Modern Healthcare - - REGIONAL NEWS -

OAKLAND, Calif.— The Kaiser Foun­da­tion Health Plan was fined $4 mil­lion by the state of Cal­i­for­nia for fail­ing to cor­rect vi­o­la­tions of men­tal health laws, in­clud­ing pub­lish­ing ma­te­ri­als that wrongly said the or­ga­ni­za­tion could deny long-term men­tal health­care ser­vices to some plan en­rollees. The health plan, part of not­for-profit Kaiser Per­ma­nente’s in­te­grated de­liv­ery sys­tem, also was ac­cused of vi­o­lat­ing state law by mak­ing some pa­tients wait more than 14 days for an ini­tial men­tal health ap­point­ment. And it was ac­cused of keep­ing data in ways that made it im­pos­si­ble to tell whether the plan was meet­ing its obli­ga­tions to of­fer men­tal health ap­point­ments to pa­tients quickly enough un­der the law, ac­cord­ing to a 23-page de­fi­ciency re­port is­sued by the Cal­i­for­nia Depart­ment of Man­aged Health Care. The depart­ment said in its com­plaint that the is­sues sur­faced dur­ing a rou­tine re­view of the health plan that be­gan in Jan­uary 2012. The National Union of Health­care Work­ers, how­ever, took credit for trig­ger­ing the in­ves­ti­ga­tion with the pub­li­ca­tion of a 34-page re­port on what it called the health plan’s “fail­ure to pro­vide timely and ap­pro­pri­ate men­tal health ser­vices.” Kaiser of­fi­cials said they will con­tact state of­fi­cials to dis­cuss the $4 mil­lion fine, which the sys­tem viewed as “un­war­ranted and ex­ces­sive” in light of the sys­tem’s on­go­ing ef­forts to re­solve the is­sues out­lined in the re­port. “Each of the find­ings in the 2012 DMHC sur­vey has al­ready been cor­rected, or is very far along to­ward res­o­lu­tion,” Kaiser said. “Im­por­tantly, the DMHC sur­vey did not iden­tify short­com­ings with mem­bers’ abil­ity to re­ceive ur­gent or emer­gency men­tal health­care. Fur­ther, the sur­vey did not iden­tify prob­lems with the qual­ity of men­tal health care that our pro­fes­sion­als pro­vide to our mem­bers.” —

Joe Carl­son

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