NUHW Sues California’s “Obamacare” Exchange to Protect Patients from Kaiser Permanente’s Substandard Care

Kaiser Healthcare ProsSeptember 10, 2013

Sacramento—Today, the National Union of Healthcare Workers (NUHW) and five other plaintiffs filed suit in the Superior Court of Sacramento, California to block Kaiser Permanente from participating in California’s Health Benefit Exchange due to its substandard care that violates the Exchange’s rules.

In June, the California Department of Managed Health Care (DMHC) fined Kaiser $4 million for committing multiple and “serious” violations related to its mental health services, including failing to give patients access to care and violating California’s Mental Health Parity Act. The DMHC’s fine is the second largest in the agency’s history and stems from a complaint filed in November of 2011 by NUHW’s mental health clinicians on behalf of their patients.

According to state and federal law, the Health Benefits Exchange can only contract with HMOs that “are in good standing with their respective regulatory agencies,” which is further defined as “the absence of any material statutory or regulatory violations, including penalties, during the prior year…”  

Nonetheless, last month California’s Health Benefits Exchange ignored state and federal law by signing a contract with Kaiser even after the Exchange had been fully apprised of Kaiser’s ineligibility to participate in California’s new health insurance market. Today’s lawsuit simply asks a judge to compel the Exchange to follow state and federal law, including the “good standing” requirement.

“Before Kaiser is allowed to enroll thousands more patients through the Exchange, it should first demonstrate that it can take care of the patients who already rely on Kaiser for their health care,” said Dr. Horace Beach, a psychologist who has worked at Kaiser Vallejo for many years.  “It’s unfortunate that it takes going to court to protect California consumers. But the Exchange shouldn’t allow a plan like Kaiser to participate until it can demonstrate that it has corrected all of the serious violations documented by the DMHC and has paid the $4 million fine to the state.”

The National Union of Healthcare Workers represents 10,000 frontline caregivers, including nearly 5,000 healthcare professionals employed by Kaiser Permanente, including registered nurses, psychologists, licensed clinical social workers, opticians, and other professionals.  In October 2011, NUHW released a 34-page paper entitled “Care Delayed, Care Denied:  Kaiser Permanente’s Failure to Provide Timely and Appropriate Mental Health Services,” which first made public Kaiser’s substandard mental health care.