Associated Press: Kaiser Permanente fined $4 million by Calif agency

NUHW In the NewsJune 27, 2013


State officials fined Kaiser Permanente $4 million, saying the health care giant failed to provide adequate mental health services, a newspaper reported.

The fine issued on Tuesday by the California Department of Managed Health Care is the second-largest in the history of the agency, the Sacramento Bee said.

Investigators said Kaiser failed to see mental health patients fast enough and that the company’s description of its mental health services was so complicated and misleading it “could dissuade an enrollee from pursuing medically necessary care.”

“The amount of the proposed penalty is unwarranted and excessive, and is unnecessary to ensure our corrective actions,” said John Nelson, vice president for Kaiser Permanente. “We will review this with the DMHC.”

The department issued a report three months ago listing numerous deficiencies that noted a “Frequently Asked Questions” sheet for Kaiser in Northern California said the company did not offer long-term individual psychotherapy.

The department also pointed out a website for Kaiser’s Northern California Department of Psychiatry that said the company did not “begin treatment with individuals whose problems are of such long-standing nature that short-term treatment would probably not be helpful.” It went on to say the psychiatry department would refer such people elsewhere, although the treatment would not be covered by Kaiser.

Officials with the managed health care agency said advising patients that long-term psychotherapy is unavailable violates a state law that says mental illness must be treated on par with physical illnesses.

Kaiser, which has 7 million members in California, was fined after it failed to move fast enough to correct deficiencies pointed out last year, DMHC Director Brent Barnhart said.

Nelson said Kaiser has hired new providers to reduce the waiting time for appointments and is recruiting more.

In 2008, Anthem Blue Cross was accused of wrongly rescinding health care coverage and hit with a $10 million fine.