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This web page contains the "gag" clause of the Kaiser Permanente Retirement Plan for Physicians Serving Members of  Kaiser Foundation Health Plan contract.  An explanation of what this document is about is directly below. Above each of these three pages of documents is a transcription of the photocopies so you can copy and paste the material into e-mails or reports.  

This document was obtained from a current physician source within The Permanente. It is now very clear that current and former Permanente Physicians have no business being in government positions, especially within regulatory agencies where patients can be abused by the former employees of Kaiser and the Permanente.  Their refusal to enforce either regulation or law or to find factual wrong doing is a direct result of this "gag" clause.  If these doctors and other Permanente employees find any wrong doing by Kaiser or the Permanente they will face very expensive to fight legal retaliation.  

It is very unlikely that the "gag" clause that is in this document is legal and that any court of law would actually find for Kaiser.  That is evident in the last document on this page:  Item - I-5 Aids to Construction.   However, Kaiser has  and does continue to enforce it in civil court against any employee bound by this contract.  Permanente physicians have explained that this part of the contract is not generally presented to the physician until they have been working for them at least a couple of years.  By that time either a physician will either not pay attention to the additional paperwork and will just file it away or in the event that the physician would attempt to improve the system and wish to make it a safer place for the patient this contract section is brought out to intimidate.  Then the physician will be informed that he is a part of all wrongdoing that he has witnessed and because he has waited so long to complain that the authorities will hold him responsible as well as any other wrongdoer that may be caught.

If the physician persists they enforce Article G-1 - G-6 of the contract.  This costs a great deal of money for the physician to fight; consequently most just give up and keep quiet.

While eventually a court will most likely, and generally does rule in favor of the employee that the Kaiser and/or Permanente have taken action against, fighting it in court is very expensive.  Several physicians have done the right thing and have gone to the authorities.  They have been retaliated against by Kaiser and the Permanente and one of the ways is through this contract.

The above applies to current and former employees bound by this contract that go to work for any government agency.  This also includes positions representing the government in an advisory capacity while still being employed by Kaiser or the Permanente.  If they find wrong doing they lose a lot of money.

Now you know the reason that no matter what evidence is presented to CMS, DMHC, Medical Boards, CDC, FDA, etc., little if any wrong doing is ever found against Kaiser.   Now you know a big reason why investigations are diluted, no wrong doing is found or the public is repeatedly advised that more evidence is always needed.

Here are the documents.  There are variations floating around from the various Permanentes.  At their core they all have this section inserted.  May physicians refer to it as the "Till death do they part" clause.  The contents of the documents are transcribed and placed above the photocopies.  

Kaiser Permanente Retirement Plan for Physicians Serving Members of  Kaiser Foundation Health Plan
Kaiser Permanente Retirement Plan for Physicians Servicing Members of Kaiser foundation Health Plan cover page
Article G. Disqualification
G-1.  Cause for Disqualification.  The Plan does not attempt to require you to perform any Additional Services or to refrain from any Competitive or Improper Activity, nor does it attempt to solicit your promise to perform any Additional Service or to refrain from any Competitive or Improper Activities.  Rather, the Plan makes Health Plan's promise to pay you a Retirement Income expressly conditional on your performance and forbearance.  In legal parlance, the consideration for Health Plan's promise to pay you a Retirement Income is in part your loyalty in providing Medical Services to Health Plan Members, which serves as the measure of your Retirement Income under the Retirement Income Formula, in part the Additional Services you perform at Health Plan's request, and in part the Competitive and Improper Activities which you continue to avoid.  Thus, your interest in the Plan continues and your effort consistent with your physical condition, to perform to the best of your ability any Additional Service requested by Health Plan and so long as you do not engage in any Competitive or Improper Activity.

G-2.  When Disqualification Occurs.   Only the Administrative Committee can determine Disqualification, but it is the duty of the Administrative Committee to determine and Invoke the Disqualification of a Participant if and as soon as it determines that such Participant (i) did not make every reasonable effort to perform to the best of his or her ability any Additional Service requested by Health Plan during his or her Service or Retirement, or (ii) engaged during such period in any material Competitive Activity without first obtaining the written approval of Health Plan, or (iii) engaged in any Improper Activity.

G-3.  Effect of Disqualification.  Notwithstanding any other provision of the Plan or any inference that may be drawn from one or more of these provisions , the Disqualification of a Participant cancels, forfeits and forever terminates any and every interest and claim of interest the Participant had in or under the Plan at the time of Disqualification.  On and after Disqualification of a Participant, no Retirement Income or other payment of any kind is owed to the Participant or his or her Joint Retirement Income Recipient or Beneficiary or any other person whose interest or right might otherwise be derived through the Participant, but any Retirement Income payments made before Disqualification are not recoverable by Health Plan.

G-4.  Additional Services.   At any time during your Service or Retirement, Health Plan may request you to render any of the Additional Services listed below.  You will be entitled to reimbursement for all expenses necessarily incurred by you in performing a requested Additional Service.  You will also be entitled to a reasonable payment for performing any requested Additional Service listed in (a), (b), (c), and (d) below, but not for the Additional Service described in paragraph (e).  The amount of this payment will take account of the fact that performing Additional Services is part of the consideration for Health Plan's promise to pay you a Retirement Income under this Plan.  Any of the following are included within the term Additional Services which Health Plan may request you to perform:

    (a)  Consult with a physician rendering Medical Services to any Member if such physician has requested Health Plan to provide a consulting physician.  

Permanente Physicians Retirement Article G. Disqualification
(b)  Study and advise Health Plan in connection with any matter within the scope of Health Plan's activities.

(c)  Serve on a board of review or any panel or group established to mediate, arbitrate or otherwise advise on or decide any matter in which Health Plan is interested.

(d)  For a period  not to exceed 90 days in any year, render Medical Services at a Medical Service Center which is away from your home if a serious shortage of physicians available to render Medical Services occurs at such Medical Service Center because of war, epidemic or other national calamity.

(e)  Serve as a member of the Administrative Committee described in Section I-I

G-5.  Competitive Activities.  You will be considered to have engaged in a Competitive Activity if at any time during your Service or Retirement you perform or engage or assist anyone in any of the following acts or activities unless you first obtain the written consent of Health Plan:

(a)  Render professional medical or administrative services to or on behalf of any other hospital service plan or medical service plan operated on a group practice prepayment basis within any area served by Health Plan on the date your Retirement begins.

(b)  Make available to any individual, company, plan or other organization competing with Health Plan any confidential information regarding Health Plan, a list of Members, or membership groups, or otherwise assist any such competitor to solicit any Members.

G-6.  Improper Activities.  A Participant is subject to Disqualification for an improper Activity if at any time during his or her Service or Retirement:

(a) The Participant performs any act or engages in any activity, the principal purpose of which is to damage or discredit Health Plan or physicians serving  Members, or to restrict Health Plan in the legitimate operation and expansion of the hospital and medical service plans it now offers or may hereafter offer; or

(b)  The Participant's professional license is revoked by any state for reasons or under circumstances which tend materially to discredit Health Plan or physicians serving Members; or

(c)  Final judgment is entered against the Participant in a criminal or civil action based on gross negligence, willful misconduct or moral turpitude under circumstances which tend materially to discredit Health Plan or physicians serving Members.
Permanente Physicians Retirement punishment
Article I. Administration

I-1.  Establishment of the Administrative Committee.    The Plan is administered by an Administrative Committee of not less than five individuals, at least 10% of whom are Participants, appointed by Kaiser Foundation Health Plan, Inc. to serve at its pleasure.  The Administrative Committee acts by resolution adopted by oral vote at a meeting or by written vote without a meeting, of a majority of its members, except that every determination under Article G required the affirmative vote of more than 95% of the Administrative Committee.  The Administrative Committee may appoint subcommittees from among its members and others with such powers and duties as the Administrative Committee specifies, except that no subcommittee may make any determination under Article G.

I-2  Duties of the Administrative Committee.     The Administrative Committee makes such rules, regulations and Interpretations and maintains or causes to be maintained such records, including those of Its own proceedings, as may from time to time be necessary to perform its duties under the Plan in a fair and nondiscriminatory manner.  The Administrative Committee's decision on any matter within its jurisdiction is final and binding for all Plan purposes.  The Administrative Committee obtains from Health Plan or other sources such data as it may need from time to time.

I-3 - Compensation and Expenses.     No compensation is paid to any member of the Administrative Committee for serving as such, but Health Plan pays all travel expenses of Administrative Committee members and all necessary expenses of the Administrative Committee, including but not limited to fees of actuaries, accountants, lawyers and others needed by the Administrative Committee for their special skills, as well as the direct costs of performing its duties under the Plan, gathering data and maintaining records.

I-4.  Immunity from Liability.      No member of the Administrative Committee shall incur any liability for any loss or damage which may result in connection with the execution of his or her duties or the exercise of his or her discretion, or from any other action or failure to act hereunder, excepting only liability for his or her own gross negligence or willful misconduct.  Health Plan shall indemnify each member of the Administrative Committee against any and all claims,  losses, damages and expenses, including counsel fees, incurred by the Administrative Committee and any member thereof and any liability, including any amounts paid in settlement, arising from any action or failure to act, except when the same is judicially determined to be attributable to the gross negligence or willful misconduct of such member.

I-5.  Aids to Construction.     California Law Governs.     All matters affecting the validity and construction of this Plan are determined in accord with the laws of the State of California.

Unenforceable Provisions.     If any provision of this Plan is invalid or unenforceable, the remaining provisions shall nevertheless be carried into effect to the fullest practical extent.
Permanente Physicians Artick I Administration



 

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