Kaiser sues Hawaii hospital system over balance-billing plan

Kaiser Foundation Health Plan is suing The Queen's Health Systems, alleging the Honolulu-based nonprofit organization notified Kaiser of plans to unfairly bill patients, according to Pacific Business News.

Kaiser, part of Oakland, Calif.-based Kaiser Permanente, accuses Queen's of threatening to balance bill Kaiser health plan members at Queen's hospitals, according to the Business News report, which cites the lawsuit. The lawsuit says this would apply to members who receive emergency medical services.

"QHS has notified Kaiser that it intends to directly bill Kaiser members who receive emergency medical services at their facilities for amounts that they are not legally obligated to pay. Further, QHS disclosed that it intends to bill Kaiser — and then Kaiser's commercial members — 100 percent of its full billed charges for all services, including emergency services," the lawsuit states.

"Without a contracted rate for our commercial members, QHS is threatening to bill patients for the balance of any charges, above what KP pays," a Kaiser spokesperson added, according to the Business News. "This practice, known as balance billing, is intolerable and puts patients, who may already be dealing with serious and stressful health issues, in the middle of a contract dispute. Kaiser Permanente must act to protect our patients from unfair billing practices."

The lawsuit asks the court to determine these billing practices are not within Kaiser's legal rights.

Kaiser reportedly filed the lawsuit after an insurance contract between The Queen’s Medical Center and Kaiser Foundation Hospitals expired on May 30. The agreement allowed Kaiser health plan members to access care at Queen's hospitals on Oahu, Molokai and the Big Island at in-network rates.

In a statement to the Business News, Queen's spokesperson Minna Sugimoto said the hospital was reviewing the allegations:

"While we do not comment on pending litigation, we can say that we will continue to ensure all patients who seek our help, regardless of insurance coverage, receive the highest quality of care. It has been our mission for 160 years to provide great clinical care for all the people of Hawaii, and we will continue to serve all patients, including Kaiser members, any time they need our services."


More articles on healthcare finance: 

How a rural Alabama town helped save its hospital
5 tips from hospital CFOs
Cost-cutting trails revenue growth as 2019 priority, hospital CEOs say

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars