Another Slam On Kaiser Psych Services
The Department of Managed Health Care issued a mixed interim report on Kaiser Foundation Health Plan's move toward improving access to mental health services, concluding that the Oakland-based insurer has fixed two deficiencies but that two others have yet to be fully addressed.
According to the survey that was released on Feb. 24, the DMHC concluded that Kaiser had fixed deficiencies in regards to capturing and tracking data to determine if mental health services were being delivered in a timely fashion under California law. It also concluded that Kaiser had fixed the methodology issues regarding how it tracks and reports timely access to services.
But the agency was less sanguine about how Kaiser was providing services to its health plan enrollees. It concluded that the insurance giant had failed to improve care when deficiencies were identified, and that it still failed to provide “accurate and understandable” information about its behavioral health benefits and also failed to provide the appropriate education to enrollees about the coverage it provides.
The DMHC made those conclusions after examining the records of 297 Kaiser enrollees regarding their experiences accessing initial and followup mental health services. It determined there was “volatility in timely access to behavioral health services” in both Northern and Southern California, and that in many instances those enrollees were given “inaccurate and misleading health education information to enrollees regarding the scope of their coverage.”
The DMHC fined Kaiser $4 million in 2013 as a result of the initial findings of the deficiencies. It said in its latest report that it would refer Kaiser to its Office of Enforcement “for further investigation and possible disciplinary action,” suggesting that more fines are likely.
“Although Kaiser has taken substantial steps to identify and monitor issues related to timely access to behavioral health services, significant and serious concerns remain,” said DMHC Director Shelley Rouillard. “Kaiser’s actions have not been sufficient to ensure enrollees have consistent timely access to behavioral health services.”
Kaiser spokesperson John Nelson said in a statement that “we are proud of the progress we have made to improve access to mental health care. The DMHC’s initial survey was conducted in 2012. This follow-up survey was conducted in 2013-14, including the case review portion. Since the follow-up review was conducted, we have made even more progress.”
According to Kaiser, it has hired more mental health therapists statewide and is recruiting more. It also hired an outside firm, ValueOptions, an Orange County-based company that provides behavioral health services.
