A union is accusing Oakland, Calif.-based Kaiser Permanente of mishandling decisions about mental health services, the Los Angeles Times reported April 9.
The National Union of Healthcare Workers, composed of thousands of Kaiser mental health professionals, filed a complaint to state regulators earlier this year alleging that Kaiser inappropriately handed off "decisions about whether therapy is still medically necessary," according to the news outlet.
Specifically, the union said Rula Health, a contracted network of therapists that Kaiser uses to provide virtual care, was advised by Kaiser to conduct "illegal criteria" to make those decisions.
According to the publication, California mandates that determinations regarding mental healthcare must adhere to criteria established by professional organizations. However, the union alleged a lack of evidence supporting this practice. It expressed concerns that Rula relied on information provided by Kaiser patients regarding their symptoms.
Fred Seavey, a researcher for the union, cautioned that this approach might lead to patients with psychological disorders being unfairly denied necessary treatment by Kaiser.
The union is urging the California Department of Managed Health Care to instruct Kaiser to stop the review process immediately and inform any Kaiser patients whose treatment had been "illegally terminated" by Rula.
Kaiser told the Times it does not impose restrictions on the number of therapy sessions. Kaiser also emphasized that decisions regarding the necessary level of therapy, frequency and number of sessions are made collaboratively by their mental healthcare providers and patients, tailored to the patient's clinical requirements.
A spokesperson from the Department of Managed Health Care said its enforcement office is investigating concerns raised by the union as part of the department's recent settlement with Kaiser. The agreement, finalized in the fall, mandated Kaiser to pay a $50 million penalty and allocate $150 million over five years toward enhancing its mental healthcare services, according to the report.
The state agency stated that it discovered deficiencies at Kaiser, including delays in providing appointments, lack of proper supervision of medical groups in determining suitable care, and insufficient management of patient complaints, among other issues.
Kaiser told the publication that it is making significant changes as outlined in the settlement agreement, such as a notable rise in the number of available providers for their members, including both newly hired and contracted therapists.
A spokesperson from Rula mentioned that their therapists, working together with their patients, are responsible for making all clinical decisions regarding the treatment plan.