctor a one man death panel?
By Dwight Smith
The Pulmonologist caring for my father pulled me aside and asked me to sign a slip giving Kaiser permission to disconnect my father from a ventilator. Horrified, I said, “Ask him yourself, he’s fully conscious.” Terrified, I asked my father to take a quiz: Write the first six letters of the alphabet, which I’d written at the top of a blank page. My dad did so in a shaky but readable hand. I then demanded that the charge nurse place the document into my father’s chart and handed it to her.
The next day when I arrived, my brothers were in a tragic huddle. During the night, transportation aides had taken my father for a CAT scan. During the process, the lanyard keeping his ventilator tube in place had been untied, and the entire two foot length of his air tube “accidentally” got pulled from his throat. In spite of the fact that he was to undergo x-radiation, no Doctor was present, and when one was finally summoned to re-insert his airway, so much time had elapsed that my father had suffered irreversible brain damage.
When a clumsy attempt to sample my father’s arterial blood gasses, which involved digging deep into his arm with a needle elicited no response at all, I realized the time had come to disconnect my father, just as the Pulmonologist had requested. The heavy lanyard securing his airline took some time to undo, and I held him as we pulled the tube from his lungs and watched him die. I realized at that moment that it required deliberate and intentional malice to accidentally “disconnect” a patients airway.
As I left to attend a meeting wherein the Pulmonologist persuaded my three brothers to argue me out of an autopsy, I looked at the bulletin board at the side of his bed. The quiz that proved he was alert and conscious, his last six letters, written in response to my written question, was posted as patient art.
Make no mistake about it – Kaiser doctors kill patients.
Below are ten more Kaiser Permanente scandals from the time period when we were not regularly updating this website. Most of this information comes to us in Google News and Blog Alerts, but recently the Big G has taken it upon itself to carry water for Kaiser, and has blocked most critical websites from the Alerts. We still find them, but it requires us to go actively looking, which is obviously more time consuming. For that reason, if you ever run across an article or blog post that we haven’t reported, or see something in the news, we’re requesting that you send us an email to let us know.
If you hate censorship, and find Google’s blatant effort to bury criticism on behalf of one of its biggest advertisers as appalling as we do, then please consider walking with your fingers and using a different search engine. Hit ‘em where it hurts — in the advertising revenue. You may have noticed that we removed our own Google Ads (we never made money from them, but they covered the costs of running the site), and now you know why. We recommend DuckDuckGo for offering its users real privacy, and Bing as the next best alternative.
- KP’s Oakland hospital was fined $50,000 for a medication error involving a 90 year old man.
- Non-profit Kaiser posted $2.1 billion in profits for the year 2009. That’s the money that was left over after your health care was provided and all operating expenses were taken into account. This when people are struggling to pay ridiculously high insurance premiums and 22% of California residents are uninsured. Appalling.
- Four patients at KP hospitals in Northern California were served chicken noodle soup with fragments of glass in it. Mm mm good!
KP surgeon, Dr. Michael Meehan, was arrested on a DUI charge after a head-on crash in Napa that injured 5 people. If you receive health care at the Vallejo Medical Center you had better hope he doesn’t operate on you while drunk, because he’s still working there and he looks a little toasted in his official KP
Kaiser Vallejo Surgeon Dr. Michael Meehan
mugshot portrait, at right.
- KP was sued by the family of a 69-year-old California woman who died after consuming food contaminated with salmonella, while recovering from surgery at the Hayward facility. We always like to remind people that it is the members who ultimately pay the cost for all of these lawsuits.
- A KP Manteca registered nurse, Gerado Cuevas, was sentenced to 12 years in prison for sexually molesting a 13 year old girl, along with another man who was also found guilty of the crime. According to an earlier article, the abuse happened more than once and was videotaped. Sickos.
- On track to exceed 2009 earnings, KP reported $706 million in net income in the first quarter of 2010 alone. And they are so proud of getting rich off of the sick and suffering that they send out a press release.
- A woman claims she was treated with such negligence in the KP emergency room that she developed ulcers the circumference of a man’s fist and lost all sensation and use of her body below her neck.
- In another outrageous breach of privacy and abuse of power, KP inserted itself into the middle of a family dispute between members. The site admins redacted the company name, but we are sure it was Kaiser because we saw it at the time.
- In a follow up to the case of Dr. Death Jayant Patel, Kaiser members ask the question, “Why wasn’t he stopped?”
More scandals to come…
Lawsuit alleges that a runner collapsed & died at the finish line of the Kaiser Permanente San Francisco Half Marathon & 5K Run, because the medical tent was staffed by chiropractors and chiropractic students rather than medical doctors & EMTs, and no defibrillator or ambulance was present.
That’s KP for ya – always trying to save a buck without regard for human life. And guess who gets to pay for the lawyers to defend the lawsuit? Kaiser members!
Read the legal complaint via Kaiser Bad News (PDF).
Could your private medical file be sitting in some guy’s garage in Indio? A small cataloging and storage company claims it has the records of hundreds of thousands of Kaiser patients that KP hired it to process, but refuses to pay the bill to return or destroy.
Kaiser Permanente stuck in odd struggle with tiny Indio vendor – San Francisco Business Times
Stephan Dean of Surefile Filing Systems
Giant Kaiser Permanente has found itself locked in a David-and-Goliath-scale struggle with a tiny Southern California record storage vendor over up to 1 million unencrypted Kaiser patient records the vendor claims remain on servers in his house and garage.
Former KP psychiatrist Dr. Stephen Melcher
Yesterday, Sacramento Business Journal
and CBS13 News
reported on the case of a Kaiser Permanente psychiatrist who has been convicted of a felony sexual act with a minor. Dr. Stephen Melcher was sentenced to one year in jail for a lewd and lascivious act against a child under 14 — in this case an 11-year-old boy.
The Medical Board of California says it is also pursuing disciplinary action. According to MBC records, the boy was molested after a dinner party at Dr. Melcher’s Sacramento area home on October 8, 2011.
Melcher was arrested the following December, but continued to practice at KP until March, when he finally resigned from his position there. In April he pleaded “no contest” to the charges, which lead to last week’s sentencing.
It’s not clear when Kaiser became aware of the allegations, but from the following statement it looks like they did know about the arrest, but chose to allow him to continue working until his resignation.
“Dr. Melcher is no longer with Kaiser Permanente. The charges against Dr. Melcher relate to an incident that occurred in a social situation outside of Kaiser Permanente and his medical practice.
“Kaiser Foundation Hospitals and Health Plan must take into account the legal and due process rights of employees and physicians while they await adjudication. Dr. Melcher’s practice involved only adults. We evaluated Dr. Melcher’s practice and confirmed that the charges against him related to an incident that occurred in a social situation outside of Kaiser Permanente and his medical practice. He resigned on March 19.”
Innocent until proven guilty, as they say, but given the sensitive nature of a psychiatric practice, it seems that at the very least a suspension with pay should have been in order until the case was decided. It creeps us out a lot to put ourselves in the shoes of his patients, trusting and sharing their innermost secrets and problems with an accused child molester, unbeknownst to them. I don’t know about you, but even if it is true that he only treated adults, I wouldn’t want even an alleged pervert for a psychiatrist.
The news articles can be accessed via the links above, and we will be posting any updates that come through to Facebook and Twitter.
Received by email a few days ago. Unfortunately this is all too typical, and here’s why: Kaiser Permanente doctors are trained to minimize your symptoms, and pressured to always default to the least expensive treatment. In fact, nearly all of the grievances we hear about are at least partially due to this cost-saving practice. Many never find out they have been receiving substandard care until they change insurance, because KP won’t even tell you more expensive alternatives exist. That is what happens when your doctor is employed by your health plan. Money first; Hippocratic Oath last.
By Michael Doering
I left Kaiser some time ago because my son has epilepsy and needed a better choice of doctors to deal with his problem. My own problem was pretty simple compared to his. Shoulder trouble. I went to the Kaiser same day appointments for years and to the “sports medicine” doc, named Holmes. I also reported it to my primary care physician, a Dr. Lane. All I ever got from them was a shot of cortisone and one session with a physical therapist who said I needed to hold my shoulders back more. She was a contractor. One session. That was about 5 years ago.
Today, on another medical plan, outside the bureaucracy of Kaiser, I went to a GP called Chambers. He asked me to lift my shoulders and move my arms in one or two other positions. He saw me trying to get my wallet out of my pocket. In about ten seconds he could see the problem. He said “You have frozen shoulder.” He took an X-ray and referred me to an orthopedic surgeon. Before I left he spoke to me and said I had severe arthritis in my shoulder and probably some cartilage damage too and would probably need surgery. SO WHERE WERE YOU ON THAT ONE, KAISER? 5 years I waited in pain, unable to sleep at night.
We’ll call this one the “George Halvorson, first reform your own organization” Edition.
- An Elite Notary explains why it is so difficult to obtain legal representation in California in medical malpractice cases. Hint: it’s all about MICRA and mandatory binding arbitration, and claims against Kaiser have decreased 20% as a result. Just the legal filings, mind you, not the number of malpractice incidents.
- Matt Welch prefers the French health care system to ours in the US, in part because his wife’s breast cancer was missed by an indifferent KP doctor. What kind of doctor dismisses any kind of breast lump as harmless without testing? Now you know.
- A concise compilation of Kaiser scandals that clearly illustrates its unsuitability as a model for US health care reform. Not that we at Kaiser Thrive Exposed are against health care reform in general — our problem is with Kaiser-style health care deform.
- Hillarie Levy continues her struggle to make doctors accountable for the kind of misdiagnosis that caused the death of her daughter. Robyn Libitsky’s cancer was found to be untreatable after having been missed by KP doctors for 14 visits over a 5-month period. Kaiser subsequently tried to cover up for several of the doctors involved.
- KP apparently limits the number of test strips for diabetics that it will pay for, regardless of patient need. I’m not a diabetic, but I can attest to having my monthly allocation of asthma medicine limited by KP, which landed me in the ER via ambulance once. What’s more expensive? A few more test strips or a diabetic coma? An extra inhaler or an ER visit? Maybe they hope you’ll just die so you can’t complain, and if you do your family won’t be able to find an attorney.
- Most folks are probably not aware that Heather O’Rourke – child star of the Poltergeist movies — died at age 12 due to misdiagnosis of a bowel obstruction by none other than Kaiser Permanente.
- Kaiser Santa Rosa earned certification as a Primary Stroke Center in January of 2010. Problem is that only a few months earlier they were found to have the highest stroke mortality rate in Sonoma County in an independent report by the Niagara Health Quality Coalition. Could they really change it up that fast, or do they just have the hardest working PR goons and biggest bank account in existence? We would never suggest any impropriety, but The Joint Commission, which bestowed the award for this seemingly miraculous turnaround, just happens to be supported by payments from the HMOs it rates. Yeah, makes you go hmm.
- KP routinely misdiagnoses Lyme Disease, and here is one case. Imagine being told you have ALS, which is terminal, when a long-term course of antibiotics could help you. And of course once KP finally reaches the correct diagnosis, they also want to deny the treatment.
- Please don’t claim we only have negative things to say about KP, because we’re actually happy about this. Never mind that it shouldn’t have been necessary.
- KP doesn’t want to “needlessly” alarm patients by fully disclosing test results. Who are those electronic medical records supposed to benefit again?
Well there’s another month of Kaiser scandals. As always, much more to come.
At the end of February, the California Department of Managed Health Care (DMHC) issued a cease and desist order against Kaiser Foundation Health Plan, for denying physical, occupational and speech therapy to members with “non-physical conditions.” This action was in response to more than 100 complaints that were received by the department since 2009.
According to Anthony Manzanetti, chief of enforcement for the DMHC, “That means that people who may stutter or lisp or who have developmental delays don’t receive speech therapy.” Members with mental illnesses are also excluded.
The DMHC investigation found that Kaiser routinely denies coverage for these therapies on the basis that the enrollee does not have a physical condition, regardless of medical necessity. Denials such as this are in direct violation of the Knox-Keene Act and the state’s mental health parity law. In California, health plans are required to cover medically necessary basic health care services, including speech, physical, and occupational therapy. In addition, state law requires coverage for diagnosis and treatment for certain mental health conditions.
In the letters that are sent to patients, Kaiser cites its clinical practice guidelines as a reason for the denials, which state in part:
A service is NOT a physical or occupational therapy Health Care Service…when the therapy does not meet the indicators in these Guidelines. Some of the circumstances are described below: …Programs for communication / cognitive deficits from developmental disorders – where deficits do not impact overall health.” [Bolding, capitals and underline in original]
There is a similar section in KP’s guidelines for speech therapy.
Of course Kaiser denies it. Quoted in the San Jose Mercury News, a KP executive claimed to be surprised and disappointed by the DMHC action:
“The department appears to have misunderstood or mischaracterized Kaiser Permanente’s approach to providing speech, physical and occupational therapy to our members,” said John Nelson, Kaiser vice president, in a written statement.
“These therapies are not limited only to patients with physical conditions,” he said.
We don’t think so, Kaiser Executive. You’re just trying to put your organization’s typical Goebellesque spin on the matter, and it shows.
We have archived the full order here (PDF).
An interesting podcast from Sarah Varney of KQED’s The California Report, on why Kaiser’s premiums have risen in recent years to levels often on a par with traditional health insurance rates. Among others, she interviews KP CEO George Halvorson, who as usual would like his customers to disbelieve their own experiences in favor of his PRBS™ spin. Also note the customary lack of transparency.
You may be surprised to learn that we have never thought the idea behind Kaiser Permanente is a bad one. We believe the problems are in the execution, and are mostly due to issues inherent in its corrupt corporate culture. We can only hope that the more direct competition that is spoken of in this report might someday put pressure on KP to clean itself up, as well as keep prices lower in the future.
Our transcription for the hearing impaired and folks without audio is below the embedded player.
Announcer: As I just mentioned, the federal health law now under review by the US Supreme Court tries to tackle the problem of high health care costs with financial rewards to providers who do a better job coordinating patient care. And in that regard, Kaiser Permanente, here in California, is often touted as the nation’s best hope for bringing health care costs more in line with other developed nations. But, if that’s the case, asked The California Report’s health reporter, Sarah Varney, why isn’t Kaiser less expensive?
Sarah Varney: Kaiser Permanente rose out of a utopian industrialist’s dream. During the 1930s and 40s Henry J. Kaiser wanted to make sure the workers at his Richmond shipyard were steady and strong.
Cut to vintage promotional recording: A medical dream comes true under the drive of industrialist Henry Kaiser, who holds the plans of the ultra modern hospital, designed by…
George Halvorson: When Henry built things he tended to assemble an entire team to build all of the parts.
SV: George Halvorson is KP’s current CEO.
GH: So when he started providing health care to his workers he used that model, which was to have a Kaiser hospital, Kaiser clinics…
SV: KP opened its doors to the public in 1945 and offered health coverage that was considerably less expensive than conventional insurers like Blue Cross. The strategy worked because it owned and operated its own hospitals and clinics, and directly employed physicians. But Mark Smith, head of the California Health Care Foundation, says KP is no longer the bargain it used to be.
Mark Smith: They got where they are in part by being the cost leader in the market, and they no longer are.
SV: Indeed, health care researchers and Kaiser’s biggest customers say the price gap between Kaiser and other insurance companies has narrowed or closed all together. CalPERS, the state agency that manages benefits for retired public employees, negotiated premiums with Blue Shield that are less expensive than Kaiser. That was unheard of just a few years ago. Smith, of the California Health Care Foundation, says because Kaiser is both the insurer and the health care provider the company hasn’t faced much competition.
MS: They’re not really pressed to be that much cheaper; they’re kind of shadow pricing, is what economists would say. So if your competitor takes $4 to make a banana and it only takes you $2 to make a banana, you price your banana at $3.95 and you kind of pocket the rest.
SV: That’s a charge Kaiser’s CEO George Halvorson vigorously denies.
GH: We’re at least 10% better everywhere, um, sometimes we’re 15 or 20% less expensive.
SV: Kaiser sets its rates, says Halvorson, based on how much it spends on patient care. It has nothing to do, he says, with what other insurers are charging. And, he adds, Kaiser offers richer benefits than other plans.
GH: Everybody else is stripping their benefit packages down, so they’re putting in higher and higher deductibles, and that’s just shifting the cost to the employee.
SV: Since negotiations between health plans and employers are largely confidential, and each insurance plan offers different services, it’s difficult to discern just how Kaiser fairs against other companies. In documents filed with state regulators, Kaiser Permanente says the cost of running its entire operation increases by about 5% each year. But some of Kaiser’s biggest customers — companies that are household names in California — say their premiums have jumped much higher. In some cases 20%. David Lansky heads the San Francisco based Pacific Business Group on Health, which represents large employers.
David Lansky: Kaiser seems to have a difficulty of explaining why their price is what it is. So they can’t explain it very well to the benefits manager of a large company, who then can’t explain it to his or her boss. Why should we keep Kaiser? Why is this price legitimate? If Kaiser can’t document their internal cost structure and pricing, then there’s a whole chain of mistrust that gets generated because of a lack of transparency and clarity.
SV: The frustration seems to stem in part from the very trait that makes Kaiser so good at taking care of patients. It doesn’t price out procedures, tests and doctors’ visits on a menu of fees. These so called fee schedules are often arbitrary. A procedure can cost a thousand dollars at one hospital and ten thousand elsewhere.
GH: Fee schedules are a very primitive way to buy care.
SV: Kaiser’s CEO Halvorson says his company’s focus on patient outcomes is what matters.
GH: We have cut the rate of broken bones for, um, for our seniors, by about 40%, and we do nine things for the seniors to cut the broken bones. Six of the nine things do not show up on the Medicare fee schedule.
SV: Still, large employers say that because Kaiser doesn’t price out its services, it’s difficult to know why premiums rise every year. One large employer, who is not authorized to speak publicly because negotiations are confidential, told me Kaiser’s rate increases don’t seem to reflect changes in the use of Kaiser services. David Lansky says Kaiser is much more efficient than other insurers and providers. For example, patients can avoid unnecessary office visits by talking with doctors over email, but Lansky says employers, who pay the bills, aren’t yet seeing the savings.
DL: I told you what we all went through with the banks when they went to ATMs and stopped having tellers in the retail points of service. You’d think that would actually lower costs; instead we started paying fees at the ATMs.
Bob Kocher: A lot of us in health policy land have scratched our heads at that and said well, you know, why can’t Kaiser be a heck of a lot cheaper.
SV: Bob Kocher, now a partner at the venture capital firm Venrock, served as a health care adviser to President Obama. Kocher is a big fan of Kaiser’s highly coordinated system, saying that its model was at the back of many policy makers’ minds when they pushed to include in the federal health law financial enticements for hospitals and doctors to essentially form Kaiser lookalikes. Still, Kocher says he would hope the Kaiser model would deliver steeper savings.
BK: How do we unleash that sort of pressure on price to have them not be compelled to raise their prices by 8, 9, 10% a year?
SV: Kocher and other policy experts suspect that pressure to compete might come when, and if, those Kaiser mini-mes get off the ground. For the California Report, I’m Sarah Varney.