Quest bungles plan flier

The state Medicaid health insurance program, which has more than 318,000 beneficiaries, mailed out fliers in August incorrectly stating that Kaiser Permanente Hawaii is not accepting new Quest members.

The open enrollment period allowing Quest members to switch between health plans ran from Sept. 2 to 30.

"Since discovering the error, all beneficiaries have received correct information and the opportunity to select Kaiser for coverage beginning Jan. 1," said Kayla Rosenfeld, spokes­woman for the Department of Human Services Med-Quest division, which administers the program for low-income residents.

Rosenfeld would not say how many people received the flier, which lists Quest plan choices that include AlohaCare, Hawaii Medical Service Association, Kaiser, ‘Ohana Health Plan and UnitedHealthcare Community Plan. A separate highlighted box next to the plan choices states that "Kaiser has met its enrollment limit and therefore cannot accept new members."

Kaiser spokeswoman Laura Lott said officials at the state’s largest health maintenance organization have "no idea" how the error happened and are working with DHS to fix the mistake.

"It wasn’t our action. We just found out about it a few days ago," she said. "We’re hopeful that it can be resolved so that it won’t impact people who want to select Kaiser. We are the top-rated Medicaid plan in the state. We’re around 24,000 Quest members and have a cap of 30,000, so we’ve got plenty of room."

Rosenfeld said DHS officials would be discussing the issue at a legislative briefing before the Human Services and Housing and Health committees at 2 p.m. Wednesday at the state Capitol.

Lawmakers have received complaints from residents who wanted to sign up for Kaiser but were told by DHS they could not and were sent to other insurers, said Sen. Roz Baker (D, West Maui-South Maui), vice chairwoman of the Health Committee.

"There was some kind of glitch in the system. They (DHS) really won’t own it, and they won’t do anything about it to make it right," Baker said. "The director of the Medicaid division basically said it’s Kaiser’s fault because they increased the number of people they could take. There are a number of legislators who have asked Med-Quest to fix it and correct it, and as far as I know, they have been unresponsive to fixing the problem."

Lott said Kaiser notified DHS in May that it would raise its Quest enrollment cap to 30,000 from 24,000 members as of July 1.

This isn’t the first time DHS has had problems with mailing blunders.

Earlier this year at least 4,582 Quest families received erroneous notices saying their coverage would end at the end of June. At the time, DHS estimated it would spend $2,500 to inform recipients of the mistake.

DHS also mistakenly notified 4,500 aged, blind or disabled individuals in May that their benefits would end. The notices were generated "as a result of adding new long-term care functionality" to DHS’ $95 million online eligibility system, known as Kolea, the department said at the time.

A year ago the state sent 250,000 Quest members information about health insurance options in Hawaii but inadvertently left out Kaiser’s information. In that case the state was forced to send a third mailing because of problems with the first two correspondences. Correcting that mistake cost taxpayers $176,254.