OAKLAND, Calif. (CN) - Kaiser illegally fails to treat serious mental illness on par with treatment for physical illness, a class claims in a lawsuit filed last week.
Charles Dion sued Kaiser Foundation Health Plan, on behalf of himself and other plan members with serious mental illnesses, in Alameda County Superior Court.
Dion, who has obsessive-compulsive disorder (OCD), requested individual cognitive behavioral therapy in October of 2013, according to the complaint.
It continues, "Specifically, his request was for Exposure and Response Prevention therapy, a type of psychotherapy for the treatment of his OCD. On Nov. 6, 2013, he met with Timothy Brown PhD, a Kaiser psychologist. Dr. Brown advised Mr. Dion that Kaiser does not offer the individualized psychotherapy treatment for patients with OCD. He stated that other than medication, the only treatment that Kaiser offered for OCD was group therapy classes -- which Dr. Brown ran. Dr. Brown acknowledged that Mr. Dion has severe OCD and that group therapy once a week would be insufficient. He stated that he might be able to refer Mr. Dion to a non-Kaiser anxiety clinic. That clinic is nearly 100 miles away from Mr. Dion's home.
"Because he could not receive the individual therapy within Kaiser, Mr. Dion began treatment outside of Kaiser with a non-Kaiser therapist. Mr. Dion filed a grievance with Kaiser on Nov. 19, 2013. On Dec. 31, 2013, Mr. Dion received a letter from Kaiser that stated that it would pay for his current Exposure and Response Prevention therapy (ERP) but only as a 'one time courtesy' and only through Jan. 31, 2014. Kaiser refuses to provide Mr. Dion with individualized and consistent psychotherapy despite his severe mental illness and need."
Kaiser has engaged in "systematic violations" of California's Mental Health Parity Act (MHPA) Dion says in the complaint, on behalf of the class.
The plan fails to provide services for treatment of the serious mental illnesses covered by the law on terms equivalent to those applied to physical illnesses, Dion says. The law covers mental illnesses such as schizophrenia, bipolar disorder, severe depression and obsessive-compulsive disorder, according to the complaint.
The MHPA requires health plans to provide all medically necessary treatment for the illnesses on the same financial terms as those applied to physical illnesses, Dion says in the complaint.
The complaint continues, "Kaiser has failed to provide psychiatric and psychotherapy office visits sufficient to treat the law's enumerated serious mental illnesses and by limiting the number of office visits a member can receive, or requiring members to wait extensive periods of time between office visits to receive treatment. Kaiser has also refused to provide individualized treatment, steering members to attend 'group' therapy sessions without regard to individual therapeutic needs. Additionally, Kaiser has failed to provide adequate specialty physicians or treatment modalities to treat the specified serious mental illnesses and has required members to travel unreasonable distances to non-Kaiser providers to receive proper treatment. These illegal practices have been followed by both Kaiser and its affiliated medical groups."
The class claims Kaiser participates in unfair business practices, and seeks declaratory and injunctive relief.
The class is represented by Robert S. Gianelli and Jully C. Pae of Gianelli and Morris, a Law Corporation, in Los Angeles, and Scott C. Glovesky in Pasadena.
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