URL: http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2001/11/29/BU138426.DTL
 

A federal judge has ordered the state's HMO czar to answer to potential contempt charges in connection with a $1.1 million fine the department levied against Kaiser Permanente.

The judge's order comes just as Kaiser, headquartered in Oakland, prepares to appeal the fine -- the largest ever issued against a health maintenance organization in California -- on Tuesday in the state Office of Administrative Law in Oakland.

"I am not going to abandon this case because of the threat of contempt," said Daniel Zingale, head of the state Department of Managed Health Care, who has been ordered to appear Dec. 10 in U.S. District Court in Los Angeles.

The fine, which was issued over systemic problems in Kaiser's emergency care system, was based on the 1996 death of a San Leandro woman, Margaret Utterback, from a ruptured aneurysm after being repeatedly denied emergency care at the Hayward hospital.

Since the fine was issued in May 2000, two additional patients have been added to the list of defendants. One of the deceased patients, of Woodland Hills (Los Angeles County), was a Medicare recipient.

The patient's Medicare status is significant because in August the state HMO lobby group, the California Association of Health Plans, won a federal ruling in a separate case that determined federal law pre-empts state law when it comes to federally funded Medicare patients. Using this ruling, Kaiser has now objected to the inclusion of Medicare patients in the case.

"This is really to call them (the Department of Managed Health Care) in to explain why they do not view this to be a violation of (the federal) judge's earlier court order," explained Kaiser spokesman Tom Debley.

Debley said Kaiser plans to continue with the appeal on Tuesday. "We're the ones who requested the administrative hearing in terms of challenging the department's actions. We're prepared to proceed with that case," he said.

Zingale, who could face jail time for contempt, said he will appear at the hearing to explain why he should not be held in contempt. He said his department is simply using a Medicare patient's experience to show a systemic problem with an HMO that his department regulates.

Consumer activist Jamie Court said a contempt ruling could hinder state patient laws enacted recently by taking away some of the department's enforcement abilities. "These are serious stakes and Zingale is rightly fighting for a very important principle," he said.

E-mail Victoria Colliver at vcolliver@sfchronicle.com.

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