HomeMy WebLinkAboutCOM 0292.000 1996-1998
OJ-29%9i TL'E 1$:JI FA.I" 808 X251515 TO)1 RLiSSI X001
April 29, 1997 . _1
Attn: L,.La '97 F'R 30 P(1 7 11
Could you please see that all the council menu~ers get ~pp~~~aati that
on May 13, at the Kona meeting, they have some backgro k3at~r! ~`#~e
speaking about. Also, I will be mailing the original letter of request to speak
at that meeting.
Thank you for your time.
Sincerely,
c
Tan Russi
P.O. Box 3586
Kailua-Kona, FII 96745-3586
808/325-1515
;king Di,a ~ a ~ ~
M~~ 0 j 1997
0{;2S%Oi TL'E 18:91 F.41 808 9251515 TO)1 RLISSI X002
April 29, 1997
Jimmy Arakaki
County Council
25 Aupuni St.
Hilo, HI 96720
Dater Jimmy:
This is to request to speak at the County Council meeting on Public Works
at the Kona Surf on May 13, 1997. at 2:30 p.m.. My subject matter is covered
in the £ax I sent to your office today.
Tharilc you,
i
Tan Rossi
P.O. Box 3586
Kailua-Kona, HI 96745-3586
Oa; 29%9i TL'E 18:31 Fdl' 808 3251515 TC\I RUSSI f~003
April 23,1997
This Fax is for everyone I have Caen corresponding with for the
last 7 months, except fnr Mayor Harris, who refused to correspond
with me.
I owe one of you a big MAHALO. Someone called me tonight and
just said "Buy the Honolulu Advertiser." Thank you very much.
The article is very interesting. Answers a lot of questions for
me on cvhy ~ questions have gone unanswered. And why my phone
calls have gone unreturned, Mr. Alex Santiago.
The article was very intormatlve in the fact that our Community
Hospitals are in trouble and the cuts they'll have to make. It
leaves out one interesting point. The point I have been trying to
make for 7 months. One of the reasons our Community Hospitals are
in trouble is because a contract has been approved by 3 people
that sold us out. The money is not to be found in the taxpayer's
pocket. It's in HMSA's pocket and we need to find Someone with
enough muscle to go get it. There's got to be one of you out there
with enough integrity and ethics to do what's right.
My wife and I ask one of you to please do what's right here.
People like us are tired of this kind of government. Leave this
kind of b.s. for Washington and show your real Aloha.
Sincerely,
Mr. and Mrs. Thomas Russi
P.O. Box 3586
Kailua-Kona, HI 96745-3586
808/325-1515
P.S. To: Bob Loy, Tim Tindall and Sade tdoon
Isn't it funny how things come around sometimes and bite
you in the ass?
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01: 29. 9i TLE 18:52 F.L.I' 808 J251515 TO\1 RL;SSI f~00a
BENJAMIN J. CAYEfANp • .rrr ,
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cov(laon ! h~~` ~ clacroa
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STATE OF HAWAII
INSURANCE DIVISION
DEPA.., MENT OF COMMERCE AND CONSUMER AFFAIRS
P. 0. BOX 76f a
NONOWIU. HAWAn 9G811~7Gta
Aso s. uuc sr., srN rwox
NONOLUIU. MIW1tl 9y10
April 28, 1997
Mr. and Mrs. Thomas Russi
P O Box 3586
Kailua Kona HI 96745-3586
Dear I4r. and Mrs. Russi:
Thank you for your recent correspondence concerning the
Community Hospital System. A review of our office's records
confirms Ms. Christine Paul's complaint against HbISA was received
on April 14, 1997. Our investigation branch has begun an
investigation into Ms. Paul's concerns and, upon conclusion of
their investigation, will respond to the complaint.
Please note, hocaever, the State of Hawaii Insurance Division
does not have jurisdiction over the State of Hawaii Department of
Health and/or the operation of Hawaii's Community Hospitals. You
may wish to bring your concerns to the Office of the Ombudsman
which oversees all State offices.
Thank you for bringing your concerns to my attention. As
our investigations are conducted in writing, you may not hear
from our office for 45-GO days.
very truly yours,
RE RAOL C
I}~s ance C mmissioner
l_..~'
Cc:sy
0~.29~9i TPE 18:x2 FdS 808 X251515 T0~1 RUSSI 0 005
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~1T]IIT~~7 II~ ~?I~2YTT
3 Aupum Street Koom 215 - File, Hawaii 9h
.U•;252 (6a3j 963-621] • Pax (936j 961-6553
KONAr 755:66 Kuakioi Highway, Sci~ 103 Kxilua-Knpx, Hawaii Y67;a
I6n913'_9-5116 • tax (368)32fi-5663
October 15, 1996
1'4r_ Tom Russi
P.O. Box 3586
Kailua-Kona, HI 9F745
Dear Mr. Russi:
Thank you for your telephone call and information regarding
HN.SA's rel mbUrsemerit and 315COUnt COntraCt With Ollr State
co•nmunity hospitals.
It is my understanding that a discount contract is fairly
common practice in the insurance business, but hospital
administrators agree that HMSA has been underpaying the State
for many years.
It is also my understanding that new contract negotiations will
resume shortly and our hospital administrators will try to
improve the situation. Z have offered my assistance in this
matter.
T ?nnrE?riatg yn»r r(3ncerr. about this issue and will Continue to
try to assist in a~iy way I can.
Sincerely,
Ste hen K. Yamashi~o
I OR
cc: Mr. David Patton, Administrator
The Honorable Benjamin J. Cayetano
0l;29.9i TLE 18:92 FdS 808251515 TOJI RUSSI ~ 008
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April 2l, 1997
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'°O'"' Mr. David Patton
`,EnV. EE=N<N~~: Administrator
_ <T~ Kona Community Hospi[al
,~„T~, P.O. Box 69'
°>,-~N.~- Kealakekva. HI 96750
-err - - ~ .
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Dear~4r.Patton:
dui<N T~Nif.VC~~ '
:nao:,~_.~N<;,. Please find attached a copy of a letter, with enclosures, from Mr. Tom Russi
regardin_ his new contract with Hl^ISA and its impact on the Kona
_ CotnmutTity,Hospital.
'~~",._N.,~;.."~_~, I would appreciate your responding to me in writing addressing Mr. Tom
s:r__r:-i,:,is%=: c- Russi'sconcems.
q(j CIrN R<a<JCID
=E Your attention to this matter is greatly appreciated.
,:,,.,~<,_,T_ With warm personal regards,
=<LNr, anwnup V
~'Im n1'Na.N9~ a ly urs,
+~~nu E6 nwi^
_ W ALF
• V.!3 VCpc, ~t
,:•:e..*-=;.:_-"._-~ Senator,2"d isttiet
V<a E.:.- ter.
< cc: 'vtr. Tom Russi
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Oa%29:91 TL'E 18:99 FdS 808 0251515 TOTE RUSSI ~ OOi
yee'~~; ;e
RENlAMIN J. CAYEOWO ~ ~ ~ ~
uJdnvon I
a;
MARGERY S. BRONBTER
•TrDRNEY GE•FRC~, MOTA T. OAVENRORT CRAY
STATE OF HAWAII DIRECTOR
DEPARTMENT OF THE ATTORNEY GENERAL
OFFICE OF INFORMATION DRAG .CES
205 5 BERETANIA STREET, ROO.U. 7qa
NONOLU~U. MI 98B13.2a3T
TELEPHONE: BOB-BEB-160D FA%_ BOR.B86.1412
March 10, 1997
Mr. Tom Russi
P.O. Box 3536
Kailua-Kona, Hawaii 96745-3586
Dear Mr. Russi:
Re: Request for 1995 HMSA-Kona Community Hospital Contract
This letter is a response to your October 10, 1996 request to have the
Office of Information Practices assist you in obtaining a copy of the above-
referenced contract.
As we have discussed during past conversations, the Uniform
Information Fractices Act (.'Modified), chapter 92F, Hawaii Revised Statutes_
("UIFA"),allows mer,:bers of the public to inspect and copy government
records unless public :.ccess is restricted or denied by law. Haw. Rev. Stat.
§ 92F-11(a) (1993) • "Government records" is defined to mean
"information maintained by an agency in written, auditory, visual,
electronic, ol• other physical form." Haw. Rev. Stat. § 92F-3 (1993).
Because the contract between Kona Community Hospital ("Hospital") and
Hawaii Medical Service Association ("HMSA") ("Contract") is information
maintained in written form, it is a government reccrd which must be
disclosed upon request unless the public's access is t•estl•icted or denied by
law.
One such restriction states that an agency is not required to disclose
government records which "must be confidential in order fol• the
government to avoid the frustration of a legitimate government function[."
§ 92F-] 3(3) (T 993)• The OIP has intel•preted this to mean, among other
G.l:28%9i TL1E 18:95 FdS 808 5251515 TO]1 RPSSI l~008
Ivll•. Tom Russi
Ma •ch 10, 1997
F: gs 2
things, that confidential business information contained within a
government record need not be disclosed to the public and may be redacted
before the record is released. OIP Opinion Letter No. 94-14 (Aug. 10,
1994).
HMSA has asserted that some of the information within the Contract
is confidential business information and has specified which parts of the
Contract should be segregated before the information is made available to
any public requester. To date, I have not had the opportunity to complete
the analysis regarding whether the information HN.SA has identified is
actually confidential business information. However, because I understand
that you are anxious to obtain the Contract as soon as possible, I have
recommended that the Hospital release to you those parts of the Contract
which HMSA is not asserting to be confidential business information. i
have asked David Patton to make the necessary arrangements and his office
will contact you when the documents are ready. In the meantime, 1 shall
continue my analysis regarding whether the redacted parts of the Contract
qualify as confidential business information and will send my findings to
you as soon as I have completed my analysis.
If you should have any questions, please feel free to contact me.
Very h•uly yours, ~
enni r M.L. Chock
Staff Attorney
JMLC:sc
c: David Patton
Bertrand Kobayashi
0-1;29.91 TliE 18:J~ F:1S 808 J251515 T011 RliSSI QJ009
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March 25, 1997
Mr. TOM RUSSI
P.O. Box 3586
Kailua-Kona, Hawaii 96745-3586
Dear Mr. Russi,
~ Thank you for your letter of March 12, 1997 relating to
Russi/HMSA/State of Hawaii contract for State hospitals
pointing out the discrepancy in payments under the old and
. _
the new contracts.
- - Please keep me apprised of this situation as you seek a
. a. m -,-.I -NO
solution to the problem.
-
With warmest regards,
- . A Leiomalama Solomon, Ph.D.
- Senator, First Senatorial District
MS:jkc
01.29.91 TL'E 18:Ja F.a1 808 5251515 TG\1 RI;SSI X010
April 3, 7997
Dave Patton
Kona Community Hospital
P.O. Box 69
Kealakekua, HI 96750-0069
Dear Mr. Patton:
In November of 1996, I told tinny Robb and Kona Community Hospital,
that my hospital bill was just that. Mine! What my husband, Tom,
is pursuing, has nothing to do with the bill that I am responsible
for. tinny agreed to accept my $50.00 per month I've been paying
until I could get this paid off. Apparently, it is not quick
enough for you. And, how dare you throw ~ obligation up in his
face because oY th2 incompetence of your administration office for
losing your copy of a contract you were recommended to send to him
by the OIP. If you were half as interested in getting the millions
of dollars HMSA is depriving our State hospitals of, as you are in
my $800.00, our hospital would be on the right track. And ironically,
you'd be working with Tom to help the hospital!
You know what the problem is, Mr. Patton? The "Good Ole' Boys" at
HbiSA and the State are really the "Bad Ole' Boys", and the "Bad
Ole' Boys" are the ones who are all about the money. They're not
about ethics or the principal of things, like my Tom.
Attached, please find my credit card information to pay in full my
account ~ 116392 in the amount of $799.25.
First, it was you not understanding my husband in his meeting at
your hospital. Now, it is you attempting to humiliate him by
accusing him of owing your hospital money. which he does not.
Cheap shots, Mr. Patton. Last time, Bert Kobayashi had to apologize
for your behavior.
Sincerely, n
Christine Paui
cc: Jolin Westerman
Bert Kobayashi
Lawrence c4aki i
Mayor Steve Yamashiro
Governor Ben Cayetano
Gary Allen
0.3:28.81 TC'E 18:~~ Fd1 808 X251515 TOJI RUSSI ldt'll
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1.
STAI E OF HAWAII •"~Y'
DEPARTMENT OF HEALTH
KOtvA COMMUNITY HOSPITAL -
P.O. 30X 6S
KEALJ.KEKUA, NnWail 9b750-0089
April 7, 1997
Christine Paul
P.O. Box 3586
Kailua Kona. HI 9674;
Deaz Ms. Paul:
Thank you for writin, the hospital regarding your bill. I appreciate very much yotu
payment in full for $799.25. I was nut "throwing your obligation in your husband's
fact", but you must realize that your husband has involved himself in all aspects of our
discussions regarding your bill, even to the point of appearing at a joint meeting of
administrators, muses, your physician and you. I hope you realize the confusion this
' creates for me and other hospital staff regarding what is "your" business and what is "his"
business. I can assure you that none of the hospital staff, htcluding me, have any interest
in `'humiliarin~" your husband.
1 am dumbfounded by your al]egation that Kona Community Hospital is disinterested in
improving our contractual status with IIA4SA. You can be sure that the entire financial
staff of the hospital, with my support, is working hard to enhance our reimbursement
from all of the insurance companies of which I•Iiv1SA is the largest. In fact, l am the
chairman of a contracting committee representing all of the Hawaii Health Systems
Corporation facilities that is charged with the task of improving our third party contracts.
YliLf SCfntlnGlJg j' that w'e air "good :;lc boys" just doesn't fa:. Tltc cl:;cf financial offxer
of Kona Community Hospital is a CPA,1 have an V1BA and a Ph.D., otu contracting
committee includes another accountant and a healthcare attorney, and we are all working
hard for the State of Hawaii, doing the best job we can. Furthermore, we all must
participate in continuing education to maintain our professional status, and most of this is
obtained at our o.rn expense. Hcaltllcare, particularly the hospital industry, is in a period
of rapid change and environmental turbulence, and the strategies to best manage this
change are being debated at all levels of goventment and business. I-Iospitals, physicians,
other healthcare providers, and insurance companies aze all looking for ways to better
sen-e the healthcare constuner, maintain affordable prices, and at the same time survive
economically in an increasinKly competitive and hostile business climate.
O a, 29.9i TL'E 18:95 FdS 808 9251515 TOJ! RliSSI 012
One final point requires a briel'respunse. Bert Kobayashi may have apologized for
himself; but not for mc. 1 have nevi r engaged in cvmersation with you or your husband
that required an apology. Convey, e;y, your husband has spoken rudely with several
members of vur stat'P. He abruptly hung up on me the last time we spoke in the midst of a
conversation in w;_.:h 1 was trying to respond constructively to his most recem ~:.rnands.
W`e are here to sen-e all of our patients in dte most competent way we know how. YIy
on-going commitment to you is that we will continue to serve you, your family, and all
who seek care at Kona Community Hospital with respect, professionalism and caring.
A4ahaly for your payment and your letter.
Sincerely,
David W. Patton, Yh.D.
?administrator
cc~ Governor Bcn Cavetano
La~crence 1liike, \4.D.
Bertrand Kobayashi, Ph.D.
Steve Yamashiro, Mayor
John Westerman, IIHSC
Gan• :Alen, HMSA
Daryl Kurozawa, M.D.
0.1:29%97 TL'E 18:J5 FdS 808 x251515 TO1i RUSSI X015
April 11,1997
Dave Patton
Kona Community Hospital
P,O. Box 69
Kealakekua, nI 96750-0069
Dear Mr. Patton:
I am in receipt of your letter dated, April 7, 1997, and am in
the process of responding, However, I am very busy and ask
for your patience.
ThankL ery mu h,
Christine PaulJ1A_.I`'1'//~~
OJ,29%9i TPE 18:05 FAl 808 3251515 TOJf RLiSSI ~ O1J
April 18,1997
Dave Patton
Kona Community Hospital
P.O. Box 69
Kea!akekua, HI 967 0-0069
Dear Mr. Patton:
I am going to try to make you understand. There is no need for
you to respond to this letter. I need to write it to clarify to
you and to everyone I carbon copied, the facts. Not as you see
them. I will begin at the third sentence in your letter.
The joint meeting you mentioned was a month before T told Ginny
Robb that my bill was mine. You cannot fall back on it being
confusing. You know that I told your hospital not to listen to my
husband, Tom, concerning my bill. And the fact is, he did not
involve himself with my bill to the hospital from that point
forward. There was no confusion, Mr. Patton. When I talked to
Ginny, she went to you to approve my payments. I don't know why
in your next sentence, you tried to involve the hospital staff in
my comment about trying to humiliate Tom. I didn't accuse them.
I accused you. I don't know why you would try to drag them into
this2 I guess it could be for the same reason you felt it
necessary to carbon copy Dr. Kurozawa on your letter. Why would
you feel the need to involve him? Let me tell you why.
You knew from our joint meeting, that T was against involving Dr.
Kurozawa, which even created a problem between my husband and I,
when he went against my wishes. Let me go a little further, since
you did. The only reason I think you carbon copied Dr. Kurozawa,
was to give me a little jab. Well, you°re not as clever as you
think, Mr. Patton, because what you did there, was cross the line.
See, what you men don't understand, you men with your need for
power and credentials and winning, is that women develop a special
admiration and respect for their doctor (especially when he saves
my life). And that is why I didn't want to involve him. Sut since
you started it again, then I'll finish it. i was in your hospital's
care for 18 hours with a ruptured appendix and almost died and I
blame HMSA for this. Let me explain: If your hospital had the
millions of dollars that the HMSA contract is depriving you of, you
as the administrator, could hire a 24 hour a day, well paid
emergency room/trauma specialist that I feel Hawaii State Hospitals
deserve, since we havo one of the highest costs of living in the
nation.
You said you were dumbfounded? You can imagine hour dumbfounded
we were when vre found out, 6 months into this situation, that you
were one of the people approving the contract that is now in place
that paid our hospital 310,000 out of the $24,000 On my operation
and would pay $70,000, even though the national average is $14,500
0!%29:9i TCE 18:96 FdS 808 9251515 TO)f RC?SSI ~ O15
have Patton - cont'd
on this nr<~cedure. Can you now see why I would fee". you are not
that interested in improving your contractual stat.ly with HMSAZ
And might I add at this point, that back in pctpber 1996, in our
joint meeting at the hospital, you did r^t mention your involvement
in this contract, when we started this pursuit. Enclosed is a
letter from Rep. David Tarnas that I believe would interest you. It
appears that everybody agrees ElMSA has too much muscle and it`s
either their way, or no way. Well, I feel that HMSA doesn't have
more power than the people, especially the people that this contract
affects in their quality of health care and it is beyond my wildest
thoughts of why the State doesn't let the people help. It also
appears that this negotiating team, that you pointed out, representing
the people and the State of Hawaii, needs a little less credentials
and a little more muscle.
it's interesting, Mr. Patton, that when you read the paragraph that
I mention the "Good Ole' Boys", you included yourself in there. I
didn't say you were one:
And on your one final point. Mr. Kobayashi had no reason to
apologize for himself. The reason he apologized for you, which
you chose not to d~~~~t was about misleading my husband on how this
$94,000 procedure(jb~came a $24,000 one when your hospital felt a
financial responsibility to me because I was in your care for 1$
hours with a ruptured appendix. As for my husband's attitude,
whey. the OIP recommended that you send him an approved copy of the
contract in question - instead, you send him non-applicable contracts,
documents and letters, duplicates of the non-applicable contracts
and everything but what was recommended - he calls Ginger at your
hospital, who eras the one who signed the cover letter - she gets on
the phone and finds out she is talking to my husband and says, and
I quote "I do not feel comfortable talking to you, Mr. Russi" - my
husband, having the s¢nse of humor that I love about him, tells her
"Sti'e11, why don't you sit down" -and that ends the conversation.
IIut the point is, when people can't talk to someone, it's because
they are either lying, or they are afraid of telling the truth. My
husband has dealt with 7 months of-this, with many people, Pir.
Patton. So, I think this explains why my husband hung up on you
and Ginger when you were explaining that your administration lost
the applicable contract he was originally looking for but in your
words "trying to respond constructively to his most recent demands",
but then somehow slipped in how he owed Kona Hospital money, which
is where I started this letter. And as you experienced, my husband,
to this day, does not feel that I owe your hospital this money, what
with the problem I had between Kona Village Resort, HMSA and the
DoL. But I chose to take care of it. You were just as angry as
him and lashed out in front of Ginger the only way you knew how. I
don't blame him for hanging up on you.
It takes a big man to apologize, Mr. Patton.
Sincerely,
~_~/p(~,r~, ~ John Westerman Steve Yamashiro
Chzistine Paul Gary Allen Diane Plotts
cc: Bert Kobayashi Lawrence Miike Governor Ben Cayetano
0„29%9i TL'E 18:98 F.aS 808 X251515 TO?t RUSS1 1dJ018
April 1, 1997
Be:t.-and Kobayashi, Ph.D.
Deputy Director
State of Hawaii
Department of Health
Community Hospitals Division
P.O. Box 3378
Honolulu, HZ 96801
Dear Hert Kobayashi:
I have been instructed by the OIP to Formally request a copy of
the Participating Hospital Agreement for Hospital In ati Services
for 1995 contract From you due to the fact that Kona Hospital told
the OIP that they have lost their copy.
Thank you for your time.
Sinc.~',ely,~}
Tom Russi
P.O. Box 3586
Kailua-Kona, HI 96745-358b
BDB/325-1515
0l.29~9i TL'E 18:58 F.4S 808 J251515 TO\f RUSSI ~Oli
January 28, 1997
Si ate of Hawaii
office of Information Practices
235 S. eeretania St., Room 304
Honolulu, HI 96813-2437
Dear Jenny Chock:
I spoke with Gary Allen from HMSA over a week and a half ago, who
promised to send me the one item of information that I was requesting
from Lhe HMSA/State contract. He was reluctant to send me the whole
contract because he said I could "sell" this information to Aetna, I
have yet to hear from him and am tired of promises and of pursuing
this for four months with no results.
I am now requesting a copy of the entire contract between HMSA and
the State of Hawaii.
Thank you very couch for your tirtce.
Sincerely,
Thomas J, Russi
01;29.91 TLE 18:31 FdS 808 3251515 TO?S RLISSI ~ 018
March 24, 1997
Gary Allen
HMSA
818 Keeaumoku St
Honolulu, HI 96802
Dear Pir. A11en:
As a member of HIASA and a citizen of the State of Hawaii, I am
formally requesting the Maximum Eligible Charge HMSA would allow
for DRG #1b6, Appendectomy without Complicated Principal Diagnosis
with CC. Due to the fact that I have been pursuing this for six
months, T will give you 10 days to respond, at which time I will
take further action.
Sincerely, ~.Jr~
T~si/J/
P.O. Hox 3586
Ka11ua-Kona, HI 96745-3586
8081325-1515
HbiSA ilember kR1751623-8
0-1.29%9i TliE 18:91 F:1S 808 0251515 T0.11 RL15SI 019
March 24,1997
John 47esterman
Hawaii Health Systems Corp.
688 Kinoole St. Suite 121
Hilo, HI 96720
Dear Mr. Westerman:
As a member of HMSA and a citizen of the State oP Hawaii, I am
formally requesting the maximum Eligible Charge HMSA would allow
for DRG #166, Appendectomy without Complicated Principal Diagnosis
with CC. Dve to the fact that T have been pursuing this for six
months, I will give you 10 days to respond, at which time I will
take further action.
Thank you for your time.
Sincerely
- ~m
r~'~~
Tom Russi
P.O. Box 3586
Kailua-Kona, HZ 96745-3586
808/325-1515
HMSA member #R1751623-8
01%29~9i TUE 18:91 F.aS 808 9251515 TOPS RUSSI 0 020
Dlarch 24, 1997
Dave Patton
Kona Community Hospital
P.O. Box 69
Kealakekua, HI 9=150-0069
Dear Dave:
As a member of HMSA and a citizen of the State of Hawaii, I am
formally requesting the Maximum Eligible Charge HP1SA would allow
for DRG #166, Appendectomy without Complicated Principal Diagnosis
with CC. Due to the fact I have been pursuing this for six months,
I will give you 10 days to respond, at which time I will take
further action.
Thank you for your time.
Sincerely,
Tom Russi
P.O. Box 3586
Kailua-Rona, HZ 96745-3586
808/325-1515
HMSA Member IFR1751623-8
03;29%9i TC`E 18:Ji FdS 808 J251515 T07I RUSSI fm 021
April 22,1997
Senator Daniel K Akaka
I just. wanted to give you a brief background on my concerns. I
have been pursuing this HMSA/State contract since October 1996,
and as disturbing as it seems that I haven't been given access to
it yet, that is not the focus of my concern. Aiy real concern is
what this new contract means for Kona Community IIospital and all
State Hospitals. My wiL•e and I were pursuing something through
the Dept. Of Labor and HMSA's explanation of that situation
accidentally gave us this information that I am sending, front
file paperwork attached, you can see that, according to ItMSA's uwn
information, under the old contract, Kona Hospital would have
received almost $?.4,000 of my wife's hospital bill in payment.
Under i-he ncvr contract, they received only $10,043 - less than half.
That is !5i 9,000 on one procedure alone. How can our State Hospitals
provide us with good healt'n care under this new contract?
Thank you vary much for your time.
Sin~cerrel
Tom Russi
P.0. Sox 3586
Kailua-Kona, HI 96745-3586
t3Utl/325-1515
P.S. According l.o MC?dirarc~, the national average for t:hc procedure
Christine received is $14,500, which is sti1J $4,500 above
what lIM5A pays.
Also, according to Gerold Nagata at Hawaii Health Systems,
the 514,000 difference the hospital wasn't paid should have
been categorized differently and compensated somehow by HMSA,
however, this did not happen.
My husband and I feel that HMSA put people in certain
positions within the State Government which eventually led
to the approval of a contract which deprives our State
Community hospitals of millions of dollars.
C(titi~t`kQ,
Christine Paul
O.ti29~9i TUE 18:98 FMS 808 9251515 T0~1 RLiSSI ~ p22
DANIEL K. AKAKA Mf4tf 11' '
dAwul COMMIT'IFF ON ENERGY dNp
asemGroN orr¢E: NdTUML RESOURCES
CDMMITTEE ON GOVERrvMENTAL AFFARS
TIG N~nr SENZtt DrilU
EVILDING `united ~tatc~ ~C11ate COMMITTEE ON INOWJ AFFAIRS
WASNiNGTON. DC 70510 CAtAMffTFF ON VETERdNS' dFRAiRS
Turnonc 1302122fl~2G1
WASHINGTON, DC 20510.1103
NONttVw JfiiC[:
3rN Mmn JuN.w Nuniu
I(zuNm,YOLE FEOEML BVRDING April 11, 19 9 7
F.O. Boz 501A<
RONOLUfu. N196E50
TF.E W ONC: IEGPI 577- 0
Ns. ~hriStine D. Paul
P.O. Fiox 3586
Kailua-Kona, SI 96795-3586
Dear Ms. Faul:
Thank you for contacting me regarding the October "ll, 1996,
iett2r you SeriL tc President Clinto_~-
I understand your disappointment that the President did not
respond l:o the concerns expressed in your correspondence. in an
effort to be of assistance to you, I have forwarded the coF~y of
the letter you provided tt~ me to President Clinton.
I sincerely hope you will receive a response this I:ime.
Aclain, thank you for contacci.ng me f.or assistance in this matter.
Aloha pumehana,
DANIEL K. AKAKA
U. S. Senator
PRINTED ON RECVCLFC RAVER
03; 29; 9i TL'E 18: J8 Fdl" 808 9251515 T011 RLISSI (~jp2~
Apri1.Z2,1997
The Honorable Daniel K. Akaka
72^ Hart Senate Office Building
W~.hington, DC 20510
Dear Senator Akaka:
I would first like to send you a sincere thank you for taking the
time to send my letter to the President from your office. I hope
I will hear from him this time and will keep you informed.
Secondly, I would ask if you could please let me know if there is
any avenue within the federal government that my husband and I can
pursue concerning the information that I am now sending you.
Thank you for your time.
Sincerely,
C'1~,~~ i --Q.
Christine Paul
P.O. Box 3586
Kailua-Kona, HI 96745-3586
808/325-1515
0.3;29%9i TDE :8:J8 FA1 808 X251515 TOJI RUSSI 1~J02a
April 25,1997
Internal 2eveia~e Service
P.U. Bo.: 12947 83
Fresno, CA 93779
Dear IRS:
I've been advised by Senator Daniel Akaka's office to contact you on this
matter. I was told by my contact at your 800 number to send all my
information to you.
Tnis all began when my wife, Christine, almost died at our State Oorimunity
Hospital. When she was brought into their Emergency roam, her appendix had
already ruptured. 'There vns not a qualified F3nergency roast doctor on duty,
because the hospital doesn't have enough money. So, she wasn't diagnosed
for 18 hours and almost died. Fort:unatc>.ly, everything worked out, except
for when we got the bill.
Let me say, first, that we had no pmblem with the 524,000 bill from the
hospital to save Christine's life. Our concerns started, when the hospital
was IN Id only x'10,000 of that $24,000, because of a contract between Hawaii
tiedical Service Association (HMSA), the insurance company, and the State of
Hawaii, which runs our Carmnmity hospitals. My pursuit started under the
Freedom of Information Act under State laws to get a copy of this contract
to see how bad it really was. I started in October 1996, and 1 still have
not received it. During this time, I have found out that the premiimis that
HI'nSA collects from the members they insure has gone up, and in the paperwork
attached, I :.how that the money they pay out has dropped by 42b. HMSA is a
"non-profit" organization and with your help, I think we can prove, this is
not the case.
Let me add one last thing. Our lcxyislature does not approve these wntracts.
The contract in question was approved by threw people. These three people
were put in State positions by HMSA. One of them is the administrator of our
Co*mnwiity hospital who approved this contract that pays his own hospital
810,000 out of a 524,000 bill.
If Federal laws do not permit your agency to pursue this, could you please
advise us where we can continue to pursue this in the Federal Govercnnr~tt,
since our State governmectt refuses to cooperate under their own laws.
Thaz~k you very much for your time.
Sincerely,.~~ . ~ i'~ ~
Tom Russi
Christine Paul
P.O. Box 3586
Kailua-Kona, HI 96745-3586
808/325-1515
0.1:29.91 iL'E 18:09 F.4S 808 J251515 TOIL RUSSI i~o25
I-IMSA
Blue Cross
Blue Shield
® ~ of Ha:vail
+!1 InC:: °S~rn:'. ••uPr.; of m- ]ior:. n: i9 9't ec nSAO i W n
February 19, 1997
Ms. Christine Paul
P.O. Rnx 3586
Kailua-Kona, Hawaii 96745
RE: Christine Paul
HMSA 1tR1751623-8
pear Ms. Paul:
We are writing in response to your request for a breakdown of benefits that
would have Uccn paid under your previous Plan 4 Coverage 121 with Major
Medical Rider A (your "Previous Plan"?. Phis breakdown is in follow-up to our
review which indicated your copa}ment under your Previous Plan for services
rendered by Kvna Hoa-pital during the period of May 28, 1996 through ,Tune 5,
1996 would have been $842.31.
The requested information is enclosed. PluaSr. Hole, a typographical error was
discovered while reconstructing the Ureakdown of charges. This error results
in a member copayment of $842.11 rather than 5842.31.
We trust this information is helpful. Please feel free to contact our office
should you have any questions regarding this matter.
Sincerely,
Christine M. Scina
Legal Communications Specialist
Community Relations
enclosure
Mawati Medical Service gssociatiDn B7B Keaaur. =im 5trecl • ~ J Bcr 2977 'BUei S-i+-59an _ u,d: x'~ces ow~eo on
41cc0~alc.MU:Wi 552C2d37^, F6T lB.~'i 4:9~c5c5 4aw,.._Mauavntl n£.aa.
Od!29!9i TCE 18:99 FAS 808 9251515 TOJI RLiSSI fm 028
P~~~ ~ ~Fw
RE: Chrislinc D. Puul
HMSA pR1751623.8
Service Dote: 5/28/96 - 6105/96
Dzscti tion Ac ~ :'J Char~•c Eli••ihlc Clurd HMSA Allow MME Eli iblc
bled-Sur hul S 6,096.00 S 3.906.00 S 3,904.00 S
PltarinaeV S 8,0_6.25 5 8.026.'5 S 8,026.35 S -
hlcdlSuc Sv Iies S S,UUS.4G S 5.001.46 S 5,UU4.46 S
l.al~oralorv 5 ;.707,19 5 2.707.79 5 1.353.90 5 1,353.90
Patlfolo Lab S 149.10 S 149.10 S 74.55 S 74.55
OR z-17v S 763.88 5 763.86 S 381-94 S 381.94
Oli services S 1,110.00 5 1.110.00 5 1.110.00 S -
Anexlhcxia S 7US.UU 5 7U4.UU S 704.00 S -
lntnsnnnd S 647.86 S 643.88 5 321.91 S 3?1.94
lame ere Honm 5 263.00 S =63.00 S 210.40 5 5'_.60
I'ulmnna Function S 131.38 5 131.38 S G5.G9 S 65.69
Recuvery Romu 5 195.00 5 195.00 S 195.00 S -
TOTALS: S 23,794.7s S 23.60'_.7b S 21.35:.!3 S 30.6^_
Afinus MMC• Annual Dcdactiblc; S 1250.001
TOTAL: 5 '.000.62
Times BOSo MME Hcnclit 80Y
TOTAL h1ME Payment. 5 L600.50
Raxic Allows S '_1,35"_'.13
Mh1E Allow: $ 1.400.50
Total Allow: S '2,952-G3
Actual Charge. 5 23,794.73
Minus Hh15A Tutul Allow: S ("!)52.631
Member Copaymcnt; S 832. t t
D~-~
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01/29i9i TUE 18:99 Fdl' 808 J251515 T0.**,: RUSSI ~ pY7
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0329/97 TUE 18:30 FdS 808 9251515 TO\i RUSSI ~ 028
STATE OF HAWAII
Insurance Division
- p. d. Box 3614
H~nOlulu, Hawaii 96811
(°elephone: 586-2790)
COHPLAINTlSN UIRY FORM
ASSISTANCE Iv YEEDED CONCERNING: / / A Complaint / xx/ An Znquir~
PLEASE PRINT 012 TYPE:
Christine Paul FIAISA - Hacaaii Medical Service Assoc.
Your Name ~ ^ ~ Name c: Insurance Company/
- Ird_viNv.el Involvad
PD Sox 3586 818 Kecaumoku
Address Address
i<=i1 x n~~ Kr armies zsa~__ o
- GILy, SCate,Z~p Goce ity, SLaCe, Zip Cade
809 32~-iS15 / -
Res. Teleohare / Sus. Telephone ':elephone
817516236
Please indicate policy nuaber andior claim ru:n~er, i. known:
STA±£ TAz RELIEF SOUGHT:. A lot Of QUeStlOnS answered, please.
l1[1[1U'[][1[i[i[1[][][IU[1[lU[1[][1(1[1[][][][1[1[1(1 [1 [1 [1 Ii [1 [1[].:l[1L'i'.
STAT£ SUMS"ARY Or GOMPLAIf1i/INQU=RY:
As a member of IiMSA and a citizen and tax a er of the State of
Hawaii I WOUId like tO knoW hQw R Camnany likes HMSA ran r_l aim tn-
be a non-profit organization when their premiums have gone up and
their maximum eli4ible charges that they t,av to our om unity
Hospitals has dropped by 423. Just because this is a logal and
binding contract between HMSA and the State of Hawaii, it doesn't
makc_ it right to deprive ma, my family, and all the citizens of _
this State the best medical care possible at their Community [tospitals.
HMSA has millions of dollars that belong to our Community Hospitals.
!COmplece on r°verse side)
01129%9i TLE 18:10 FdS 808 9251515 TOH RUSSI ~ 029
ICortlruation of Su::a'.ary of Complaintllnquiryl
EIIC]~Sed. nlpagP finA ~ostinnnt A~....,....,..t_ a_ _
A??ACH COPIES OF' -°ERTINEI4T t;ccaneNxs. DO NOT SE21D ORIGINALS.
yOTTCE: A copy of this form may be sent to the insu_ar.ce cempzny and/
or individual-involved.
Your signature Date
[)[iU[1[][1[1[][1[]U[1[lU(1[i[i;i[](l[lUfi[1[1[][1[][][]U[I[7[1[iii[]t][i
03%29i9i TL1E 18:10 F:1I 808 J251515 TO1l RUSSI DOJO
April 24,1997
Jennifer M.L. C:o~k
State Of Hawaii
Office of Information Practices
235 Beretania
Honolulu, HI 96813-2437
Dear Jenny:
This is to confirm that as of today, April 24,1997, I have not
received the Inpatient Contract that you recommended the State
send me, first on March 10th from Kona Hospital and then in April
from the State.
it appears that possibly the only way I will ever receive this
information I am seeking is through a courtroom.
So, I would like to request from you in writing, that you are
aware of the outcome of your recommendations to Kona Hospital and
the State, both saying that they lost or purged the information I
am asking for.
I caould also like to add that the Honolulu Advertiser covered this
situation that I have been pursuing for 7 months in their April
23rd edition on the front page. I am now aware that I have been
treated this way in order for our Good ole Boys to pass this
through legislation to take money from the taxpayers instead of
from HMSA. Boy, this is really starting to stink. Jenny, i
don't know if you watched the news last night, but there was a
real bad odor in Honolulu that someone was complaining about.
Maybe someone should check out the State Capitol. I am just about
at the end of my rope with these people.
~/S~(i,~/n~~c,',(e~~re l y ,
' TOm Russl
P.O. Sox 3586
Kailua-Kona, HI 96745-3586
808/325-1515
OJ/29~9i TUE 18:J1 °dS 808 0251515 TO\1 RL'SSI ~ 091
9ENJtMIN J. CLYETANO I ~ [ ~ , ~ , t
covi nnuw :n ~m.4n VIk~ 1 UWflENGE AIIIKE
.:.~~::I
STATE OF WAWAII
DEPARTMENT OF HEALTW m~.m~~,oi~a..R+...I~
r.o. soz are °x"
nowow~u, wavmn ~weo+
April 16, 1997
BK-97-036
Mr. Tom Russi
Y.O. Box 3586
Kailua-Kona, Hawaii 96745-3586
Dear Mr. Russi:
since receiving your fax on April 2, 1997, we have been looking
for a copy of the HMSA Participating Hospital Agreement for
Inpatient services for Kona Community Hospital for 1995.
We have not been able to find a copy of that specific contract as
our files had been purged. All that I have been able to find is
a sample of the HMSA agreements which our hospitals entered into
with a fee schedule for Maui Memorial Hospital, our largest acute
hospital. The fee schedules differ for each hospital and Kona
Hospital's fee schedule is not in our files. At that time,
contracts were signed at both the division and the hospital
level, as indicated by the attached letter from HMSA dated
September 25, 1995, and contracts retained for recordk¢eping
purposes at either the division or the individual hospitals.
Even in 1995, as indicated by the attached September 25, 1995
HMSA letter, the division office found it-more convenient to_
request HMSA provide us with copies of contracts of our various
hospitals with HMSA rather than seek various contacts from a
number of hospitals. I have checked with my secretary and with
the division Fiscal Office, both of which may have had the
original records but cannot find the specific contract you are
seeking.
I would think that since Kona Hospital cannot find the copy of
this contract, that HMSA is the likeliest party to have a copy of
the contract you are seeking.
Sincerely,
~ , j~
BERTRAND KOBAYASHI, Ph.D.
Deputy Director for Community Hospitals
c: Kona Community Hospital