North Bay Biz Journal: Kaiser fined $4M over mental health care

NUHW In the NewsJune 27, 2013

North Bay Business Journal:

The California Department of Managed Health Care on Tuesday issued a $4 million fine against Kaiser Foundation Health Plan for “serious deficiencies” in how it provides mental health services, but Kaiser said it has worked to correct the issues.

“The department’s actions are a result of both the seriousness of the deficiencies and the failure of Kaiser to promptly correct them,” said Brent Barnhart, department director, in a statement. “The department is taking this action to ensure that Kaiser promptly corrects these deficiencies and provides its patients with the mental health care promised to them by their health plan.”

But Kaiser officials said it did work quickly to correct any issues, and that the amount of the fine is “unwarranted.”

“We respect the regulatory process, and we appreciate that it can help create opportunities to improve performance,” John Nelson,vice president of Oakland-based Kaiser Permanente said in a statement. “However, in light of the steps we have taken over the past year to improve timely appointments and oversight, and the significant progress we have made, the amount of the proposed penalty is unwarranted and excessive, and is unnecessary to ensure our corrective actions. We will review this with the (Department of Managed Health Care).”

The deficiencies, according to the department, include that Kaiser does not:
  1. ensure its systems “accurately track, measure and monitor the accessibility and availability” of mental health provided
  2. “sufficiently monitor the capacity and availability of its provider network to ensure that appointments are offered within the regulatory time frames”;
  3. take effective action to improve identified deficiencies; and
  4. provide “accurate and understandable” education materials on its mental health services.

Mr. Nelson said Kaiser has corrected or is working to correct all issues related to an initial report by the department in 2012 that first called into question the HMO’s mental health practices.

“We have been fully engaged for more than a year in the work to improve the timeliness of initial, non-urgent appointments and record keeping,” Mr. Nelson said in a statement. “Each of the findings in the 2012 (Department of Managed Health Care) survey has already been corrected, or is very far along toward resolution.”

For example, the handful of outdated or incomplete brochures and other materials describing mental health services identified in the survey were updated or removed last year, according to Mr. Nelson.

In addition, Mr. Nelson said the department’s survey found no shortcomings with patients’ ability to receive urgent or emergency mental health care, and that the survey did not find any issues with the quality of mental health care. He also said the department’s findings matched Kaiser’s own findings, and work to correct the issues has been underway for more than a year.

The department said it will conduct a follow-up survey in October “to ensure that Kaiser has corrected each of the deficiencies and is complying with the law.”