Healthcare Giant Won't Pay $5,418 for Services, Hospital Says
5-15-2015 22:26:00

MONTEREY, Calif. (CN) - Kaiser unlawfully pays only a portion of the cost of emergency services provided to its members, a hospital alleges in a Monterey County Superior Court complaint.

Community Hospital of the Monterey Peninsula provided out-of-network emergency care to four Kaiser patients between April 26 and August 21, 2013. 
The hospital says Kaiser has a practice of covering only a portion of its patients’ bills, claiming that some treatment and procedures “exceed what was reasonable and customary” and that Kaiser will continue its implementation of the policy in the foreseeable future unless ordered to stop, according to the seven-page complaint.
“Kaiser is required to pay Community Hospital for the emergency services provided to its members without requiring prior authorization, pursuant to the public policy favoring patient access to health care,” the complaint states.
“The failure of Kaiser to pay Community Hospital’s claim for emergency services for patients constitutes an unfair business practice in violation of Business and Professions code.”
Community Hospital sued Kaiser Permanente Insurance Company for violation of California’s Unfair Competition law.
The hospital wants Kaiser to pay $5,418 in damages, plus interest and litigation costs, and to issue an injunction ordering Kaiser to pay for all future emergency services provided to Kaiser members.
Community Hospital is represented by Christopher Panetta and Elizabeth Leitzinger of Fenton Keller, in Monterey, Calif.