One of the nations most digitally advanced health insurers is being socked with a big fine for not delivering electronic data California wants in order to better rate Medicaid managed care plans. The California Department of Health Services has levied a $2.5 million fine against Kaiser Permanente, which has invested more than $400 million in data systems over the past decade, for failure to deliver electronic Medicaid data.Kaiser is one of 22 health payer organizations that administers Californias Medicaid program known as Medi-Cal. As the foundation for building a new ratings system for all Medi-Cal managed care plans next year that will track the quality of patient care, appeals processes, contract compliance and other performance measures, the department of health services gave each of its Medi-Cal administrators a deadline of June 30, 2016, to turn over electronic records for patient visits, in Medicaid terms also known as encounters.The California Department of Health Services asked Kaiser for three years of medical claims and all electronic records of physician prescribed drugs. In a June 28 letter to state officials Kaiser, which Kaiser Health News, a part of the California Health Care Foundation, saysserves about 700,000 Medi-Cal enrollees, said it could not meet the deadline.In the six months since the Medi-Cal deadline, Nathaniel Oubre, Kaiser Permanentes vice president for Medi-Cal, said its systems and technologyincluding electronic health recordsare focused on quality, access and integration of care. But he notes the systems were not designed or updated to collect information in the format required by the state, according to Kaiser Health News.We are taking steps to change this, Oubre told Kaiser Health News. We are making investments in technology that will facilitate compliance with the states data reporting requirements.In the meantime the California Department of Health Services has hit Kaiser with two fines for non-compliance including nearly $1.8 million for failure to send over required electronic medical claims data and $742,500 for failure to submit prescription data. Kaiser was unable to submit all of the required encounter data, California Department of Health Services Jennifer Kent said in a Jan. 13 letter to Kaiser. Additional penalties relating to this deficiency may be imposed from October 2016 until Kaisers encounter data deficiencies are corrected.The California Department of Health Services is in discussions with Kaiser and additional fines could be imposed depending on the companys actions and whether Kaisers violations put the agency out of compliance with federal rules. That could force the state to repay money to the Centers for Medicare &Medicaid Services, which funds the Medi-Cal program jointly with the state, according to Kaiser Health News.Kaiser isnt appealing the sanctions and the health plan says its working toward compliance, according to Kaiser Health News.

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