Kaiser Foundation Health Plan of Texas has obtained a court order temporarily barring the Texas insurance department from releasing a report that the plan says falsely charges it with inappropriately denying emergency care to enrollees.
Unfortunately for Kaiser, an insurance department official admitted in court that she already had leaked a copy of the report to a national television news show, ABC's "PrimeTime."
The controversy over the Texas report compounds problems for Kaiser, which last month saw one of its California hospitals raided by federal health officials reportedly looking for evidence of poor care (See story, p. 64).
In testimony before the Travis County District Court in Austin, Texas, Mary Keller, an associate insurance commissioner, said the report shows Kaiser, with 130,000 enrollees in the Dallas-Fort Worth area, is in acute financial trouble that's compromising its ability to deliver appropriate medical care.
Kaiser attorneys argued that the report and its handling were intended as fodder for proposed anti-managed-care legislation in the state.
David O'Grady, a spokesman for the plan, said it was the department's first quality report on Kaiser and it was based on a review conducted by officials who lacked the necessary credentials. He said the report "misconstrues department regulations regarding emergency-care services and payment of claims." He also said the report violates state confidentiality laws because it contains patient information.
Texas Attorney General Dan Morales, in a statement before a state Senate committee, said the report and Kaiser's response could lead to revocation of Kaiser's license.
But O'Grady said "no effort has ever been made to revoke our license and there are no grounds to do so."
The restraining order is in place until April 18, and Kaiser is seeking to extend it as evidence gathering is conducted in its suit against the department.
The Dallas-based plan received a full, three-year accreditation from the National Committee for Quality Assurance in June 1995.