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SF Chron: Kaiser fined $4 million over mental health access

NUHW In the NewsJune 27, 2013

By Victoria Colliver, San Francisco Chronicle:

California health regulators fined Kaiser Permanente $4 million for problems with mental health services, including making patients wait excessively long periods for appointments, providing inaccurate educational materials and failing to correct deficiencies.

The fine, issued Monday but announced Tuesday, was the second-largest enforcement action by the state Department of Managed Health Care, which regulates the state’s health maintenance organizations. In 2008, the agency fined Anthem Blue Cross $10 million for improperly canceling policyholders’ coverage often because of minor or inadvertent errors by patients in their applications.

Department officials said the hefty fine against Kaiser reflects the seriousness of the problem as well as the Oakland HMO’s failure to respond.

“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,” agency director Brent Barnhart said in a statement.

Kaiser officials disagreed with the department about their response to the problems, which came to light during an investigation conducted in 2012. The results were issued in March. Spokesman John Nelson called the fine “unwarranted and excessive.”

“We certainly feel it’s disproportionate to the findings in the (investigation), and it’s certainly out of step with the work that’s been done over the last year and a half,” he said.

Nelson said the deficiencies outlined have either already been corrected or are “well on the way to a resolution.”

For example, he said, Kaiser has updated educational materials and has been hiring and recruiting mental health providers since early 2012. The HMO also said it’s made progress on one of the most serious concerns, that patients were waiting longer than the 10-day period allowed by law for initial nonurgent appointments.

Officials from the National Union of Healthcare Workers, which prompted the investigation in November 2011, said the fine affirms the findings of an exhaustive complaint filed by Kaiser Permanente’s frontline mental health clinicians, who are represented by the union.

The Department of Managed Health Care plans to conduct a follow-up survey in October to make sure Kaiser has corrected all the deficiencies and is complying with the law.

Online: Read a copy of the state Department of Managed Health Care’s report of Kaiser’s behavioral health services at http://bit.ly/121rl3t.

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