Kaiser to pay $200M for behavioral health access violations

Kaiser Permanente reached a $200 million settlement with California for violating the state's behavioral health access laws. 

The settlement is the largest the state has ever reached with a managed care plan, according to an Oct. 12 news release from the state Department of Managed Health Care. 

Kaiser Permanente will pay $50 million in fines to the DMHC and $150 million to the state over five years, which will go toward improving California's behavioral health system. 

A non-routine survey of Kaiser Permanente members and an enforcement investigation found several violations of California's laws regarding behavioral health access, the state said. Kaiser violated timely access and clinical standards, and in some cases it canceled members' behavioral health appointments. 

The state opened a targeted investigation of the plan in August 2022, in the midst of a 10-week strike during which 2,000 of Kaiser Permanente's behavioral health workers walked off the job. Kaiser was still responsible for meeting timely access standards during the strike, the DMHC said. 

"Our agreement with the DMHC takes full accountability for our performance during the survey period including our shortcomings, acknowledges our work to improve mental healthcare, and ensures that our ongoing investments not only help the members of Kaiser Permanente but also build a stronger mental health foundation in the communities we serve," Kaiser Permanente CEO Greg Adams said in an Oct. 12 statement. 

As part of the settlement, Kaiser will work with an outside consultant to improve its members' access to behavioral healthcare, including broadening access to out-of-network providers when Kaiser providers cannot see patients according to timely access standards and improving its grievance and appeals policies for mental health treatment. 

The $150 million Kaiser will invest in California's mental health system will go toward programs such as youth mental health initiatives, new digital wellness offerings and integrating behavioral health with primary care, Mr. Adams said. 

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