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Mental Health care
Class Accuses Kaiser
of Patient Dumping
[on taxpayers]
By RENI ANGUELOVA
Courthouse News

LOS ANGELES (CN) - Kaiser
forces patients who suffer from
mental illness to cancel their
insurance and then shifts the
cost of treatment onto
taxpayers through a patient
dumping scheme, a family
claims in a class action lawsuit.
The 1999 California Mental
Health Parity Act requires
health insurers to provide all
medically necessary treatment
of patients suffering from a
severe mental illness on the
same financial terms and
conditions as for physical
illnesses.
The law states that mental
illness is real, can be reliably
diagnosed, is treatable, and
the treatment is cost-effective.
Mental illness covered by the
Parity Act include pervasive
developmental disorder of
children such as autism,
obsessive-compulsive
disorder, bulimia, anorexia
nervosa, panic disorder, major
depressive disorders,
schizophrenia, and bipolar
disorder, according to the
complaint.
Kaiser claims to provide health
plans for all medically
necessary treatment and
defines "medically necessary"
as a service required to
prevent, diagnose, or treat a
condition in accord with the
generally accepted
professional standards of
practice that are consistent
with a standard of care in the
medical community.
It claims that its medical health
services include inpatient
psychiatric hospitalization and
intensive psychiatric treatment
programs. In the
mental/behavorial health
service disclosures a section
titled "Limitations &
Exceptions," 'the summary
states, "none," according to
the complaint.
Plaintiff Matthew Szitkar-Kerr,
21, suffers from schizophrenia
and bipolar disorders, he says
in the complaint.
Szitkar-Kerr claims he was
hospitalized for his condition at
a Kaiser Permanent facility
and then placed in a
conservatorship the following
month.
Conservatorship, otherwise
known as "LPS
Conservatorship," is a
short-term (one year) service
for people suffering from a
mental disorder who are
gravely disabled and require
psychiatric treatment in a
locked facility, according to the
complaint. The yearlong
conservatorship can be
renewed annually if necessary.
Once placed on
conservatorship, Szitkar-Kerr,
says he was instructed to
"disenroll" from the Kaiser
health plan.
He claims that Kaiser
telephoned him and said that
"it was time" to terminate his
status as a dependent insured
so that he could be provided
more treatment in a residential
program at a Los Angeles
County facility known as "La
Casa."
Szitkar-Kerr says his treatment
is now funded by the county,
the state (through Medi-Cal),
and the federal government
(through Social Security and
Medicare).
Despite its obligation to
provide medically necessary
services, including treatment
for mental health, Kaiser
systematically denies
coverage, ensures a
mandatory disenrollment to
LPS conservatorships, and
then dumps the costs of
psychiatric treatment onto the
government and taxpayers,
Szitkar-Kerr says the
complaint.
He seeks class certification
and damages for civil rights
violations, unfair competition,
fraud and bad faith.
He is represented by Kathryn
Trepenski, of Beverly Hills.
Kaiser Permanente Denial of Care
Courthouse News Service
September 19, 2014
   
Woman Blames Kaiser Error for Increased Costs
By PHILIP A. JANQUART
           

DENVER, Colo. (CN) - A woman's treatment costs escalated because her
health failed when Kaiser cancelled her policy in error for 2 months, she says
in a Denver County District Court complaint.
Lamar Richardson is an employee of Colorado's Department of Corrections
and receives health insurance through the state, which contracts with Kaiser
Foundation Health Plan to provide medical services.
In 2011, the state informed its employees they needed to submit dependent
coverage information to continue receiving benefits.
During that time, his wife, Jennifer Richardson, was being treated for an
unspecified and permanent illness. The couple timely submitted the requested
information, twice, but was told each time the information was not received.
Their coverage was cancelled as of Sept. 1, 2011.
As a result, the Richardsons hired an attorney to fight for a reversal of the
state's decision to stop coverage, which ended with a reinstatement of the
medical coverage. Department of Personnel & Administration Executive
Director Kathy Nesbitt, who initially denied the coverage, sent a letter admitting
her error, according to the complaint.
The state "affirmatively acknowledged that the benefits should not have been
cancelled because materials and documents were received and faxed to the
employee benefit unit."
Yet, Jennifer was denied critical treatments from Sept. 1, 2011 into December
2011, while the matter was being resolved. The Richardsons also incurred
substantial medical expenses that had to be paid out-of-pocket.
If that was not enough, Kaiser refused Jennifer the proper medication once
treatments resumed, the complaint states.
Additionally, upon resuming medical treatment with Kaiser, the previous
medications were not effective and a more expensive medication was required,
the complaint states. Kaiser initially refused to provide the required
medication, claiming that the medication prescribed pre-termination of benefits
was sufficient.
The plaintiffs are suing the State of Colorado, Department of Personnel &
Administration and Kaiser Foundation Health Plan of Colorado for breach of
contract. They want a court to rule that both the State of Colorado and Kaiser
had a duty to provide Jennifer with proper medical treatment and that Kaiser
should have covered the treatments.
"Kaiser's refusal to provide needed medication was a breach of its contractual
obligations to the Richardsons," the complaint states. "The direct and
foreseeable injuries to the plaintiffs is that Mrs. Richardson's medical expenses
have substantially escalated and will continue to escalate throughout her life."
The plaintiffs are represented by William Finger and Andrew Newcomb of
Frank & Finger, in Evergreen, Colo.
Kaiser Continues to Lack Integrity
October 17, 2014
by Cindy Nunn
Simvastin Nightmares

I know it has been many weeks since I last posted. During that time my muscle
issues have not improved and continue to cause me chronic, soul destroying
pain. Also during that time Kaiser’s legal team apparently concluded their
“investigation” of my claims and complaints, and, as expected, have
yet
again denied my requests for a muscle biopsy, the Gold
Standard for determining muscle damage,
and they have denied
my request for compensation of lost wages and costs.

I had actually been silly enough to hold on to a small amount of hope that
Kaiser would do the right thing, that they would dig deep down into their stone
cold, greedy corporate hearts and find that small spark of humanity that still
burns in the darkest regions...

Maura Larkins comment: Well, of course they don't want to do a biopsy.  
They're more concerned about covering-up the harm they did than they are
about your health.  But here's my question: is Kaiser supported by the
medical establishment in placing its financial bottom line above patient
health?  I think the answer is YES.  Obviously, what you need to do is to find a
doctor outside of Kaiser who will do the biopsy and provide you with an
accurate evaluation.  That doctor might be harder to find than you think.
Courthouse News Service
November 21, 2014
Kaiser Doctor Alleges Dangerous Staff Cuts
By TISH KRAFT      

  PORTLAND, Ore. (CN) - Kaiser forced a "highly skilled physician" to quit
by allowing staff cuts to the point that it "jeopardized the lives of many
Kaiser patients," she claims.
  Dr. Radhika Breaden, a sleep specialist, sued Kaiser Foundation Health
Plan of the Northwest; Kaiser Foundation Health Plan Inc.; Northwest
Permanente; Kaiser Foundation Hospitals in Multnomah County Circuit
Court.
  She seeks $9 million for whistle-blower retaliation, gender discrimination
and wrongful discharge.
  Breaden claims that Kaiser brought in a "ruthless administrator who found
ways to minimize payrolls by shrinking staff while patient loads skyrocketed,
often leaving the remaining staff members trying to cope with impossible
patient care demands, which ultimately harmed Kaiser's patients."
  The administrator, Dr. Jeffrey Weisz, "prioritized saving costs and
increasing Kaiser's profits above patient care. He enacted policies that
decreased patient care and jeopardized the lives of many Kaiser patients,"
Breaden alleges.
  "To maximize profits, Dr. Weisz instituted a new policy to dramatically
decrease ... outside referrals and demanded that all patient care be
'internalized' and treated at Kaiser, disregarding the needs of the patients.
Dr. Weisz created a zero-tolerance policy for referring patients to external
health care providers, even if it was required by the Kaiser patient's treating
physician and without ensuring proper and adequate resources were
available within Kaiser," the complaint states.
  Breaden cites as an example that some of her elderly patients "expressed
that they were unable to drive long distances and wished to have sleep care
closer to their homes. Plaintiff expressed concern that Kaiser id not have
adequate facilities, the facilities were short-staffed, and that many of the
patients requiring sleep medicine evaluation and treatment were in danger
of getting in sleep-related motor vehicle accidents. Plaintiff was told that
there would be no circumstances by which these patients' wishes would be
honored.
  Ultimately, plaintiff was retaliated against, humiliated, and ostracized for
expressing her concerns and interfering with Kaiser's attempts to make as
much money as possible at the expense of patient care. Plaintiff also
reasonably believed hat Kaiser's new policy put her in danger of violating
certain laws. Plaintiff was forced to provide patient care she knew was well
below the acceptable standard of care, which dramatically changed her
working conditions. As a result, plaintiff was forced to either continue
providing significantly substandard patient care or resign. Plaintiff's
employment was constructively terminated."
  The plaintiff is represented by Roderick A. Boutin of Lake Oswego.
“Kaiser denied coverage for applied behavioral analysis
even though its own doctors said it was medically
necessary.” That’s right, when KP says in its
advertisements that medical decisions are only made by
doctors, they are flat out lying.

Arce vs. Kaiser class action lawsuit settled, and site
news
Aug. 14, 2013
KaiserThrive.org
[See also Kaiser Thrive Exposed
Facebook page.]

...The Arce vs. Kaiser autism class action lawsuit has been settled, resulting in
the creation of a $9 million fund to reimburse members who incurred out-of-
pocket expenses due to having their treatment denied. Anything left over will
go to autism research.

KP’s PR statement tells us that, “this settlement does not determine that Kaiser
Permanente acted inappropriately,” but we know better, don’t we? Just once
we would like to see something truthful come out of that BS factory. Such as,
“This settlement determines that KP acted inappropriately, by denying
treatment to members with autism. This often meant depriving them of the early
intervention that virtually every autism expert in the world deems necessary for
the best results. However, our agreement to establish a $9 million fund to
reimburse our victims should in no way be construed as concern for the actual
well being of the people we have harmed. It is merely a reflection of our
realization that seeing the lawsuit through to the end would have cost us many
times that amount, and of course our fear of the bad publicity that would have
certainly resulted.”

There is nothing KP hates more than bad publicity, and now they get to
pretend they did it out of the goodness of their black little hearts.

Below is a link to the article in Sacramento Business Journal, and the Autism
Daily Newscast has also covered the story here:

 Kaiser to pay $9M to settle autism therapy suit

 Kaiser Permanente has agreed to pay up to $9 million to settle a class action
that alleged the
health plan illegally refused to provide behavioral
therapy for autistic children before it was mandated by state law.

 The lawsuit was filed in Southern California in April 2009 on behalf of Andrew
Arce of Los Angeles and others like him. Andrew was 2 years old when Kaiser
denied coverage for applied behavioral analysis even though its own doctors
said it was medically necessary.

Did you get that last part? “Kaiser denied coverage for
applied behavioral analysis even though its own doctors
said it was medically necessary.” That’s right, when KP
says in its advertisements that medical decisions are
only made by doctors, they are flat out lying...