Kaiser reaches deal with state regulators over mental health care violations

Kaiser Mental HealthJuly 20, 2017

Kaiser Permanente and the California Department of Managed Health Care have reached an agreement to correct issues pertaining to Kaiser’s oversight of its behavioral health services and its ability to provide timely access to care.

The Stipulated Settlement Agreement requires Kaiser to take several corrective actions over the next one to three years in order to fully resolve issues that the department has documented in surveys dating back to 2013. Failure to meet corrective action deadlines could result in six-figure fines imposed by the state.

Kaiser is contracting with a mental health consulting firm to help it meet its requirements under the agreement. The firm’s role is primarily advisory. However, it will have authority to monitor KP’s compliance with the settlement agreement, including the authority to request documents from KP and notify the DMHC if it’s concerned that KP is failing to meet performance benchmarks.

The consulting period is scheduled to last up to three years. Both Kaiser and the consultant are required to first develop a work plan for addressing mental health access issues. The work plan is due by Sept. 30, 2017.

The agreement stems from a series of DMHC surveys dating back to 2013 when the department found that Kaiser was not meeting accessibility standards for its behavioral health care services. Follow-up surveys released in 2015 and 2017 found that although KP had made many improvements, it still had not fully resolved patient access issues.

Rather than attempt to pursue legal action, the DMHC opted to work with KP to remedy outstanding issues. In a public statement about the settlement agreement, DMHC Director Shelley Rouillard said, “Our goal has always been to compel the plan to fix the access problems we have identified and ensure that enrollees receive timely access to behavioral health services. We believe this agreement will achieve that goal.”