Kaiser, Don't Deny
Patients need access to timely and consistent mental health services
NUHW Kaiser clinicians team up with leading mental health parity attorneyPublished Tuesday, August 31, 2021
Kaiser mental health clinicians have a new ally in their fight to improve access to care and working conditions. Meiram Bendat, the nation’s leading attorney specializing in mental health parity law, has been retained by NUHW.
Bendat held an initial meeting this month with Kaiser Permanente clinicians and our research team to help us document access to care issues so that we are better positioned to work with Kaiser to address them.
In 2019, Bendat’s firm, Psych Appeal, won a landmark class-action lawsuit against United Behavioral Health, in which the country’s largest managed behavioral healthcare company was found liable for rejecting the insurance claims of tens of thousands of people seeking mental health and substance use disorder treatment based on incorrectly claiming that the treatments were not medically necessary.
The following year, Bendat helped author SB 855, the landmark mental health parity bill that many NUHW members helped pass into law. SB 855 requires that insurers, including Kaiser:
- Cover all psychiatric illnesses and substance use disorders identified in the most recent version of the APA’s Diagnostic and Statistical Manual.
- Standardize criteria for “medical necessity” to align with the profession’s standards of care, as opposed to the arbitrary standards insurers had previously used.
- Pay for out-of-network care if their internal network can’t meet a patient’s need.
NUHW and Bendat worked hard to pass SB 855, and we have a shared interest in making sure that the law is fully implemented and enforced. During our first meeting with Bendat, a dozen Kaiser therapists discussed several recurring issues at Kaiser clinics, including:
- The difficulty patients face in many service areas finding external providers and the lack of oversight in many service areas in documenting the outcomes of patients who are referred to outside providers.
- The challenge of using Kaiser’s templates to accurately document recommendations for how frequently a patient should be seen and whether patients are being offered treatment that meets the required standard of care.
- The disparity in external provider access for children as compared to adult patients.
- The lack of clear policies and procedures for making appropriate treatment frequency and duration available to a patient once a clinician has determined which psychotherapy interventions are medically necessary.
- The overbooking of therapy groups in certain service areas that are not in compliance with limits set by Medicare.
Bendat is very familiar with our battle for behavioral health parity over the past decade, and he’s as excited to work with NUHW, as we are to work with him.
“What you’re doing is very noble,” Bendat said during the meeting. “I’m really impressed with all the efforts… I love working with groups that are passionate about what they are trying to achieve. It’s really terrific and great to be a part of that.”