Sunday, December 22, 2024
Hawai'i Free Press

Current Articles | Archives

Saturday, July 18, 2015
Lawsuit: Kaiser Barely Pays for Medevac
By Selected News Articles @ 2:36 PM :: 5102 Views :: Health Care

Kaiser Barely Pays for Medevac, Class Claims

by Barbara Wallace, Courthouse News, July 18, 2015 

HONOLULU (CN) - Kaiser barely covers emergency air transport, a class of patients claims in a lawsuit filed in the U.S. District Court for the District of Hawaii.

Lead plaintiff Toby Sidlo sued Kaiser Permanente Insurance Company and Kaiser Foundation Health Plan, on behalf of himself and all others similarly situated, for violations of the Employee Retirement Income Security Act.

Sidlo had Kaiser health insurance coverage through his employer, non-party Kauai Sea Tours, according to the lawsuit.

"On or about July 17, 2014, plaintiff was badly injured during an accident in which he suffered serious and potentially life-threatening burns over large portions of his body. At the time of his accident, plaintiff was located in Kauai, Hawaii. Unable to adequately treat plaintiff's serious burn injuries, a decision was made by treating health professionals to transport plaintiff to Oahu, Hawaii to be treated in a suitable burn center and trauma unit," the complaint states.

Non-party Hawaii Life Flight, Inc. flew Sidlo to non-party Staub Medical Center where he received skin grafts which left him with scars covering 30 percent of his body, according to the complaint.

Although Sidlo's Kaiser policy said it would cover 80 percent of the cost of medically necessary emergency transportation services, Kaiser denied most of it, leaving him with a $36,000 balance due, according to the complaint.

Sidlo contends Kaiser customarily underpays emergency transportation services.

"Defendants and their related entities have established and carried out a deliberate and systematic policy to deny all claims for proper emergency transport reimbursement, even though it knows that the terms of its own plan documents purport to provide full reimbursement coverage for the medical services minus a standard 20 percent co-pay applicable to the class," the complaint states.

Kaiser banks on seriously ill or financially strapped folks not being able to "physically or financially challenge the Kaiser under-reimbursement program," to save tens of millions of dollars, the complaint continues.

"The average cost of an emergency air medical flight is $40,000," the complaint states.

But Kaiser has under-reimbursed almost 100 such flights in Hawaii since 2013, reimbursing at rates of only 10 to 20 percent, according to the complaint.

Sidlo and the class seek declaratory and injunctive relief, costs, interest, attorney fees and equitable disgorgement. The class is represented by Michael A. Lilly and Valerie Kato of Ning, Lilly & Jones in Honolulu.

PDF: Text of Lawsuit

Links

TEXT "follow HawaiiFreePress" to 40404

Register to Vote

2aHawaii

Aloha Pregnancy Care Center

AntiPlanner

Antonio Gramsci Reading List

A Place for Women in Waipio

Ballotpedia Hawaii

Broken Trust

Build More Hawaiian Homes Working Group

Christian Homeschoolers of Hawaii

Cliff Slater's Second Opinion

DVids Hawaii

FIRE

Fix Oahu!

Frontline: The Fixers

Genetic Literacy Project

Grassroot Institute

Habele.org

Hawaii Aquarium Fish Report

Hawaii Aviation Preservation Society

Hawaii Catholic TV

Hawaii Christian Coalition

Hawaii Cigar Association

Hawaii ConCon Info

Hawaii Debt Clock

Hawaii Defense Foundation

Hawaii Family Forum

Hawaii Farmers and Ranchers United

Hawaii Farmer's Daughter

Hawaii Federation of Republican Women

Hawaii History Blog

Hawaii Jihadi Trial

Hawaii Legal News

Hawaii Legal Short-Term Rental Alliance

Hawaii Matters

Hawaii Military History

Hawaii's Partnership for Appropriate & Compassionate Care

Hawaii Public Charter School Network

Hawaii Rifle Association

Hawaii Shippers Council

Hawaii Together

HiFiCo

Hiram Fong Papers

Homeschool Legal Defense Hawaii

Honolulu Navy League

Honolulu Traffic

House Minority Blog

Imua TMT

Inouye-Kwock, NYT 1992

Inside the Nature Conservancy

Inverse Condemnation

July 4 in Hawaii

Land and Power in Hawaii

Lessons in Firearm Education

Lingle Years

Managed Care Matters -- Hawaii

MentalIllnessPolicy.org

Missile Defense Advocacy

MIS Veterans Hawaii

NAMI Hawaii

Natatorium.org

National Parents Org Hawaii

NFIB Hawaii News

NRA-ILA Hawaii

Obookiah

OHA Lies

Opt Out Today

Patients Rights Council Hawaii

Practical Policy Institute of Hawaii

Pritchett Cartoons

Pro-GMO Hawaii

RailRipoff.com

Rental by Owner Awareness Assn

Research Institute for Hawaii USA

Rick Hamada Show

RJ Rummel

School Choice in Hawaii

SenatorFong.com

Talking Tax

Tax Foundation of Hawaii

The Real Hanabusa

Time Out Honolulu

Trustee Akina KWO Columns

Waagey.org

West Maui Taxpayers Association

What Natalie Thinks

Whole Life Hawaii