Assembly on Tuesday to consider bill requiring Kaiser Permanente to streamline full reimbursement for patients with out-of-pocket mental health care expenses due to its failures
AB 1429 comes in response to a 2023 Settlement Agreement that required Kaiser to pay $200 million in penalties for multiple mental health violations and acknowledge that it doesn’t have enough therapists to provide timely appointments
Tuesday’s hearing comes on the heels of another mental health parity bill, sponsored by the National Union of Healthcare Workers, advancing in the State Senate
SACRAMENTO — The fight to protect the rights of Kaiser patients seeking mental health care will shift Tuesday, April 29 from the picket lines in Southern California to the State Capitol in Sacramento. During a 9:30 a.m. session, the Assembly Health Committee will hear AB 1429, a bill authored by Assemblymember Dr. Jasmeet Bains, D-Delano, that would require Kaiser Permanente to provide full reimbursement for patients who are paying out-of-pocket for behavioral health services that Kaiser should be providing.
The hearing can be viewed live at 9:30 a.m. Tuesday, April 29 at https://www.assembly.ca.gov/schedules-publications/todays-events
The bill would require Kaiser to streamline full reimbursement to enrollees who incur out-of-pocket costs for mental health or substance use disorder treatment or medications from non-Kaiser providers or facilities dating back to May 1, 2022. The requirement would remain in effect until the Department of Managed Health Care certifies that Kaiser has successfully completed its Corrective Action Work Plan to address numerous deficiencies in its mental health services and violations of state mental health law cited in a 2023 Settlement Agreement that required the HMO to pay a $200 million penalty, including a record $50 million fine.
Because of Kaiser’s well-documented systemic failure to provide adequate behavioral health services, patients would qualify for reimbursement based solely on attesting in writing to Kaiser’s failure to provide necessary services and submitting their receipts and prescriptions for treatment from a non-Kaiser licensed mental health provider.
“As a physician, I see firsthand how delays and denials for care severely harm health outcomes,” Dr. Bains said. “The law needs to make patient care a priority and ensure patients receive timely and appropriate mental health care.”
Kaiser has a long history of violating mental health laws and clinical standards. It was fined $4 million by California regulators in 2014 for denying members timely access to care, and fined $50 million in 2023, the largest fine in state history for violating multiple mental health laws. In agreeing to the fine, which was part of the $200 million Settlement Agreement, Kaiser acknowledged that “it lacks sufficient behavioral health providers” and that “This lack of clinical staff has resulted in excessive wait times for enrollee individual therapy appointments…”
AB 1429 is sponsored by the National Union of Healthcare Workers, the union that represents nearly 5,000 Kaiser behavioral health workers in California and Hawaii. In Southern California, approximately 2,400 NUHW members, who include mental health therapists, social workers, psychiatric nurses and psychologists, have been on strike since October seeking provisions that would help Kaiser attract and retain more mental health workers.
“Before I went on strike, I would do 15 patient intakes per week and so many people would say they had tried Kaiser before, but their therapist left or wait times were so long they just gave up,” said Kassaundra Gutierrez-Thompson, a therapist for Kaiser in Los Angeles. “This bill would help Kaiser patients get the care they need and help hold Kaiser accountable to finally provide the behavioral health services that its patients are paying to receive. I’ve been a Kaiser patient my whole life, and I’ve often had to pay out of pocket for mental health therapy, but never for medical care. That’s not parity, and it shouldn’t be acceptable.”
The bill would require Kaiser to establish procedures for reimbursing patients and submit a monthly report to state officials detailing the reimbursements. Failure to provide reimbursements would result in penalties paid to the patient as well as a $5,000 fine per incident.
State Senate Committee Advances Parity Bill
Last Tuesday, the Senate Labor Committee voted 4-0 to advance another NUHW-sponsored bill, SB 747, Wiener, D-San Francisco, that is also aimed at advancing parity for mental health care. To get a better handle on the compensation disparity between behavioral health workers and comparable workers who provide medical/surgical care, the bill would require large health plans and medical groups to report compensation data for both classes of employees to the California Department of Industrial Relations.
Currently, Kaiser pays its Southern California non-mental health workers, who have similar educational, licensure and patient care responsibilities, such as occupational therapists and physical therapists, up to 50 percent more than its mental health therapists, even as Kaiser claims there’s a shortage of mental health therapists.
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The National Union of Healthcare Workers is a member-led movement that represents 19,000 healthcare workers in California and Hawai’i, including more than 4,700 Kaiser mental health professionals.
