Kaiser Permanente Accused Of Using EMR As Smokescreen

Posted on March 27, 2013 I Written By

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.

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.