Kaiser Permanente Foundation Health Plan has reached a settlement with the California Department of Managed Health Care that calls for significant changes to Kaiser’s delivery of behavioral health care services.
The settlement, announced Thursday, Oct. 12, includes a $50 million fine and will require the healthcare provider to take corrective action to address deficiencies in delivery and oversight of the behavioral health care services it provides to enrollees.
The settlement grew out of a non-routine survey of Kaiser the DMHC conducted in May 2022.
The DMHC found that Kaiser canceled behavioral health appointments and often failed to schedule appointments in a timely manner, which were still required, regardless of a strike among mental health clincians in August 2022.
The agency also noted a “shortage of contracted high-level behavioral health care facilities” in the plan’s network, as well as “inadequate oversight of the plan’s medical groups in evaluating appropriate care.” DMHC also said Kaiser failed to make out-of-network referrals, which are required under the law, when in-network providers are not available.
Kaiser has also pledged $150 million in additional investments over the next five years into programs to its improve its behavioral health care programs.
The settlement comes amid labor unrest that could potentually fuel a week-long strike among 75,000 Kaiser workers next month.
In a statement issued late Thursday, Kaiser CEO Greg A. Adams said the company has seen “an unprecedent rise in demand” for mental health care services over the past three years, driven largely by the COVID-19 pandemic and its aftermath.
“We have increased our staffing and facilities to help meet this growing need,” he said. “Since 2020, we have invested an additional $1.1 billion to provide mental health treatment for our members.”
Adams said Kaiser hired nearly 600 additional therapists and expanded its networks over the past three years…
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