Kaiser Permanente has been under intense scrutiny this week following their settlement with the U.S. Department of Labor for alleged violations of mental health parity requirements. Individuals who utilize Kaiser and other major health systems believe that mental health care access is often exaggerated on paper compared to how they actually get access to services. Families typically waited for long periods of time to see a therapist, had limited choices of mental health specialists and faced a confusing denial of benefits. Even when someone can obtain health insurance, these access barriers have the potential to erode true mental health care access.
Federal parity legislation was written to require that mental health care access be comparable to physical health care access. Historically, there have not been many enforcement actions taken against these mental health parity violations. The Kaiser settlement signals that state and federal regulators care more about how companies actually deliver mental health care access than what they say in their benefit brochures. The settlement includes corrective actions designed to enhance network adequacy and appointment availability as well as require that there be greater internal oversight of the network between Kaiser and its contractors so that individuals are able to obtain access to mental health care in a timely and equitable manner.
For many patients, the development of this settlement is both a source of frustration and relief. On the one hand, the settlement provides validation for many who have reported for years that mental health care is more difficult to access than other types of medical care (even in well-established systems). On the other hand, many individuals presently on waitlists or struggling to find providers will still require meaningful action in the community. Advocates state that it can be construed as a start, rather than a finish, to the overall reform of mental health care access for individuals and families across the nation.
Experts assert that significant improvement in access to mental health care is unlikely to occur through punitive monetary penalties alone. Experts are suggesting that improved access to mental health care will require transparency regarding wait times for appointments, increased oversight for provider networks, and ultimately, incentives to invest in community-based and digital services that can provide greater access to mental health care for individuals living in underserved communities. The expectation from all individuals and families is simple: if and when individuals reach out for assistance, mental health care should be provided to these individuals in a manner that is easily accessible (hopefully, providing them with the necessary tools to facilitate their recovery).
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