Fines expected in DMHC investigation into Kaiser’s handling of consumer complaints

By | June 15, 2007

[kaiserthrive.org editor’s note: Hallelujah, regulators have finally seen the light! Too bad Kaiser will respond with another useless ‘plan of correction’, with no real intentions of actually following through with it.]

From San Francisco Business Times:

DMHC probe of Kaiser delayed, fines expected

by Chris Rauber

An investigation of Kaiser Permanente by the state Department of Managed Health Care, originally expected to conclude last October but later expanded, is taking far longer than expected to complete.

The department oversees HMOs and other managed-care plans. At stake is whether Kaiser is in compliance with California’s Knox-Keene Act, which regulates the state’s managed-care plans.

The probe, originally part of investigations into Kaiser’s now-defunct Northern California kidney transplant program, was later expanded to cover how the Oakland-based health-care giant handles consumer complaints and a wide spectrum of quality of care and oversight issues.

“It’s a really complicated report, and we’re working (on) some corrective actions,” DMHC spokeswoman Lynne Randolph told the San Francisco Business Times this week. In addition, Randolph said, the department would be “penalizing” Kaiser with monetary fines, but she said details aren’t clear yet.

Ultimately, however, some combination of required corrective actions and financial penalties is expected, Randolph said.

At this point, a final report is expected by mid-July, roughly eight and a half months after the original deadline. Since then, state officials have said at various times that the expanded investigation would be completed in the first quarter, by late April and by late May.

In November, state health regulators widened a probe of Kaiser’s process for handling complaints beyond its ill-fated San Francisco-based kidney transplant unit and into other operations at the health-care behemoth. The investigation grew to include Kaiser’s entire California system and a broad spectrum of quality-of-care and oversight issues, regulators said in November. It involves the Kaiser Foundation Health Plan’s responsibility for overseeing the quality of care at its medical centers and medical groups, including the Permanente Medical Group in Northern California, state officials said at the time.

Back in November, Denise Schmidt, another DMHC spokeswoman, said the investigation expanded when regulators realized problems at the troubled kidney unit may have been a small piece of a larger puzzle. “In this case, the kidney program (is being) closed down,” Schmidt said at the time, “so if they correct the way that particular program handles grievances, that’s not going to solve the problem.”

Cindy Ehnes, the department’s director, initially thought the investigation would be finished last October, but that was before its scope expanded.

Previously:

State regulators widen probe into Kaiser?s ills

9 thoughts on “Fines expected in DMHC investigation into Kaiser’s handling of consumer complaints

  1. Robert Weiss

    Another Kaiser “quality of care” deficiency concerns their qualification requirements for the physical therapists who are allowed to perform manual lymph drainage (MLD) as part of complete decongestive therapy CDT) for lymphedema. Physical therapists with as little as 22.5 hours of specialized lymphedema training over and above their license requirements are allowed to treat lymphedema patients. National lymphedema therapist certification requirements are a minimum of 135 hours followed by one year of professional practice under a certified therapist. The California Physical Therapy Board has stated that a therapist with inadequate training and competence providing MLD/CDT to a lymphedema patient is practicing outside of their license. [Details and Kaiser’s response to my complaint are available from this writer.]

  2. anonymous

    How about this “plan of correction”? Kaiser decides that it’s corporate presence is hopelessly sick, degraded and crumbling, and in the interest of empathy for patients everywhere, it closes down all its ‘health care’ centers and thus frees up hundreds of badly needed independent doctors. 🙂

  3. Admin Post author

    I watched a movie called Resident Evil on the SciFi channel tonight, and this was the narrated opening:

    At the beginning of the 21st century, the Umbrella Corporation had become the largest commercial entity in the United States. Nine out of every ten homes contain its products. Its political and financial influence is felt everywhere.

    In public, it is the world’s leading supplier of computer technology, medical products, and healthcare. Unknown, even to its own employees, its massive profits are generated by military technology, genetic experimentation and viral weaponry.

    Yikes! Sound like anyone we know?

  4. Adam Mitchell

    It sure does.

    Michael Moore addressing the California state legislature on his new movie ‘Sicko’:

    In this film that you will see tonight, we obtained some of Nixon’s famous White House tapes. These aren’t the discussions about Watergate. I will show in this film on February 17, 1971, a conversation between John Ehrlichman and Richard Nixon. They’re about to put forth the bills that would bring us the modern-day HMOs. And Ehrlichman says to Nixon, “Now, there is one more piece of this we have to figure out, we want to talk to the Vice President about this, and it is about these health maintenance organizations like Edgar Kaiser’s Permanente thing”, as he put it. And Nixon interrupts him and says “I don’t want to talk about these damn medical programs.” And Erlichman goes “Wait, this is a private enterprise one.” And Nixon goes, “Oh, okay, I like that.” And then Ehrlichman essentially boils down what would become the health insurance system that we now have today. Ehrlichman says to Nixon “the genius of Edgar Kaiser is what they want to do here is try and provide as little care as possible so they can make the biggest profit possible.” And suddenly Nixon lights up. And he says, “Oh, okay, this is great, fine, not bad. Let’s do this.” That is what they did. Once they understood what the basic premise was, that it was to provide less care for more profit, that was something that they loved.

    That is the system that we have. The reason why, as our friend here said, the reason why we have to eliminate health insurance companies, I mean, they literally have to be removed from the equation, the reason for this is that there is no room for them. Because there should never be room for the word “profit” when you are trying to make a decision whether or not to provide somebody care when they get sick. Bottom line. You can never allow this to happen. They can’t make a profit unless they deny care, unless they deny claims, unless they keep people off the rolls who have preexisting conditions or kick people off the rolls who have diseases that become too expensive for them. They can’t make a profit.

    http://www.michaelmoore.com/words/latestnews/

  5. Admin Post author

    We have the transcripts from that conversation between Nixon and Ehrlichman on the About Kaiser page.

  6. anonymous

    So, when the DMHC releases this report next month, who is coming with me to see it unveiled. I think that there should be a large public presense and an aggressive media response at corporate HQ and the various local entities. Does anyone care to comment upon the effect that this will have on folks who were bambuzzled and thought that justice would be denied. There is no statute of limitations when fraud was involved so where will this lead ultimately.

  7. Anonymous

    “There is no statute of limitations when fraud was involved so where will this lead ultimately.”

    If this truly is the case then there would not be ANY statute of limitations in Kaiser cases EVER since losing/witholding/destroying records IS fraud.

    I was under the impression that if fraud was involved then mandatory binding arbitration no longer applied.

    I would love to be there to see the report unveiled.

  8. A

    Kaiser Riverside Medical Facility, Audiologistcompleted an evaluation on 5/14/2010. I exploaned that I am a Veteran and have processed medical evaluations with the Veterans Administration. After the evaluation was completed, I requested a print out. In the impression section, he wrote, “Malinguerin”. meaning to seek monetart compensation. I was upset of the false allegation and implecation. After further thought, I will ask Kaiser to remove me from medical membership after over 35 years. There is still racial medical profiling and this was observed by the not mentioned Audiologist at Riverside Kaiser MC.

Leave a Reply

Your email address will not be published. Required fields are marked *