Kaiser agrees to $200 million settlement over mental health delays in California

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Healthcare giant Kaiser Permanente has agreed to a $200 million settlement with the state of California to resolve investigations into its behavioral health system that found patients experiencing delays in care.

The settlement announced today includes a $50 million fine and requires Kaiser Permanente to fix major problems in its behavioral health services, such as providing patients with access to timely care. Kaiser Permanente also agreed to invest $150 million over five years to improve its programs.

Governor Gavin Newsom called the settlement a tectonic shift in terms of our accountability in providing behavioral health services. It is the largest penalty ever imposed by the foreign affairs department that oversees mental health services.

The California Department of Managed Health Care announced an investigation into Kaiser in May 2022, when the agency received an unusual number of complaints from enrollees, providers and other stakeholders. other stakeholders related to the program’s behavioral health care activities.

Just three months later, a union representing 2,000 Kaiser Northern California mental health workers led a 10-week strike over long patient waits and doctors’ heavy workloads. clinical. The State Department opened a second investigation related to Kaiser’s behavioral health services during the strike.

Sal Rosselli, president of the National Union of Healthcare Workers, which led last year’s strike, said the report (state investigation) confirms everything Kaiser therapists have said about Their patients cannot receive adequate and timely mental health care.

The settlement comes amid another labor dispute at Kaiser. More than 75,000 lower-paid Kaiser employees in five states went on a three-day strike to call for higher pay. The union coalition representing them has warned that another strike is possible next month.

The Department of Managed Health Care found that Kaiser’s average wait time for follow-up behavioral health appointments is longer than 10 days, the waiting time required by law. In 2021, Kaiser’s average wait time for follow-up therapy appointments was 19 days.

By law, when a health plan cannot make timely appointments, the plan must refer patients to out-of-network providers and pay for those services. Regulators found Kaiser did not consistently arrange out-of-network care. The investigation also found that Kaiser relied heavily on group behavioral health programs, even when individual therapy would have been more appropriate.

DMHC is committed to using the full extent of its authority to hold Kaiser accountable and ensure enrollees have access to behavioral health care when they need it, said Mary Watanabe, director of the department.

Greg Adams, chief executive officer of Kaiser Permanentes, noted in a statement that California is experiencing an unprecedented need for mental health care. A shortage of mental health providers, clinician burnout and strikes in recent years have contributed to Kaiser’s difficulty meeting demand, he said. .

We saw a 33% increase in demand during the pandemic and a 20% increase in people seeking care in 2023 compared to this time last year,” said Adams.

Our agreement with (state) to take full responsibility for our performance during the survey period, including any shortcomings, acknowledges our work to improve care mental health and ensure that our continued investments not only help Kaiser Permanente members but also build a stronger community. mental health foundation in the communities we serve.

According to the state department, the survey of Kaiser’s mental health and substance use disorder services is ongoing.

Supported by the California Health Care Foundation (CHCF), the organization works to ensure that Everyone has the right to access the care they need, when they need it, at a price they can afford. Visit www.chcf.org to find more about.