The U.S. Department of Labor announced on February 10, 2026 a settlement with Kaiser Foundation Health Plan Inc. to resolve multiple investigations into the company’s failure to provide timely and appropriate access to mental health and substance use disorder services.
The settlement between the Department’s Employee Benefits Security Administration and Kaiser affects millions of members in California who receive coverage through their employer, and sets up a claims process for covered members to seek reimbursement for certain out-of-network expenses.
The agreement resolves allegations that Kaiser did not maintain adequate provider networks for mental health and substance use disorder care and used patient responses to questionnaires to improperly prevent patients from receiving care. As a result, many members were unable to access in-network mental health or substance use disorder care and were forced to seek care outside Kaiser’s network, often at higher out-of-pocket costs.
Under the settlement agreement, Kaiser will pay at least $28,323,219 for costs its members incurred when seeking out-of-network mental health and substance use disorder services. Kaiser will also pay a $2,832,321 penalty to the federal government.
In addition to these payments, Kaiser agreed to reform company policies and practices to improve access to mental health and substance use disorder care. These reforms include steps to reduce appointment wait times, improve care review processes to ensure members receive medically necessary care, and monitor network adequacy to ensure members have access to appropriate mental health and substance use disorder providers and facilities.
As part of the settlement, Kaiser has provided notices to members in California who participated in the plan after January 1, 2021, and were likely to have paid for out-of-network mental health and substance use disorder services after trying to obtain in-network services to let them know they may be eligible for reimbursement.
The company stated after the settlement was announced: “We have made many enhancements to our mental health care delivery system and acknowledge there is still work to be done to ensure our interventions and therapies are aligned with our members’ expectations and to ensure we achieve the best patient outcomes.”
Kaiser Permanente states on its website: “No matter where you are on your mental health journey, we’re with you every step of the way. At Kaiser Permanente, you can get help navigating major life events like being pregnant or caring for a newborn, or for managing issues like stress, depression, or substance use. Whatever you may be going through, we’ll connect you to the support you need.”
If you or a loved one suffered serious harm as a result of mental health negligence in the United States, you should promptly find a mental health malpractice lawyer in your state who may investigate your mental health malpractice claim for you and represent you or your loved one in a mental health malpractice case, if appropriate.
Visit our website or call us toll-free in the United States at 800-295-3959 to find medical malpractice attorneys in your state who may assist you.
Turn to us when you don’t know where to turn.
