Lisa S. Kantor

Kantor, part of the husband-and-wife team that runs plaintiffs-side ERISA firm Kantor & Kantor, said she's committed to expanding on the settlement she achieved a year ago with Kaiser Permanente in a major patient-dumping case.

"We're now working with the Department of Mental Health [in Los Angeles County] to make sure that the diversion of all patients into mental treatment is done appropriately," Kantor said. "We want to make sure that people arrested with mental issues are checked to see whether they have private insurance that could pay for their treatment."

She represented a class of Kaiser patients with mental disabilities who faced a common plight: after suffering a severe psychiatric episode, the big hospital system placed each in a conservatorship, dis-enrolled him or her from Kaiser coverage and enrolled each in Medi-Cal. That allowed the former Kaiser members to be transferred to a county-funded mental institution and transferred all costs from Kaiser to taxpayers. Kerr v. Kaiser Foundation Health Plan Inc., BC556863 (L.A. Super. Ct., filed Sept. 9, 2014).

"Kaiser forced taxpayers to pay for these people," Kantor said. "When we filed this case and informed the Los Angeles county counsel about the issue, she was shocked because she had no idea of the back-story here. She fully supported our case."

The December 2018 settlement with Kaiser required the defendant to cease dis-enrolling such patients and to allow each of the 124 class members to re-enroll in a Kaiser policy. Kaiser agreed to provide them residential services valued at more than $10 million.

And it led Kantor to realize that beyond the confines of the case itself, there was more work to be done. Now, Kantor and county officials are planning to educate those in the justice system who encounter mental health cases about possible options that could save taxpayers a lot of money.

Police officers, public defenders, judges and other officials tend to expect that people who are really sick and homeless do not have private health insurance, but in reality many are enrolled under the Affordable Care Act and do not have to become wards of the state, Kantor said.

"Public funds are so limited, but the ACA has broadened the base of people privately insured," she added. "Insurers try to hide that fact, but we want them to step up and do what they're supposed to do."

When people are diverted away from the penal system into so-called institutes for mental disorders, they get better--and it's cheaper than jail, Kantor said, especially when private insurance pays.

"Our idea is to get L.A. covered on this, then take it statewide," she said.

-- John Roemer