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Southern California Hospital System Sues Kaiser Permanente for Managing Bills Rather Than Managing Care
Date:2/13/2008

and safety. Dr. James Lally, Medical Director of Chino Valley Medical Center, expressed frustration with Kaiser because "I am pressured by Kaiser to transfer patients when I do not believe that the patient is stable for transfer". Dr. Humberto Silva, Medical Director of Desert Valley Hospital's Emergency Department, noted that "Kaiser insists on the transfer of patients down the treacherous Cajon Pass even though doing so may sometimes be life-threatening". Dr. Luis Noronha, Medical Director of Desert Valley Hospital, has "personally witnessed Kaiser calling patients' families urging them to request transfer to a Kaiser facility even though the patient is not stable".

Many providers believe that Kaiser's aggressive and intractable approach is part of a larger decision on Kaiser's part to pad its bottom line by simply denying payments due to outside providers by hook or crook. Kaiser has been sued in both Northern and Southern California by hospitals seeking reimbursement for services provided to Kaiser members as referenced by legal proceedings commenced by Alvarado Hospital Medical Center, Providence Medical Center, South Coast Medical Center, Glendale Adventist Medical Center, Simi Valley Hospital, and North Bay Medical Center to recover amounts due for healthcare services. Prime Healthcare also believes that several other prominent hospitals are engaged in legal disputes with Kaiser and may be filing similar lawsuits in the near future.

Kaiser's profits are even greater than other for-profit HMOs because it is not required to pay taxes on a single penny of its earnings as it enjoys the status of being a non-profit entity. The only real difference between Kaiser and other for-profit health plans is that Kaiser is not required to pay taxes. Even though Kaiser is a non-profit entity, it provides very little, if any, charity care at the hospitals it owns and the emergency departments in these hospitals see very few Medi-Cal patients and uninsured patien
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SOURCE Prime Healthcare Services
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