Kaiser Settles Transport Payment Squabble

Kaiser Settles Transport Payment Squabble
By PHILIP A. JANQUART

(CN) - A stipulation agreement has led to the dismissal of claims that Kaiser Foundation Health Plan failed to pay a company that transported patients to dialysis.
ProTransport-1 LLC, which claimed to transport Kaiser patients with end stage renal disease, had filed the lawsuit under the False Claims Act in 2012.
It said that Kaiser takes hundreds of millions of dollars from the U.S. government to care for seniors and patients with special needs, but that it pockets the money and has contractors like ProTransport bill the California Medical Assistance Program, known as Medi-Cal, for services rendered.
Claiming that the Medicare Act allegedly requires Kaiser to pay the company in the first instance, ProTransport said the insurer's conduct amounted to fraud.
The complaint spared no words in blasting Kaiser as an "unscrupulous" entity whose "greed" compels it to steal from and defraud the government.
This past August, U.S. District Judge William Orrick refused to let ProTransport advance claims that the alleged billing was part of Kaiser's plan to kill its patients.
The complaint had stated: "Of course, Kaiser knows very well that without dialysis, these patients will die within weeks. That is part of Kaiser's plan. Dialysis is expensive, so is transporting patients to and from dialysis. By killing off these patients, Kaiser is left with a much more profitable patient base, resulting in billions in profits."
But Orrick had no patience for the "scandalous" allegation.
"References to Kaiser welcoming deaths, causing deaths or profiting from deaths - unsubstantiated by factual allegations - are immaterial and scandalous and should be stricken," he wrote.
ProTransport eventually dropped seven of its 10 claims.
The parties agreed to mediation in late August and ProTransport's attorney, George Azadian, of The Matthews Law Group in San Marino, Calif., revealed this week that they entered a stipulation agreement to dismiss the case.
Azadian stressed stipulation agreements are generally confidential and that he could not reveal the conditions of ProTransport's agreement with Kaiser.
Attorneys for Kaiser did not return a request for comment.
Orrick dismissed the case Tuesday.

http://www.courthousenews.com/2013/12/06/63522.htm