Kaiser Permanente under scrutiny for delays in mental health services

Kelly Gooch -

Oakland, Calif.-based Kaiser Permanente is under scrutiny for delays in behavioral health services.

In 2013, the California Department of Managed Health Care conducted a medical survey of behavioral health services for Kaiser Foundation Health Plan and identified four uncorrected deficiencies. They were: that the plan fails to ensure that quality assurance systems accurately track, measure and monitor the accessibility and availability of contracted providers, per timely access standards; fails to sufficiently monitor the capacity and availability of its provider network; fails to ensure that effective action is taken to improve care where deficiencies are identified in service elements; and fails to provide accurate and understandable effective behavioral health education services, according to a recent follow-up medical survey of behavioral health services for the plan.

The follow-up survey found that the first two deficiencies were corrected, according to a news release. However, the two latter deficiencies have been referred to the DMHC's Office of Enforcement for further investigation, the release reads.

The DMHC said although the plan has made significant strides toward correcting deficiencies related to its obligation to monitor and provide access to behavioral health services, the corrective actions "have not sufficiently fixed access-related problems."

The DMHC also found that the plan "failed to provide accurate and understandable behavioral health benefit and coverage education services."

Furthermore, the DMHC said that in Kaiser's Northern Region, appointments for mental health services did not occur within the required regulatory timeframe in 22 percent of the medical records reviewed. And in Kaiser's Southern Region, appointments did not occur within the required regulatory timeframe in 9 percent of the medical records reviewed, the DMHC said. The DMHC also found that Kaiser providers "relayed inaccurate and misleading information to enrollees in regard to the scope of behavioral health services available."

In response to the department's survey, Kaiser said it is "committed to its history of full and frank discussion with the DMHC" and "committed to providing high-quality behavioral health services and seeking ways to constantly improve."

It also notes that over the past several years, the plan's contracted Medical groups have hired hundreds of Kaiser Permanente therapists in California and are working to hire more. It also mentions that the plan's California membership grew by about 8 percent from 2011 through October 2014.    

The next routine survey of Kaiser, which will include both medical and behavioral health services, is tentatively scheduled to begin in late 2015.

 

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