Kaiser Permanente’s mental healthcare services faulted again

kaiser-permanentes-mental-healthcare-services-faulted-again

For the second time in two years, the state of California has faulted HMO huge Kaiser Permanente for failing to provide patients with proper access to mental healthcare.

Some Kaiser clients still have to wait weeks or even months to see a therapist or psychiatrist, which breaches state laws meant to guarantee timely access to mental health treatment, the state Department of Managed Healthcare stated in a report launched Tuesday.

In addition, the department, which manages California’s handled healthcare companies, found that Kaiser’s informative materials– along with some providers themselves– poorly indicated that long-term individual therapy was not available to enrollees, despite the fact that coverage of treatment for severe mental illness is required under state and federal psychological health parity laws.

Tuesday’s report is a follow-up to an examination report released in March 2013 that identified 4 major deficiencies in the health insurance’s delivery of psychological health services. Kaiser consented to pay a $4 million fine– one of the biggest ever by an insurance provider in the state. At the time, the handled healthcare company said it would follow up on the strategy’s development a few months later on. The results of that were not released previously.

In the follow-up report, the department found that Kaiser had addressed two of the four problems by enhancing the way it gathers and assesses data about access to proper mental healthcare.

“Kaiser has made progress in having the ability to identify when and where the problems around access are taking place, but they are still unable to address the problems when they arrive,” said department director Shelley Rouillard. “They still have a great deal of work to do.”.

Kaiser authorities say they have actually made considerable strides in boosting their carrier network, consisting of enhancing their therapist staff. In addition, Kaiser is dealing with a separate company called ValueOptions to offer extra psychological health services when needed.

“We are proud of the development we have made to enhance access to psychological healthcare,” Kaiser Permanente officials stated in a statement. “We are committed to continuing to enhance. We acknowledge there are still some areas where we have to continue making progress and do better for our patients,” including improving access to appointments at some places.

In Kaiser’s Northern Region, the handled health care department found 22 percent of patients did not have timely access to either a preliminary or follow-up appointment. In one case, a sexual assault victim identified with post-traumatic stress disorder and significant depression was recommended an antidepressant in a preliminary visit, however no follow-up consultation was set up.

The patient tried to schedule both individual and group treatment check outs, but her psychiatrist reacted by “providing psychotherapy in the community at the patient’s cost and suggested that the client examine appropriate group therapy in the community since weekly individual treatment was not offered in the Strategy, and Strategy group therapy did not attend to sexual assault,” according to the report.

The patient was ultimately able to schedule an appointment with a Kaiser therapist– five months after her initial check out, the report stated.

In another case cited by the department, a psychiatrist wrote an e-mail to a client saying, “No one ever sees a therapist as soon as a week in the Kaiser Health insurance. Not a covered advantage for the past 20-something years and will not be an advantage in the future.”.

Based on Tuesday’s report, the managed healthcare department’s Office of Enforcement will certainly consider whether Kaiser Permanente should face more corrective action, which might include another fine.

Kaiser Permanente is one of the largest not-for-profit health insurance in the country, with an operating profits of $56.4 billion and nearly 7.5 million members in California.

The company has been in a lengthy labor conflict with the National Union of Healthcare Employees, which represents the plan’s therapists. Union leaders have implicated the health insurance of a “persistent failure to supply … quality mental health care.” In its composed statement, Kaiser blamed the union for continued issues in supplying timely access to psychological health care.

“We need union management to work constructively together with us to get rid of barriers and solve problems faster,” the statement stated.