Kaiser fined $4M for failing to provide mental health access

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California officials have fined Kaiser Permanente $4 million for failing to provide access to mental health services for its members.

The penalty, which the California Department of Managed Health Care announced Tuesday, stems from a routine survey in March that found Kaiser wrongly denied members appropriate access to mental health, including subjecting them to long periods between appointments and providing inaccurate information about coverage.

"The Department's actions are a result of both the seriousness of the deficiencies and the failure of Kaiser to promptly correct them," DMHC Director Brent Barnhart said in a statement. "The Department is taking this action to ensure that Kaiser promptly corrects these deficiencies and provides its patients with the mental health care promised to them by their health plan."

DMHC specifically determined Kaiser failed to:

  • ensure its quality assurance systems accurately track, measure and monitor providers' accessibility and availability;
  • monitor that its providers' appointments were offered within regulatory timeframes;
  • ensure it took effective action to improve care when deficiencies were identified; and
  • provide accurate and understandable mental health education materials to its members.

But Kaiser said it already corrected most of the identified problems, including hiring new providers and updating its materials describing mental health services. Kaiser spokesman John Nelson also highlighted that DMHC didn't say the insurer's members failed to obtain quality mental healthcare services, reported the Sacramento Business Journal.

Since it has been working with the DMHC to rectify these problems, Nelson said the penalty amount is "unwarranted and excessive." Kaiser plans to dispute the penalty, he added.

DMHC noted it will conduct a follow-up survey in October and will continue monitoring Kaiser as necessary.

To learn more:
- here's the DMHC statement and survey (.pdfs)
- read the Sacramento Busines Journal article

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