Kaiser Permanente mental health reimbursement settlement

EDITOR’S NOTE 8/25/25: Some details in earlier versions of this article described the Kaiser Permanente settlement as a “class action settlement.” The official notice clarifies that this is not a class action lawsuit or class settlement, but a claims review and reimbursement process overseen by the California Department of Managed Health Care. This article has been updated to reflect those corrections.

Kaiser Permanente members in California who were unable to access in-network mental health or substance use disorder care may qualify for reimbursement of out-of-network treatment costs. This process was created under oversight by the California Department of Managed Health Care (DMHC) to address concerns about access to care.

Unlike a traditional class action settlement, there is no common settlement fund and no class counsel. Instead, individual reimbursement requests are reviewed on a case-by-case basis, and members must provide documentation of their out-of-pocket expenses.

Kaiser Permanente is a health insurance company that offers a range of plans to consumers. The company offers in-network services to its members.

Who’s Eligible

You may qualify if:

• You are or were a Kaiser Permanente member in California, and

• You attempted to access in-network mental health or substance use disorder care but could not, and

• You received and paid (or are currently obligated to pay) for out-of-network treatment on or after Jan. 1, 2021.

Special cases: Claims can also be submitted on behalf of a deceased member, a minor, or an incapacitated adult member. In those cases, the claimant must complete Addendum 1 and provide documentation such as a death certificate, letters of administration, or proof of guardianship.

Potential Award

Varies.

Proof of Purchase

To submit a claim, members must provide documentation that supports their out-of-network care and payment, including:

• Provider name, phone number, and email address

• Itemized bills or invoices showing the dates of service, services provided, and amounts billed

• Proof of payment (receipts, cancelled checks, acknowledgements of payment, or similar documents)

• Amounts still owed, if applicable (members can submit claims for services not yet paid but for which they are obligated)

• Information on whether ongoing care is being received from the provider

Claim Form

NOTE: If you do not qualify for this settlement do NOT file a claim.

Remember: you are submitting your claim under penalty of perjury. You are also harming other eligible Members by submitting a fraudulent claim. If you’re unsure if you qualify, please read the FAQ section of the Settlement Administrator’s website to ensure you meet all standards (Top Class Actions is not a Settlement Administrator). If you don’t qualify for this settlement, check out our database of other open class action settlements you may be eligible for.

Claim Form Deadline

Within 180 days of receiving notice.

Case Name

In the Matter of the Investigation of: Kaiser Foundation Health Plan Inc., Enforcement Matter Number: 22-469, before the Department of Managed Health Care of the State of California

Final Hearing

N/A

Settlement Website

OutOfNetworkHealthClaims.com

Claims Administrator

Kaiser Permanente Notice Administrator
1650 Arch Street, Suite 2210
Philadelphia, PA 19103
877-684-4129

DMHC Counsel

Sonia R. Fernandes
CHIEF COUNSEL, DEPARTMENT OF MANAGED HEALTH CARE

Kaiser Counsel

Moe Keshavarzi
SHEPPARD, MULLIN, RICHTER & HAMPTON LLP