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Kaiser Foundation Health Plan Inc. is suing Hawaii Life Flight Corp., one of the state’s two air ambulance providers, for secretly funding patient lawsuits against the health plan to pay for excessive medevac charges.
The state’s largest health maintenance organization filed the suit in U.S. District Court on Feb. 18, claiming that the air ambulance company is charging exorbitant rates that are significantly higher than its competitor, AMR Air Hawaii, and contends that Kaiser and its members are not responsible for those charges. Representatives of Hawaii Life Flight didn’t return calls for comment Friday.
“What we want (is to) protect our members from abusive practices and exorbitant fees,” said Kaiser spokeswoman Laura Lott. “(Hawaii Life Flight’s) services have been reimbursed by Kaiser Permanente at reasonable levels which exceed government reimbursement rates and reflect the fair market value of the services. This is consistent with our coverage terms and our goal to provide affordable health care services to members. We believe (the) charges vastly exceed the fair market value of the services.”
Kaiser’s complaint is related to a lawsuit against the health plan by Toby Sidlo, a tour boat captain who was medevaced to Oahu after falling into a beach bonfire last year on Kauai. He is the lead plaintiff in a class-action suit against Kaiser, which paid 28 percent — or $14,000 — of his $50,000 air ambulance bill from Hawaii Life Flight. Sidlo was left with a $36,000 balance due and is attempting to get Kaiser to pay the full amount for the emergency transportation services.
Sidlo’s complaint filed in U.S. District Court on July 15 claims Kaiser is responsible for the charges under a contract that stipulates full reimbursement for medically necessary air ambulance services, minus a
20 percent patient copay. Kaiser said it doesn’t have a contract with Hawaii Life Flight.
After discovering that Hawaii Life Flight was funding Sidlo’s case, Kaiser filed its own litigation seeking to stop the company from soliciting its members in an attempt to prosecute the health plan for refusing to pay its excessive charges. Kaiser’s lawsuit cites Honolulu Star-Advertiser research that shows Hawaii Life Flight charges thousands of dollars more than AMR for similar flights.