Wednesday, June 26, 2013
The health plan is part of Kaiser Permanente’s integrated health care delivery system (Carlson, Modern Healthcare, 6/25).
The fine is the second-largest in DMHC’s history (Craft, Sacramento Bee, 6/26).
In March, DMHC issued a report finding that Kaiser mismanaged its mental health care services.
The report was released as part of a routine mental and physical health services survey conducted every three years.
The report found that Kaiser had:
- Made patients wait excessively long periods between appointments; and
- Offered patients inaccurate information that could have dissuaded them from seeking long-term individual therapy.
According to the report, Kaiser provided information sheets stating that individual counseling services “will not be a Kaiser-covered benefit and will not be paid for by Kaiser.” DMHC said that such statements “are in error because the [p]lan is required to provide coverage for serious mental illnesses under the same terms and conditions as medical conditions” (California Healthline, 3/20).
Details of DMHC Announcement
On Tuesday, DMHC said that the fine stems from Kaiser’s failure to:
- Reduce wait times;
- Fix inaccurate information; and
- Properly record tracking data for mental health appointments.
The agency has scheduled a follow-up inspection for October (Modern Healthcare, 6/25).
Following DMHC’s announcement, Kaiser officials said they plan to challenge the penalty for being too high.
John Nelson, a vice president at Kaiser, said the fine is “unwarranted and excessive.”
Nelson also said that the majority of first-time therapist appointments are booked within 10 business days and that Kaiser has hired additional staff to reduce wait times (Sacramento Bee, 6/26).
He said that each problem identified by DMHC has “already been corrected, or is very far along toward resolution” (Robertson, Sacramento Business Journal, 6/25).
Headlines and links to broadcast coverage of the Kaiser fine are provided below.
- “Kaiser Permanente Fined $4 Million Over Long Waits for Mental Health Care” (O’Neill, “KPCC News,” KPCC, 6/25).
- “State Says Kaiser Too Slow With Mental Health Care” (Milne, “KXJZ News,” Capitol Public Radio, 6/25).