One Medical's Coronavirus Vaccine Practices Spark Congressional Investigation

Mar 2, 2021
Originally published on March 2, 2021 11:10 pm

The consequences are deepening for concierge health care provider One Medical following an NPR investigation that found the company administered COVID-19 vaccinations to those with connections to leadership, as well as ineligible patients.

The House Select Subcommittee on the Coronavirus Crisis is launching its own investigation into the San Francisco-based company's practices, NPR has learned. The probe has plunged the publicly traded company, whose business model depends on patients paying a $199 annual fee for VIP health care services, into damage control mode.

"Despite being warned that the company's lax oversight of vaccine eligibility rules was allowing ineligible patients to jump the line, One Medical has reportedly failed to properly implement an effective protocol to verify eligibility and instructed staff not to police eligibility," wrote subcommittee chairman James Clyburn in a letter sent to One Medical late Monday night.

Clyburn cited multiple news reports, including NPR's investigation, to denounce One Medical's "irresponsible practices," adding that "prioritizing the vaccination of Americans who are at higher risk from the coronavirus is critical to saving lives and controlling the pandemic."

The letter demands documents and information on One Medical's COVID-19 vaccination practices within two weeks, with a deadline of March 15. Among other topics, it seeks demographic breakdowns of COVID-19 vaccines administered to date and communications related to vaccination appointments arranged for those close to the company's executives.

One Medical responded to news of the probe overnight: "We remain dedicated to lending our time and resources to providing equitable and accessible care for the communities we serve, and are confident that we will be able to clear up these misunderstandings."

As the congressional investigation begins, numerous local public health departments have halted cooperation with One Medical based on investigations that found vaccination line-skipping. Additional anecdotal reports of ineligible vaccinations were also submitted to NPR from various cities.

After reviewing internal communications, NPR found multiple instances across multiple states in which medical staffers working for One Medical sounded the alarm about improper procedures and lax oversight over eligibility requirements. "We are not policing," a top One Medical staffer told doctors and other medical providers after they raised concerns. One Medical claims that it does not knowingly permit ineligible patients to be vaccinated.

Regulators have moved quickly. NPR contacted every jurisdiction in which One Medical has a location. At least eight local departments of health that were working with One Medical on COVID-19 vaccinations have suspended allocation of doses to the company or said they had no plans to provide any in the future. Santa Clara County, for example, said it had no plans to work with One Medical again on COVID-19 vaccination.

The department of public health for San Francisco County, where One Medical is based, not only halted additional dosages of the vaccine to One Medical, but in a remarkable move demanded 1,620 doses back from the company. San Mateo County found that One Medical vaccinated 70 individuals who were not eligible for the vaccine, and it suspended work with the company, said Preston Merchant, a spokesperson for the county.

Jurisdictions like Washington state and numerous Bay Area counties have stopped ongoing cooperation with One Medical on COVID-19 vaccine administration. Marin County spokesperson Laine Hendricks said the county has halted vaccine allocations to One Medical after reviewing data on the company's vaccinations. "We have indefinitely suspended any further first dose allocations," Hendricks said. "We have also removed One Medical from our website."

Spokesperson Michael Workman said San Diego County stopped providing the vaccine to the company after "numerous complaints about charging for a membership to have access to vaccine appointments. We reported this to the state."

One Medical has said that some of these objections from local departments of health are misunderstandings and that it was working to address any other concerns that have been raised. In some cases, the company claimed, they were not aware they had been cut off by counties until the press reported it. "We're deeply disappointed, as many of the media reports about One Medical's standing with departments of health are not reflective of our direct communication with our contacts at many of those departments," said a company spokesperson.

One Medical claimed that the COVID-19 vaccinations of ineligible patients in San Mateo were done "in order to avoid spoilage" and that they were "not aware of any unresolved issues with the San Diego Department of Health prior to their statement to the media." In San Francisco County, where the Department of Public Health said it had reason to believe that One Medical vaccinated ineligible patients, One Medical contradicted the county and said the county had only requested COVID-19 vaccinations back because One Medical's "vaccine clinics were not in geographies that the DPH is currently considering the highest priority."

One Medical also said it was not aware of any instances where "senior leadership ... personally intervened to arrange for friends, family or business partners to receive vaccinations outside of eligibility requirements."

Separately, there are also indications that One Medical is seeking a commercial benefit by collecting data from nonmembers it is vaccinating. In Washington, D.C., neighborhood blog PoPville first gave voice to concerns that those who signed up for a vaccination site run by DC Health in conjunction with One Medical were pitched on a free trial membership with the concierge health care provider.

"There is very little clarity on the actual website. Instead, they make it appear as though you need a [One Medical] account or else your appointment will be canceled," said Adam Peck, a D.C. resident who tried to navigate the system last week. "Needless to say, it's resulted in a lot of confusion, and more than a few people who are signing up for [an account with] OM thinking that's the only [way] to confirm their appointments."

This is one of the areas of the congressional probe. Chairman Clyburn wrote that he is concerned that One Medical "may be exploiting the federally funded vaccine rollout to increase membership rates and generate fees, regardless of whether prospective fee-paying members are actually eligible for vaccination."

A One Medical spokesperson said that patients are asked to register on the company platform as a means to create a unique patient chart, akin to filling out paperwork in a doctor's office. "We are not asking people to pay for a One Medical membership or asking them to register for a One Medical account to then convert them to annual dues-paying members. The primary focus is on a seamless care experience and NOT on converting people to annual paid members," the spokesperson said. "That said, we do treat each of our vaccination patients just like any other patient who is new to One Medical by sharing information about our practice and about the benefits of our membership model so they can take full advantage if they'd like to."

One Medical has declined to acknowledge there is or was a problem with its COVID-19 vaccination procedures. Some of the rank and file are demoralized by this response.

"There is uniform agreement that what everyone has seen with their own eyes or read from colleagues ... is in direct contrast with what OM leadership is saying now," a One Medical staffer told NPR. "People found it demoralizing and frustrating that they are not owning the mistakes and instead ... making excuses, and finger pointing (ranging from putting blame on DPHs to our patients)."

In an interview with NPR last week, One Medical Chief Medical Officer Andrew Diamond made a number of claims, then backtracked when presented with facts. Asked about being shut off from vaccine allocations in Alameda County, he said, "we continue to receive vaccine from Alameda County."

Alameda County had earlier told NPR that it halted vaccine allocations to One Medical following a shipment in January, after the company indicated to the county that it had plans to vaccinate patients who were at that time ineligible to receive it. Informed of this, Diamond backpedaled from his prior statement that they "continue" to receive the vaccine from the county.

MAK: "You told me that the allocation is ongoing. Is it ongoing?"

DIAMOND: "Our understanding absolutely is that, I mean, we have not received any communication ... to suggest that they don't intend to fill any future orders."

Later, Diamond said, "There was no guidance [to our staff] that said, 'do not verify.' That would be counter to our principles." When told NPR had obtained internal communications showing that medical staff were told not to verify eligibility requirements, Diamond responded, "That's clearly not the guidance, nor is that the intent of the guidance. But we've been far clearer since then."

One Medical CEO Amir Dan Rubin made no apologies when asked about the situation on a call with investors. He did not specifically address the allegations or describe how he might fix these problems. "Regarding the stories, we strongly refute these gross mischaracterizations. Any assertions that we broadly and knowingly disregard eligibility guidelines are not true, and in contradiction to our actual approach," he said.

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Lawmakers are investigating a major health care provider that let people jump the line to get COVID-19 vaccines. They are following up on an NPR investigation of One Medical. Documents show that company administered vaccines to ineligible patients, some of whom had connections with company leadership. NPR investigative correspondent Tim Mak joins us now. Tim, good morning.

TIM MAK, BYLINE: Good morning.

INSKEEP: What do lawmakers want to know?

MAK: So basically, this is a subcommittee that's led by Congressman Jim Clyburn. This is the House Select Subcommittee on the Coronavirus Crisis. And what they're really looking for is evidence that the company intentionally distributed vaccines to ineligible patients across multiple states, which is, incidentally, one of the conclusions of an NPR investigation published about a week ago. One of the committee's concerns is that there should be an equitable distribution of vaccines, one that prioritizes those most at risk in society rather than the wealthy or well-connected. And so the committee is giving One Medical two weeks to provide documents about their vaccination practices. One Medical, of course, is a primary health care provider that is publicly traded and valued in the billions of dollars. Its business model is to provide tech-driven primary health care for members, who usually pay about $200 a year in annual fees.

INSKEEP: OK, so you pay this fee. You can go to the doctor when you need a checkup or whatever. They were also helping to get vaccines out there. But now here they are giving the vaccines to the wrong people. What does that mean for local health departments that were using One Medical as a distribution channel?

MAK: Right. Well, so we reached out to every local jurisdiction where One Medical does business. And we found that eight local jurisdictions have cut the company off from vaccine allocations or are not planning to work with them again in the future. So, for example, San Francisco County made the unusual move of not only halting the supply of vaccines to the company but also demanding 1,620 doses back. And San Mateo County said it had done an investigation and found that One Medical had vaccinated 70 individuals who were ineligible to be vaccinated at that time. It, too, stopped the allocation of vaccines to the company. So those are just a couple of examples.

INSKEEP: Hasn't One Medical denied that they knowingly vaccinated the wrong people?

MAK: Well, that's right. And it says that the response from these eight different departments of health and the situation it's in is largely the result of misunderstandings, that it was working with local partners to address any concerns. After I approached them about the news of this new congressional probe, they said that they are, quote, "confident that we will be able to clear up these misunderstandings." CEO Amir Dan Rubin made no apologies in a call with investors last week.


AMIR DAN RUBIN: Regarding this story, though, we strongly refute these gross mischaracterizations. Any assertions that we broadly and knowingly disregard eligibility guidelines are not true and in contradiction to our actual approach.

MAK: But the communications obtained and published by NPR suggest that the company was aware. Medical providers across multiple states were sounding the alarm internally about One Medical's lax oversight over eligibility requirements. One of the documents show a senior One Medical staffer instructing medical providers, quote, "We are not policing."

INSKEEP: OK. So again, this story was broken on NPR a few days ago. And the news now is that a congressional subcommittee headed by Jim Clyburn of South Carolina will launch their own investigation.

NPR's Tim Mak, thanks so much.

MAK: Thank you. Transcript provided by NPR, Copyright NPR.