Kaiser Permanente Hawaii update regarding The Queen’s Health Systems
June 13, 2019
Since late 2017, Kaiser Permanente Hawaii has been in ongoing negotiations with the Queen’s Health System (QHS) to renew a hospital provider contract with these QHS hospitals: The Queen’s Medical Center (the only level one trauma hospital in Hawaii), The Queen’s Medical Center – West Oahu, North Hawaii Community Hospital, and Molokai General Hospital.
We are disappointed that QHS has rejected multiple offers for a fair and reasonable contract and has not given any indication of compromise from their original demands. As a result, the four hospitals are now considered non-contracted providers.
It is important to know that Kaiser Permanente is committed to ensuring patients receive the care they need and that KP members retain access to emergency and trauma services at all Queen’s facilities, as they would at any other hospital.
We are working hard to ensure continuity of care for all our patients. Members who currently have referrals to QHS generally will not have their course of treatment interrupted and will continue to receive treatment. For future referrals, we will coordinate care for our members with quality contracted providers.
KP Medicare and Medicaid (QUEST) member’s services will be paid at original Medicare rates and Medicaid rates respectively.
QHS recently informed us that they will attempt to collect the balance of charges, above what KP pays as usual and customary, from KP commercial members who receive medical care at any of the QHS facilities. This “balance billing” is an unfair practice that puts patients, who may already be dealing with serious and stressful health issues, in the middle of a contract dispute.
We are committed to paying Queen’s fair rates for the care they deliver to our members. These rates will be set at what is called usual, customary, and reasonable, or UCR, for commercial members. These are based on industry benchmarks and existing hospital contracts in the Hawaii market.
While we want to work toward a fair and equitable agreement, we cannot agree to Queen’s demands for unreasonable rate increases. Such payments are unsustainable and would greatly increase medical inflation and escalate the overall cost of care for all Hawaii residents.
Kaiser Permanente has filed this lawsuit to protect our patients from unfair billing practices. We look forward to a court reviewing this case and are confident we will prevail following an impartial review of the facts.
If you have questions about coverage or benefits visit kp.org or call Member Services Center at 808-432-5955 (Oahu), 1-800-966-5955 (Neighbor Island).