In September 2020, I moved in with my then 89-year-old mother to help her with the necessities of daily living. On January 2, 2022, my mother fell and broke her hip. Kaiser Permanente's medical negligence crippled her. She has been in and out of hospitals, skilled nursing facilities and a board and care ever since. In February 2023, I extricated her from Kaiser, switching her to Anthem Blue Cross, which went into effect on March 1, 2023. Two days before the switch, Kaiser took her out of the (out-of-network) hospital against medical advice and, over my objections, stuck her in one of the worst skilled nursing facilities in Los Angeles County. The SNF withheld my mother's blood thinners (she's genetically predisposed to clots) without medical justification, causing her to have a stroke. No one noticed she'd had a stroke, making her ineligible for the medication which could have reversed the stroke. They told EMTs my mother had a DNR, knowing she did not. They also committed Medi-Cal fraud.

Kaiser Permanente, one of the largest health care providers in the U.S., is committing Medicare fraud, tax fraud and health care fraud, involving out-of-network hospitalizations.

On June 27, 2022, my mother was a patient at Sherwood Oaks Post Acute in Thousand Oaks, California. She was sent there by Kaiser Woodland Hills, ostensibly to receive physical therapy after she broke her hip. (Kaiser selected Sherwood Oaks. Because of limited availabilities due to the COVID pandemic, Kaiser sent her to a skilled nursing facility which was out-of-network.)

While she was a patient at Sherwood Oaks, my mother went into septic shock and was taken by ambulance to Los Robles Regional Medical Center in Thousand Oaks. (Los Robles was the closest hospital to Sherwood Oaks, and is out-of-network.) She was diagnosed with bi-lateral kidney stones in her kidneys and ureters, her right kidney was inflamed.

Los Robles saved my mother’s life. She was a patient there for twenty-five (25) days, eventually being discharged to Kaiser Panorama City on July 22, 2022.

The amount claimed by Kaiser for reimbursement from Medicare does not match the amount Kaiser paid Los Robles as settlement of their bill for my mother’s care.

Per Medicare, Kaiser filed a claim for my mother’s stay at Los Robles in the amount of $893,868.25. Medicare approved the claim in full, and reimbursed Kaiser $0.00. Per the Explanations of Benefits (EOBs) prepared by Kaiser, Kaiser paid Los Robles $59,261.79 for my mother’s hospital stay. Kaiser’s Medicare claim for this out-of-network hospital stay was $843,246.46 more than what they actually paid Los Robles to settle the bill, a difference of 1508%.

This was not an isolated incident. On August 25, 2022, my mother was taken by ambulance to Northridge Hospital Medical Center, where she was diagnosed with a urinary tract infection. She was transferred to Kaiser Panorama City on August 27, 2022.

Per Medicare, Kaiser filed a claim for my mother’s stay at Northridge Hospital in the amount of $54,342.00. Medicare approved the claim in full, and reimbursed Kaiser $144.81. Per the EOBs prepared by Kaiser, Kaiser paid Northridge Hospital $9,814.32 for my mother’s hospital stay. Kaiser’s Medicare claim for this out-of-network hospital stay was $44,527.68 more than they actually paid Northridge Hospital to settle the bill, a difference of 554%.

It would be reasonable for Los Robles and Northridge Hospital to be able to take tax write-offs for the difference between the amounts they billed Kaiser (as my mother’s Medicare provider) and the amounts Kaiser actually paid them for my mother’s care. It is not reasonable for Kaiser to file Medicare claims for reimbursement of amounts higher than they actually paid Los Robles and Northridge Hospital.

If Kaiser did what I think they did, Kaiser’s grossly inflated Medicare claims were filed to facilitate filing falsified tax write-offs, write-offs for money they never paid.

I can provide you with copies of Kaiser’s Medicare claims for my mother’s hospital stays at Los Robles Regional Medical Center and Northridge Hospital Medical Center (dba Dignity Community Care), along with Kaiser’s EOBs for July 2022, August 2022, September 2022, October 2022 and December 2022. I can also provide you with copies of my mother’s financial and health care powers-of-attorney, as well as her signed HIPAA Release.

I have already filed complaints with Medicare, the IRS, the Franchise Tax Board and the Department of Justice.

I am currently organizing my evidence regarding Kaiser’s actions to get out of paying for my mother’s care at Sherwood Oaks. When completed, I will be filing complaints against Kaiser and Sherwood Oaks for perjury (to Livanta), falsification of medical records and HIPAA violation with the FBI, the California Attorney General, and the Los Angeles and Ventura County District Attorneys. (Kaiser and Sherwood Oaks sent Livanta medical records indicating my mother received weeks of physical and occupational therapy, before deciding she had plateaued and would not benefit from additional therapy. Kaiser's EOBs prove my mother received only two PT/OT sessions, one as part of her evaluation the day she was admitted.)

So-called "health care" companies need to be held accountable for their actions. Kaiser routinely discriminates against the elderly, the disabled and the chronically ill. Kaiser has no interest in the health and welfare of their members, only in how much money they can make off of them.

I want justice for my mother. I want Kaiser and Sherwood Oaks held accountable for their actions. I want the laws changed to protect our most vulnerable citizens.

I do not wish to remain anonymous. I want everyone to know what Kaiser has done, and am willing to tell anyone who will listen.