Cutting Off Coverage? An Examination Of A Case In California
The Huffington Post Investigative Fund on the case of Heather Galeotti, a woman in a coma after being hit by a car: "[I]n July 2007, five months into Galeotti's treatment, Kaiser [Permanente] stunned the family with a letter. The Galeottis would have to find another way to pay the bills. Based on information received from her father's employer, Kaiser said that the young woman's coverage had not been in effect when she was hit." (Neither KHN nor the Kaiser Family Foundation is affiliated with Kaiser Permanente).
"....officials at Kaiser, the nation's largest nonprofit health plan, continue to maintain that the insurer's actions in the Galeotti case should not be considered a retroactive termination of coverage. That's because -- according to Kaiser officials -- a month before the car hit Galeotti, the employer's group plan notified the family that her coverage had lapsed on Dec. 31, 2006. ... Kaiser acknowledged that it made an error by not paying Galeotti's bills, but blamed the mistake on the late notification from the group plan and 'a lack of coordination' among departments inside the insurer. Spokesman Won Ha pointed out that Kaiser provides approximately 40 million patient services each year and he described the circumstances presented by the Galeotti matter as rare, with 'no regular frequency over the long run'" (Ivory, 3/26).