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Kaiser mismanages Kidney Program, gets 2M$ fine.
SACRAMENTO – Kaiser Permanente, the nation’s largest health maintenance organization, will pay a $2 million fine and give $3 million to an organ donor program because of mismanagement of its kidney transplant center, state officials said Thursday.
The fine is the largest ever imposed by the Department of Managed Health Care. Officials said Kaiser could face additional penalties generated by a continuing state investigation of its patient grievance procedures.
Mary Ann Thode, president of Kaiser Foundation Health Plan and Hospitals in the Northern California region, said the HMO deeply regretted “any problems, difficulties or concerns we may have caused any of our patients as a result of their experience” with the transplant program.
“This matter has caused our organization to reflect on how we can improve moving forward,” she said in a statement. “We have learned from our experience, and we will demonstrate that through our actions.”
Kaiser announced in May that it was closing its kidney transplant center in San Francisco and transferring its patients to programs run by the University of California.
The announcement followed news stories that reported serious failures in implementing the approximately two-year-old program and transferring Kaiser patients from transplant systems run by other health care providers.
“I think they underestimated the administrative needs to erect and implement a program as large as the Kaiser program,” said Kevin Donohue, a department deputy director.
“I don’t believe that anyone anticipated the complexity (of what) needed to be accomplished to safely transfer these people.”
He said he had told Kaiser to complete the transfers of its roughly 2,300 kidney transplant patients by the end of the year, although Kaiser will continue to do transplant surgeries if organs become available before transfers take place.
Department Director Lucinda Ehnes said problems with the program included failure to provide adequate administrative oversight and enough personnel to accomplish the transfers, give patients timely access to kidney specialists and treatment referrals, and properly respond to patient complaints.
Donohue said the department had no “strict indications” that any patients had died as a result of problems with the program.
“The information on that and the private suits (patients) may be pursing haven’t been developed to the point where there is adequate information to make that determination,” he said.
On Thursday, the Los Angeles Times reported that twice as many Kaiser transplant patients died last year as received new kidneys, the opposite of the statewide average.
Ehnes said the department suggested the $3 million contribution to Donate Life California, an organ and tissue donor registry program, saying the additional payment by Kaiser “reflected the magnitude of the issue.”
“We have structured the agreement and penalty with Kaiser in this way because not only will it acknowledge Kaiser’s serious failures to adequately administer and operate its transplant center, it will directly benefit the patients who so desperately need help,” she said at a news conference. “This funding will save lives.”
She said she wasn’t sure if the department would have imposed a higher fine if Kaiser had refused to make the donation.
She also said she didn’t think Kaiser should attempt to re-establish a transplant program, at least not soon.
“I think that the baggage is too heavy,” she said. “I think that understanding of the administrative processes requires a lot more sophistication.”
Source : http://www.mercurynews.com/mld/mercurynews/news/breaking_news/15245674.htm