United States: A medical center in the United States, ‘ Kaiser Permanente,’ is facing union accusations that patients may be unjustly denied mental health care months after the company and state authorities came to a broad deal to enhance mental health services.
Earlier this year, state authorities got a complaint from the National Union of Healthcare Workers, which showed thousands of Kaiser mental health professionals, alleging that the institution was improperly delegating judgments over whether therapy was still medically required, according to reports by the LA Times.
The Union said that during routine evaluations, Kaiser had made Rula Health, a contracted network of therapists that utilizes virtual treatment for its members, use “illegal criteria” to make those choices.
According to the Union, there is no proof that the choices on mental health treatment are being made using the standards set by professional associations, even though California made this compulsory. Rather, the Union took issue with documentation that suggested Rula was depending on responses to questionnaires regarding symptoms provided by Kaiser patients.
A Researcher for the Union, Fred Seavey, said, “The risk is that patients have a psychological disorder that requires additional treatment, and Kaiser is unfairly and improperly terminating their access to care,” the LA Times noted.
Additionally, the Union claimed that regulations prohibiting insurers from erecting obstacles to mental health care that do not apply to other medical illnesses were broken by routinely requesting such “clinical care reviews.”
The Union said in its lawsuit that Kaiser did not subject other outpatient services to similar assessments, “let alone at such frequencies.”
The Union asked the California Department of Managed Health Care to order Kaiser to halt the review process right now and notify any patient whose treatment was “illegally terminated” by Rula.
According to the reports mentioned in the Los Angeles Times, it does not set any limits or any pause on the number of therapy sessions said in a statement by Kaiser that “the level of therapy needed and the frequency and number of sessions for any patient is a decision made by our mental health care providers in consultation with patients and as appropriate based on the patient’s clinical needs.”
The Department of Managed Health Care is looking into problems raised by a union after a settlement made with Kaiser. The institute agreed to pay a USD 50 million penalty and will invest around USD 150 million over five years to improve mental healthcare. The state found issues at Kaiser, like delays in appointments and not handling patient complaints well.
Greg A. Adams, the chief executive of Kaiser Permanente, stated last year that the company had witnessed an increase in demand for mental healthcare due to the pandemic, which coincided with a 10-day strike by mental health clinicians and a “ongoing shortage of qualified mental health professionals, clinician burnout and turnover.”