State probing Kaiser transplant program

SAN FRANCISCO — State regulators are investigating whether Kaiser Permanente mishandled a vast new kidney transplant program and put hundreds of patients’ lives at risk, a spokeswoman for the California Department of Managed Health Care said Friday.

Kaiser failed to hold basic discussions with regulators on how to properly transfer up to 1,500 of its kidney patients from other programs to its new transplant center in San Francisco in 2004, the Los Angeles Times reported this week.

Paperwork errors and other administrative bungling stalled, and in some cases canceled, the processing of many patients waiting for transplants. Some patients were never told their transfers from other programs had not been processed.

The transfer for one patient, Ruben Porras, didn’t come through until September — 10 months after he was put on inactive status by his previous program, the newspaper reported. Porras died less than a month later. His wife, Elizabeth Porras, said Kaiser had given her husband "a death sentence.”

Kaiser had previously paid University of California, San Francisco and University of California, Davis to care for its Northern California kidney transplant patients.

After Kaiser told UC Davis to stop seeing its transplant patients, that university placed Porras and 66 other Kaiser patients on inactive status in November 2004, rendering them ineligible for transplants.

In the program’s first full year, 2005, Kaiser performed only 56 transplants but twice that number of people who were waiting for the organ died, the newspaper reported. Conversely, more than twice as many people received kidneys than died at transplant centers statewide during that period.

On Friday, the Department of Managed Health Care said it had been investigating Kaiser for five weeks.

"Our main concern is whether the patients had proper access to health care,” said spokeswoman Lynne Randolph. "Did they get the treatment they needed in a timely manner?”

The department is investigating whether Kaiser improperly referred patients to a program it knew to be struggling.

The Department of Managed Health Care doesn’t regulate medical issues, but is in charge of overseeing managed health care programs in the state. Kaiser could face a wide range of penalties from simply being required to fix the problems to having its managed care license yanked in California. Fines of up to $1 million are also possible.

The inquiry was launched after a former Kaiser employee filed a complaint. Randolph wouldn’t provide any more details about the ex-worker, but Kaiser spokeswoman Maureen McInaney said the former employee was with Kaiser for less than two months and was not a doctor.

McInaney said Kaiser turned over all requested documents to the department and launched its own internal investigation Thursday. McInaney said Kaiser is also contacting all of its kidney transplants patients in an attempt to assuage concerns and answer questions.

Officials with the United Network for Organ Sharing, the federal contractor that oversees the nation’s transplant system, said this week that they learned of the need to move patients to the giant HMO’s new program in September 2004, after it had opened.

The network needs detailed patient information and a patient’s written consent to process a transfer, and they were caught off-guard by the flood of paperwork.

"Normally when transfers are addressed, we handle them in onesies and twosies, as they come up,” said United Network spokesman Joel Newman, who called the situation with Kaiser "unprecedented.”

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On the Net:

HMO: http://www.kaiserpermanente.org

United Network: http://www.unos.org

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