Kaiser Announces Settlement With DMHC, Corrects “Deficiencies”
The California Department of Managed Health Care (DMHC) and Kaiser Permanente recently came to a settlement agreement which will ensure the mental health provider corrects “deficiencies” in HMO’s oversight and access to mental health services. The agreement, which is a result of action taken against Kaiser by the Department beginning four years ago, includes a number of steps the HMO must take within a specified amount of time in order to keep mental health services running smoothly. The Kaiser organization is comprised of Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and the physician-led Permanente Medical Groups.
“If the plan doesn’t meet the benchmarks and deliverables outlined in the settlement agreement, it may be subject to financial consequences up to $1 million,” said DMHC spokesman Rodger Butler. The Department already issued a $4 million administrative fine against Kaiser in 2013 for continuing services despite noted deficiencies. In a re-check a couple of years later, the Department found Kaiser continued to disseminate “inaccurate and misleading health education information to enrollees regarding the scope of their coverage for behavioral health services.”
Kaiser is scheduled to launch an expansion of mental health services in Santa Rosa in the coming week as it corrects current issues. On July 31, it will see the first patients at its new offices, which will include sixty new mental health provider offices and six group therapy and counseling offices. The number of Kaiser’s therapists, psychiatrists and other behavioral workers has grown by 50 percent over the past five years, alleges Dr. Patrick Courneya, executive vice president and chief medical officer of Kaiser Foundation Hospitals and the health plan. No other health plan in the state “can offer anything close,” he said.
From 2012 to May 2017, Kaiser has hired 850 behavioral health providers and 188 behavioral health physicians, as well as made “capital investments” for new hires, according to the settlement. Courneya said Kaiser has been “building, leasing, and remodeling treatment space so that our growing team of clinicians has places to treat more patients…The new Santa Rosa mental health offices are an example of this growth.”
The 2017 DMHC survey report found that Kaiser did not track the “availability and timelines” of follow-up mental health appointments in an appropriate manner, nor does it take effective and timely action when it finds problems. A follow-up survey will be conducted within eighteen months to ensure the company actually corrects those problems.
Courneya is confident the follow up will find no lingering deficiencies. In a statement released following the settlement, he said, “This agreement resolves the prior findings by the Department of Managed Health Care (or DMHC), and shows the path for continued improvement. More importantly, it is an acknowledgment of the significant achievements that Kaiser Permanente has made in our ongoing work to improve mental health care in California.” Courneya adds, “Over the past several years, we have improved access to care, and we are continuously working to lead and improve not only the way mental health and wellness is provided in America today, but how we measure the outcomes of that treatment to ensure patients are getting better…As a result of the work we have done over the past several years to improve and track appointment wait times, Kaiser Permanente now has the most detailed, robust and useful tools for measuring timely access in California.”