Kaiser Permanente Accused Of Using EMR As Smokescreen

Kaiser Permanente, California’s largest healthcare provider, has been cited by state officials for using its EMR to work its way around requirements to see mental health patients promptly, reports EHR Intelligence.

Potentially risking their own jobs, Kaiser’s own mental health team brought the discrepancies to the attention of the state.  Their complaint not only slams Kaiser’s practices regarding wait times, but also its overall clinical approach to treating mental health patients, going so far as to accuse the giant HMO of defrauding Medicare by upcoding cursory visits as complete.

According to the California Department of Managed Healthcare, Kaiser has been keeping two sets of records, one in its official EMR and another on paper that hid violations of the state’s law mandating short wait times for mental healthcare. The EMR also fails to retain a record of booking dates, so if an appointment date is changed, the wait time is being calculated from the most recent booking date, not the original date, the state charges.

The dual record keeping procedure allowed Kaiser to hide the fact that mental health patients may have waited weeks longer than the state’s “timely access” law requires, for illnesses such as schizophrenia, depression and suicidal ideation, as well as other serious conditions.

In defiance of the state-required two days between contacting an enrollee and booking an appointment, Kaiser had been recording initial contacts on paper, then asking patients to call back during the next window for appointments, up to four weeks later.  The EMR would then record the initial contact as taking place during the later booking windows, leaving out completely the weeks of waiting mentally-ill patients endured.

Kaiser has said that it addressed the discrepancies noted by the government, which were first brought to its attention last August, but the Department of Managed Healthcare has concluded that the changes needed have not yet been made.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

2 Comments

  • I think we’ll be seeing more “working the system” by big operators. We already see them using their systems to maximize fees…quite the opposite that an EHR was thought to do.

  • This is no surprise. Kaiser has been doing this for a very long time. Every single department at any Kaiser facility. They also have the best lier. Kaiser has made most there billions illegally. They have The Office of Cival Rights for Hippa Violations in bed with them. No matter how much evidence there is showing blantant disregard for a patients personal medical informationto be put in the wrong hands. The Hippa Violations have gone totally rampid and continie to get worse with no end in site. You have to look at it this way they have doing this for so long they wouldn’t know how to do it right. Plus they would have to train employes to do things the right way and legally, tjis would cost them. too much money. After all how do you thinkthey made those billions. One of these days Kaiser will fall harder then Rome. and it will serve them right! Nothing lasts forever.

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