Washington state has fined Kaiser Foundation Health Plan $300,000 for failing to comply with federal mental health parity requirements, though $100,000 of that amount is suspended.
The enforcement action came after Kaiser couldn’t provide adequate documentation on provider admission standards and network adequacy requirements. The insurer also failed to show how it initially addressed payment disparities between behavioral health providers and other medical professionals, according to a Jan. 8 news release.
The state’s insurance department conducted its first review in March 2019 but received incomplete information from Kaiser, leading to a second probe in January 2020. That follow-up review analyzed utilization management practices, provider admission criteria, provider directories and network adequacy measures. Kaiser provided details on remediation efforts after Washington officials began enforcement proceedings.
The state’s insurance commissioner will waive $100,000 of the fine if Kaiser avoids any mental health parity violations over the next two years and follows a state compliance plan.
Kaiser shared the following statement with Becker’s:
“Kaiser Permanente believes an individual’s physical, mental, and social health are connected and essential to total health. We also believe in the power of our integrated system and the expertise of our physicians and therapists to deliver excellent mental health and substance use disorder care as an equal and essential part of overall health care. We offer members more choice and access to mental health care than ever before.
Following the OIC’s evaluation in 2020, we took immediate action to address our parity deficiencies. Over the past several years, we’ve significantly reduced wait times by increasing the number of therapists and nurse practitioners, and we’ve integrated treatment for depression and anxiety into the primary care setting at 25 of our clinics.
We’ve also expanded our external provider network by more than 50% and increased provider reimbursement rates to further improve access to mental health care. We continue to work closely with our external mental health providers to understand the challenges our members experience and remain committed to these ongoing efforts.”
