Kidney patient beats Kaiser arbitration rule

[okarol]

Friday, March 21, 2008
Kidney patient beats Kaiser arbitration rule

East Bay Business Times - by Marie-Anne Hogarth


Kaiser Permanente must allow a patient from its closed kidney transplant program to have his case heard by a jury in a public courtroom rather than by a private judge or lawyer in a closed-door arbitration proceeding, a state court of appeal in Sacramento ruled.

The opinion in a case filed by Bernard Burks of Rancho Murieta puts a chink in a policy that has shielded the health care giant from the public eye by requiring its members to sign a form agreeing to arbitration to resolve their disputes with the Oakland nonprofit.

It marks what the plaintiff's lawyer said may be the first case to go to a jury out of more than 100 filed by patients who were on Kaiser's kidney transplant waiting list.

"There have been other times that they have lost the arbitration clause," said Michael Bidart, a lawyer with Shernoff Bidart & Darras LLP who filed the lawsuit on behalf of Burks. "But it is not frequent."

[Chris]

I do not understand fully this article. Never heard of a transplant center called a "closed transplant program" for one. Wish there was a more in depth article explaining the problem.

[Roadrunner]

I found this on the internet.  Hopefully this answers some of your questions.

In the 1950s, two separate healthcare organizations merged to form what today is known as Kaiser Permanente. Since that merger the healthcare provider has continuously grown to its current point where it includes better than eight million members throughout the Country. Although Kaiser has membership around the country, it is based out of Oakland, California and maintains an extremely high number of members in Northern California.

Since 1978, Kaiser has included a provision Most Kaiser Permanente HMO members do not know that Kaiser has established specific rules for medical claims processing. Since 1978, Kaiser Permanente has included a provision in their group policies mandating the use of a private arbitration procedure for all medical claims against Kaiser Permanente resulting from negligence, carelessness or malpractice of a health care provider.

The Office of the Independent Administrator (OIA) handles all claims made against Kaiser. The OIA has set strict time tables for resolving claims and mandates that all claims be resolved through arbitration in less than eighteen months from the date the claim is filed. T

[Chris]

So this is an insurance organization, no wonder there are problems! Time to 

[okarol]

Here's more info about the lawsuit:

Four Year Delay and No Kidney Transplant - Kaiser Patient Seeks Punitive Damages Based on Misguided Kaiser Kidney Program

    SACRAMENTO, Calif., June 19 /PRNewswire/ -- "I need a kidney, I need
help and I can't wait any longer," said a frustrated Kaiser kidney patient
Bernard Burks, who was put on a list of patients awaiting a kidney
transplant at UC Davis back in 2002. Burks filed a lawsuit against Kaiser
Permanente of Oakland, California today alleging that Kaiser's four year
delay in providing him the life saving kidney transplant has further
increased the chances of his body rejecting any kidney once he is finally
able to receive one.
    In November of 2004, Burks was notified he was being transferred from
the UC Davis transplant program to Kaiser's newly established kidney
transplant program. For Burks, that meant being transferred to yet another
long list of ailing patients awaiting transplants in what seemed to be a
never-ending line to nowhere.
    Attorney Michael J. Bidart, of Shernoff Bidart & Darras in Claremont,
California said, "This case fits the mold for a huge punitive damage award
because so much harm has been done to all these patients waiting for life
saving treatment."
    Bidart, widely considered the nation's preeminent attorney on HMO Bad
Faith insurance matters, received national attention after obtaining a
verdict of $120 million in the case of Goodrich v Aetna -- the largest
verdict ever awarded against an HMO.
    According to the complaint, Burks is seeking an award of punitive
damages against Kaiser in order to punish them for their alleged egregious
corporate policies and practices which caused harm not only to him
personally, but to hundreds of other Kaiser patients. By way of the
lawsuit, Burks is asking the Court to punish Kaiser based on the severe
reprehensibility of Kaiser's alleged misconduct and profitability.
 

[Sunny]

I have read that Kaiser was forced to cease it's kidney transplant service in that area because they so egregiously mishandled their kidney transplant wait list.