DMHC outlines enforcement history, quarterly oversight of Kaiser after 2023 settlement

Mary Watanabe, director of the California Department of Managed Health Care, told the Assembly Health Committee on May 6 that the department has taken repeated enforcement steps against Kaiser Permanente dating back to 2012 and will use quarterly monitoring and follow-up surveys to verify Kaiser’s compliance with the settlement agreement and state law.

Watanabe said the department regulates about 140 health plans covering nearly 30 million Californians and has used routine three‑year audits, non‑routine surveys and targeted investigations to identify problems. She described a 2012 enforcement action that led to a $4,000,000 fine, repeated follow‑up findings in 2015 and 2016, a 2017 settlement, a 2022 non‑routine survey that uncovered deficiencies in Northern and Southern California, and a 2023 enforcement settlement that required structural change at Kaiser.

The settlement announced Oct. 12, 2023, included a $50,000,000 administrative penalty, required Kaiser to invest $150,000,000 over five years in innovative programs beyond legal obligations, and authorized a $10,000,000 suspended penalty if Kaiser failed to meet obligations. Watanabe said Kaiser paid $40,000,000 on Oct. 19,…