Category Archives: Department of Managed Health Care

Huffington Post: Kaiser is Failing its Mental Health Patients

Kaiser Permanente is Failing its Mental Health Patients, Huffington Post

by Sal Roselli, President, National Union of Healthcare Workers (NUHW)
10/24/2014

kaisers mental health care crisisIn September, after more than a year of stonewalling its patients and employees, Kaiser Permanente finally paid a $4-million fine levied against it by state regulators because of the HMO’s chronic, illegal, and too often tragic failures in mental health care.

Spurred by whistleblower complaints from Kaiser’s own mental health clinicians, an investigation by the state’s Department of Managed Health Care (DMHC) found the HMO guilty of “serious” and “systemic” violations of California law that put mental health patients at risk. The result: In June 2013 the DMHC hit Kaiser with a $4-million fine — the second largest in the agency’s history — for forcing thousands of patients to endure illegally lengthy waits for care, falsifying patients’ appointment records, and violating the California Mental Health Parity Act, which requires HMOs to provide psychiatric services that are on par with their primary health services.

To read the rest of the article, click here: Kaiser Permanente is Failing is Failing its Mental Health Patients

Kaiser Admits Guilt and Pays $4 Million Fine

Kaiser HQIn early 2013, the Department of Managed Health Care levied a $4 million fine against Kaiser for “serious” and “systemic” violations of state law in its mental health care services across California. Since then, the fine has been on hold because of an appeal initiated by Kaiser. But on September 8, Kaiser essentially admitted guilt. Rather than go through a appeals hearing, which would be open to the public, Kaiser decided to just pay the $4 million. Kaiser may have chosen to pay the fine rather than go through the hearing because mental health clinicians from Kaiser hospitals were scheduled to give testimony about past and ongoing serious problems with Kaiser’s mental health services. These include, among other problems, long wait times for mental health appointments and patients being slotted into group therapy even when individual therapy would be clinically appropriate.

What’s the next step? This fall the Department of Managed Health Care is planning to issue the results of follow-up survey assessing Kaiser’s efforts to fix problems with its mental health services. If the DMHC finds that problems persist, an additional fine can be levied and corrective actions will be required.

This recent development has been covered in several news outlets. The following story was published in the Santa Rosa Press Democrat on September 10, 2014. To see all of the press coverage, click here: Press about the $4 Million Fine.

Kaiser Agrees to Pay $4 Million Fine Over Mental Health Services, by Martin Espinoza

Ending a yearlong challenge, Kaiser Permanente will pay a $4 million fine levied by state regulators who accused the HMO of “serious deficiencies” in providing its members with timely access to mental health services.

….

The state Department of Managed Health Care imposed the fine — the second-largest ever in the agency’s 14-year history — in June 2013. Regulators alleged Kaiser was not accurately tracking patients’ access to its therapists. The agency also said Kaiser could not ensure that patients were offered timely initial appointments with therapists for non-urgent matters, in violation of state regulations.

Kaiser challenged the fine, saying it was excessive and unwarranted. But it withdrew its appeal Monday night, hours before Kaiser representatives and state regulators were scheduled to give opening statements in a hearing Tuesday before an administrative law judge in Oakland.

The Department of Managed Health Care is conducting a follow-up survey to determine whether Kaiser has corrected its alleged deficiencies and is complying with the law, said Shelley Rouillard, the agency’s director.

….

“Kaiser finally acknowledged its violations after a year and a half of fighting a cease and desist order” from state regulators, said Sal Rosselli, president of the union. “But it has yet to take any meaningful steps to correct the underlying problems in its mental health care system.”

To read the full story: “Kaiser Agrees to Pay $4 Million Fine”

SF Examiner Op-Ed: Kaiser Must be Held Accountable for Mental Health Care Failures

The San Francisco Examiner recently published an op-ed by Sal Roselli, the president of the National Union of Healthcare Workers, calling on the Department of Managed Health Care to hold Kaiser Accountable for the various problems with its mental health care services.

Kaiser Must be Held Accountable for Mental Health Care Failures, by Sal Roselli

September 4, 2014

Kaiser Permanente is failing its mental health patients.

kaiser photoSpurred by whistle-blower complaints from Kaiser’s own mental health clinicians, an investigation by the state’s Department of Managed Health Care found the HMO guilty of serious and systemic violations of California law that put mental health patients at risk. The result: In June 2013, the DMHC levied a $4 million fine — the second-largest in the agency’s history — against Kaiser for forcing thousands of patients to endure illegally lengthy waits for care, falsifying patients’ appointment records, and violating the California Mental Health Parity Act, which requires HMOs to provide psychiatric services that are on par with their primary health services.

“Kaiser appealed, of course, but now faces the prospect of a hearing, scheduled to begin Monday in Oakland, during which patients and whistle-blowers would give public testimony regarding Kaiser’s deficient care. For weeks, Kaiser has been negotiating a settlement with the DMHC in hopes of avoiding such a spectacle, and a settlement is indeed likely given Kaiser’s political connections.

“The National Union of Healthcare Workers, which represents 2,500 mental health professionals at more than 100 facilities throughout California, stands with the thousands of patients who have suffered as a result of Kaiser’s violations in calling for the DMHC to hold Kaiser accountable.”

To read the full op-ed, click here: SF Examiner: Kaiser Must be Held Accountable.

State regulators examining Kaiser’s mental health services

The Department of Managed Health Care, one of the state agencies responsible for regulating Kaiser, is currently conducting a follow-up survey of Kaiser Permanente to determine whether or not the HMO is complying with state law. In June of 2013, the DMHC fined Kaiser $4 million for violating multiple provisions of state law, including California’s Timely Access Regulations and the California Mental Health Parity Act. The DMHC’s investigation was triggered by a complaint filed by NUHW in November of 2011 in the form of a 35-page report entitled, “Care Delayed, Care Denied.”