Kaiser asks court to prevent Hawaii health system from balance-billing its health plan members

Amid a payment dispute, Oakland, Calif.-based Kaiser Permanente has filed a temporary restraining order to prevent Honolulu-based Queen's Health Systems from directly billing patients covered by Kaiser insurance plans, according to the Honolulu Star-Advertiser.

The healthcare giant filed the temporary restraining order Aug. 22 as a battle continues between both sides over allegations that Queen's is unfairly billing patients.

Kaiser Foundation Health Plan, the insurance arm of Kaiser Permanente, filed a lawsuit against Queen's in June after a contract between Kaiser and Queen's expired on May 30. 

Kaiser aims to ensure its health plan members don't receive bills directly from Queen's for costs outside of deductibles and copays and wants a federal judge to allow Kaiser to pay only the "reasonable value of Queen's emergency serv­ices," the Star-Advertiser reported, citing the June complaint.

Kaiser spokeswoman Laura Lott told the Star-Advertiser Kaiser wants "a fair and equitable agreement" but won't "stand by while they threaten patients with surprise bills to gain bargaining leverage."

"Unfortunately, [Queen's] continues to threaten to bill patients for the balance of any charges, above what Kaiser Permanente pays. 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," she added.

But, according to the newspaper, Queen's accuses Kaiser of not "accept[ing] its responsibility to pay for the actual costs of services" for patients with complicated medical conditions.

Mich Riccioni, the hospital's CFO, described the temporary restraining order against Queen's as a response to Queen's decision earlier this month to ask for a dismissal of the lawsuit filed by Kaiser, the Star-Advertiser reported.

"In the filing, Kaiser claims it has the unilateral right to determine how much it has to pay Queen's and that Queen's has no recourse but to accept whatever Kaiser decides to pay," he told the newspaper. "Kaiser has not yet indicated — to the court or to Queen's — how much it plans to pay for Queen's services. That is completely unacceptable and is the reason Kaiser's members face the prospect of receiving bills from Queen's."

According to the Star-Advertiser, Kaiser covers more than 250,000 members in Hawaii. 

 

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