Kaiser Permanente will streamline its malpractice arbitration system in California by encouraging the use of a neutral arbitrator to settle disputes.
That change, along with dozens of others, is based on recommendations made to Kaiser by a special three-member task force assembled last year after the California Supreme Court criticized the managed-care company for using mandatory binding arbitration to settle malpractice complaints.
Recommendations to be adopted by Kaiser include:
Appointing an independent administrator to oversee the selection of an arbitrator.
Selecting an arbitrator within 30 days of a patient grievance and paying the cost.
Handling disagreements over arbitrator selection by having the administrator provide a narrowed list of names to both sides and giving them 10 days to remove "some number" of the names.
Monitoring the administrator's performance regularly through an advisory committee.
Kaiser said it would appoint an advisory panel by Feb. 1 and an administrator by April 1.
Kaiser had handled arbitration internally since it began using it in 1975. Many cases are decided by a three-member panel -- one arbitrator picked by Kaiser, a second picked by the plaintiff and a neutral party agreed to by both sides.
But the California Supreme Court voted 6-1 last July to allow the family of a Kaiser patient to sue the health plan in Superior Court, concluding there was evidence that Kaiser had stacked the dispute resolution process in its favor (July 14, 1997, p. 40).
Phil Isenberg, a former state assemblyman and special task force member, said he believes that adopting the recommendations could allow Kaiser to cut the average time to settle arbitration to 18 months in about 85% of its cases, from about 30 months.
However, consumer advocates and attorneys say Kaiser could maintain the upper hand in such disputes by compiling an extensive database on available neutral arbitrators, retaining veto power over the selection of the arbitrator, and, most importantly, still requiring patients to arbitrate and waive their rights to sue in court.