Received this press release yesterday, which we are reprinting in full below. NUHW is quickly becoming our favorite union. It is the same organization that crafted the complaint which recently resulted in a $4 million fine against KP for violating California mental health care laws. The link in the first paragraph takes you to a PDF of the lawsuit.
NUHW Sues California’s “Obamacare” Exchange to Protect Patients from Kaiser Permanente’s Substandard Care
SACRAMENTO, Calif. , Sept. 4, 2013 /PRNewswire-USNewswire/ — Today, the National Union of Healthcare Workers (NUHW) and five other plaintiffs filed suit in the Superior Court of Sacramento, California to block Kaiser Permanente from participating in California’s Health Benefit Exchange due to its substandard care that violates the Exchange’s rules.
In June, the California Department of Managed Health Care (DMHC) fined Kaiser $4 million for committing multiple and “serious” violations related to its mental health services, including failing to give patients’ access to care and violating California’s Mental Health Parity Act. The DMHC’s fine is the second largest in the agency’s history and stems from a complaint filed in November of 2011 by NUHW’s mental health clinicians on behalf of their patients.
According to state and federal law, the Health Benefits Exchange can only contract with HMOs that “are in good standing with their respective regulatory agencies,” which is further defined as “the absence of any material statutory or regulatory violations, including penalties, during the prior year…”
Nonetheless, last month California’s Health Benefits Exchange ignored state and federal law by signing a contract with Kaiser even after the Exchange had been fully apprised of Kaiser’s ineligibility to participate in California’s new health insurance market. Today’s lawsuit simply asks a judge to compel the Exchange to follow state and federal law, including the “good standing” requirement.
“Before Kaiser is allowed to enroll thousands more patients through the Exchange, it should first demonstrate that it can take care of the patients who already rely on Kaiser for their health care,” said Dr. Horace Beach, a psychologist who has worked at Kaiser Vallejo for many years. “It’s unfortunate that it takes going to court to protect California consumers. But the Exchange shouldn’t allow a plan like Kaiser to participate until it can demonstrate that it has corrected all of the serious violations documented by the DMHC and has paid the $4 million fine to the state.”
NUHW represents 10,000 frontline caregivers, including nearly 5,000 healthcare professionals employed by Kaiser Permanente, including registered nurses, psychologists, licensed social workers, opticians, and other professionals. In October 2011, NUHW released a 34-page paper entitled “Care Delayed, Care Denied: Kaiser Permanente’s Failure to Provide Timely and Appropriate Mental Health Services,” which first made public Kaiser’s substandard mental health care.
SOURCE National Union of Healthcare Workers
Now, I like this. This is the best news i’ve seen all year.
Great! Yes, I tried to get a slot in their external placement program to complete the required training and hours I need to graduate and become a licensed MFT and was told they ONLY have that program in San Francisco and they only took 5 students at a time. This is because they are making the location available to only “select” people, people Kaiser feels meets their personal criteria. Maybe if they have newly trained, eager, and enthusiastic emerging therapists, they would not be getting low ratings!
Beth: I have my doubts the lawsuit will be successful. Unions pull stunts like this to influence contract negotiations, and I expect the lawsuit to be dropped when Kaiser gives in to some of their demands. Hope I’m wrong and they see it through, but even then we know how these things usually turn out in Kaiserfornia.
Leslie: You and your future clients are better off if you never step foot into Kaiser for any kind of training. Kaiser Behavioral Health is literally the worst of the worst. Not that they don’t find a good therapist every once in awhile, but the good ones don’t stay longer than they have to. There are serious ethical considerations involved.
Covered California should give Kaiser the boot. So much corruption, inept handling of Covered California patients paperwork. One can only surmise that the care is equally inefficient and corrupt.
As soon ans follwoup at every avenue available over my ongoing issues I am dumping CC and Kaiser, never, never to return. I’ll opay the oppressive fine for not having insurance.
Covere California patients have insurance in name only, They DO NOT
have affordable health care….imagine paying $303 to see a doctor if you haven’t met the astronomical deduction.
Imagine going to get teh ‘free’ preventative services and getting a bill after wards. examples as follows:
Pap Smear exam…free..pathology report charged and desk jockey doctor’s report to your physician…charged
Mammogram…free….radiologist’s reading of films….charged
Free Physical and associated labs…not so free. Kaiser refuses to tell you what labs are considered free and have rigged the system that a supposed ‘preexisting’ condition’s labs will be billed at full non member prices. So far I have discovered the Cholesterol screen is free, provided you have never had an elevated reading before, but they won’t tell you which of 4 cholesterol panels are free. And that could be a difference between $49.00 to over $400.00 (am using Request-a-Test pricing ) depending on which panel is ordered…..
This sites Thieves logo is most apropo.
1/24/2018
I have kaiser = KP. – KP has denied medical care in regards to injuries form an auto accident almost a year ago.
Below is most of what KP has done since MAY 2107.
first;
The auto accident injuries are In initial medical reports at KP in regards to my auto accident with injuries.
At one appointment a 2nd doctor was present she asked; is my neck worse? I stated; It hurt before accident and now, the only way I can tell you it is worse is with an MRI of cervical spine. she stood in silence.
After my Grievances to KP it allows a needed MRI LUMBAR) that was denied prior.
I then was again denied standard medical care.
KP staff repeatedly denied the actual MRI study review or diagnosis with patient. I my PCP at KP told to go here by This section will decide if you need had a steroidal injection for me. That was the last thing I wanted.
At this point I was totally dissatisfied with almost all of the medical care provided at KP.
This was all due to my;
Federally contracted medical provider “KP”continuing to denying;
standard medical care.
___________________________________________________
Therefore I was forced to borrow to pay cash
To achieve; What is considered standard medical care
contacted my 3rd party ortho surgeon in a preexisting DISC rupture @ C 5/6
for the MRI lumbar findings and diagnosis.————————$1000
My 3rd party ortho DR. agreed with an injection for lumbar, I still do not!
Here is were it gets interesting;
3rd party ortho DR questioned; why no one did any studies in regards to my preexisting cervical injury requiring surgery.
I immediately contacted KP and requested an MRI of cervical.
At the same time I added the ortho DR medical report to KP medical records
KP then sets an appointment for neurosurgery;
A DR their states; You do not need MRI of neck or neck surgery, I looked at your old MRI.
Dec 29 2017 I again had to go see the othro DR he ordered MRI—-$2500.00
that MRI found new conditions at my preexisting cervical spine injury.
As I see it KP is owing me for ortho doctor ———————$4700.00
1/24/2018
Ca. managed heath care “ombudsman” has an active case for this. Today I called that agency, they were questioning if KP had followed up with me?
I stated NO.
When I requested the “ombudsman” ;
The KP contract care spokesperson told “ombudsman” staff;
‘NOT ALL SURGERIES ARE COVERED
What vague; useless statement!
I received documentation today, I obtained my evidence of coverage and was told by KP staff that ANY KP DR prescription for surgery will be NO PAY
It will be paid in full by my coverage at KP.
I kept records and advocated in addition to correcting unprofessional/ unethical conduct By medical professionals.
I have taken action to address this, and I am extremely encouraged.
Although;
I do feel an extremely huge stress and uncertainty with my lifes direction
All at the hands of KP
Please!
Any useful input would be very kind and greatly appreciated.