Kaiser Foundation Health Plan, the insurance arm of Oakland, Calif.-based Kaiser Permanente, filed the lawsuit in June after a contract expired on May 30. The expired agreement allowed Kaiser health plan members to access care at Queen’s hospitals at in-network rates.
Kaiser aims to ensure health plan members don’t receive bills directly from Queen’s for costs outside of deductibles and copays and wants a federal judge to require that the health plan pay only the “reasonable value of Queen’s emergency services,” the Star Advertiser reported, citing the June complaint.
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.
According to Hawaii News Now, out-of-network care provided to patients with Kaiser insurance coverage will result in full charges, since the contract between both sides expired in May.
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