PRINT THIS PAGE | E-MAIL THIS PAGE

Thursday, April 24, 1997

Kaiser responds to report allegations

By SARAH HORNADAY

Associated Press Writer

AUSTIN (AP) - Kaiser Permanente issued its response Wednesday to what it calls "erroneous allegations" of a state agency report that was opened to the public.

"The draft report contains flawed allegations made by unqualified and untrained (Texas Department of Insurance) reviewers, not the true facts about Kaiser Permanente's commitment to quality care," the company said in a prepared statement.

The Texas attorney general's office on Tuesday ruled the report a public record. Kaiser had sued the department earlier this year to block the release of the report. It settled the suit last week, but continued to fight the release of the document.

The settlement, agreed upon Friday, requires Kaiser to improve its recordkeeping and requires more financial backing from Kaiser's California parent company.

In the report, the insurance department alleged that Kaiser retroactively denied payment of emergency care services despite its nurses recommending such care.

The report did not release names of any patients or physicians.

It also alleged Kaiser denied payment of emergency care services in instances where patients reasonably believed they needed emergency care.

"Further investigation reveals that the emergency room claims had indeed been paid," Kaiser's statement said.

Kaiser said the allegations of incomplete medical records were false. According to Kaiser, reviewers failed to look in the medical records, relying only on notes about the medical records.

"It's absurd to reach a verdict on a health plan's quality based on a draft of a report that was later rewritten over and over by the agency that produced it," Dr. Bill Gillespie, Kaiser president, said of the report, which he claims was rewritten at least once.

"That's like giving a final grade on a term paper that's not even finished," Gillespie said. Send a Letter to the Editor about This Story | Start or Join A Discussion about This Story
Send the URL (Address) of This Story to A Friend: