California probes Kaiser over enrollee access to mental health appointments – Healthcare Dive

The more than 2,000 mental health therapists on strike will remain off the job until Kaiser increases staffing at its clinics and ends “dangerously long” wait times for therapy sessions, according to the NUHW. The union contends Kaiser is breaking California law and violating clinical standards by making patients wait months to start therapy and four to eight weeks between appointments.
California law requires health plans to arrange for care to be provided out of network if timely access to mental health services is unavailable from in-network providers.
DMHC spokeswoman Rachel Arrezola said the department notified Kaiser on Aug. 22 that it had opened an enforcement investigation. The DMHC will continue to monitor the plan closely during the strike to ensure it is in compliance with the law, she said.
“The DMHC is concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that the plan is not providing timely appointments to enrollees required by the law,” Arrezola said.
Brown said 40% of Kaiser’s clinicians are caring for members instead of striking, “with more returning each day.” In addition, Kaiser Permanente psychiatrists, clinical managers and other licensed clinicians have stepped in to meet with people needing care. Kaiser is also working toward agreements with hundreds of community-based mental health providers to open their schedules for at least two months to be able to treat more of Kaiser’s patients, he said.
“We appreciate the DMHC’s interest and accountability in understanding how we are working to deliver clinically appropriate mental health care during NUHW’s unnecessary strike,” Brown said.
Kaiser Permanente mental health clinicians in Hawaii were planning to begin a strike Monday, joining California therapists in calling for the system to address access-to-care issues.
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Mergers with geographic overlap often face challenges. This deal doesn't "raise the same red flags, but it doesn't mean that it gets waved through," said Leemore Dafny, former deputy director of healthcare and antitrust at the FTC.
Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.
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Get the free daily newsletter read by industry experts
Topics covered: M&A, health IT, care delivery, healthcare policy & regulation, health insurance, operations and more.
Mergers with geographic overlap often face challenges. This deal doesn't "raise the same red flags, but it doesn't mean that it gets waved through," said Leemore Dafny, former deputy director of healthcare and antitrust at the FTC.
Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.
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Topics covered: M&A, health IT, care delivery, healthcare policy & regulation, health insurance, operations and more.

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