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Kaiser Notice Called Ample

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Times Staff Writer

State HMO regulators said Tuesday that they had found no evidence to support allegations that Kaiser Permanente misled about 18,000 patients in the Coachella Valley about their upcoming transfer from outside doctors to the HMO’s staff physicians.

The California Department of Managed Health Care said it determined that Kaiser had sent adequate notice about the transition to members and employers in the Palm Springs, Palm Desert and Indio areas of Riverside County. The move affects only primary care physicians, not specialists.

“We did not find it to be confusing or inadequate,” said Amy Dobberteen, the department’s chief of enforcement.

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The allegations were raised by a Los Angeles attorney and doctors’ groups that have been seeing Kaiser patients under contract because the HMO has not had physician offices in the area.

After Kaiser announced plans to open such offices, the outside groups -- Desert Medical Group and Oasis Independent Physician Assn. Medical Group -- complained that the HMO’s existing physician directories continued to list their internists, pediatricians and family practice physicians even though their contracts to see Kaiser members will end June 30.

Lynne Randolph, spokeswoman for the managed care department, said Kaiser attempted to broker a deal that would have allowed its members to continue seeing the outside doctors until year’s end or until the patients could change insurers. But the offer was rejected by the doctors, she said.

Dr. Marc Hoffing, medical director of the doctors’ groups, said the payment arrangements offered by the HMO were unworkable.

“What they asked us to do at this point is just not something that was in the realm of possibility,” he said. “We will do everything we can to make sure the patients are smoothly transitioned to get the care that they need.”

The transfer of patients will proceed as scheduled. Beginning July 1, Kaiser members in the Coachella Valley must seek their primary care services at one of three new Kaiser medical centers.

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The HMO’s officials in the Southland said they are gratified by the state’s decision. “All the way back in 2005, when we initiated this process, we were quite extensive in our efforts to inform our members that they would at some point have to change primary care physicians,” said Gregory Adams, chief operating officer of Kaiser Foundation Health Plan and Hospitals in Southern California.

After the transition, Kaiser patients in the Coachella Valley will still be referred to outside physicians for specialty care. In addition, members with certain serious or chronic health conditions won’t be required to transfer doctors immediately.

Los Angeles lawyer Ray Gallo, who had encouraged the managed care department to intervene on patients’ behalf, said he is considering a lawsuit.

“It’s such a tender issue who your doctor is,” Gallo said.

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