California Court Orders Kaiser to Pay $82 Million to a Hospital It Stopped Paying Fairly — Here’s What That Means for Kaiser Members

When Kaiser members came to Pomona Valley’s emergency room, Kaiser paid at the agreed contractual rate. In a statement to Becker’s Hospital Review, Kaiser said its “payments to Pomona Valley Hospital exceeded what the hospital typically accepted from other health plans and were substantially above its costs.” Kaiser members predominantly receive care within the Kaiser system. What This Means for Kaiser Members in Southern CaliforniaKaiser’s HMO model is built on keeping care within its own system. Federal law protects Kaiser members in emergencies — they can go to any emergency room, and Kaiser must cover it.