Oakland, Calif.-based Kaiser Foundation Health Plan faces a complaint alleging it used an autonomous digital system to triage and refer behavioral health patients in Northern California without oversight from licensed clinicians.
The complaint, submitted to the California Department of Managed Health Care and the U.S. Department of Labor’s Employee Benefits Security Administration, filed by the National Union of Healthcare Workers, centers on Kaiser’s “E-Visit” tool. Enrollees seeking treatment for anxiety or depression are directed to complete an online questionnaire, and NUHW alleges an algorithm assesses the responses and generates referrals and care recommendations without review by a licensed clinician, a practice the union said violates California laws governing behavioral health triage and utilization review.
The filing also alleges Kaiser continues to rely on unlicensed telephone service representatives to conduct behavioral health triage, pointing to a separate complaint NUHW filed with the DMHC in July 2025. NUHW said thousands of enrollees each week are affected by the practices and included screenshots it said show the E-Visit system automatically generating behavioral health referrals from questionnaire responses. The union asked regulators to order Kaiser to stop the practices and impose additional financial sanctions, citing prior regulatory action against the health plan — a reference to the DMHC’s 2023 settlement with Kaiser, which included a $50 million penalty and $150 million earmarked over five years for mental healthcare improvements.
NUHW President Sophia Mendoza told Becker’s the triage system denies patients the chance to speak with a licensed therapist who can assess their needs, and that it violates state law regardless of whether the underlying technology is classified as AI.
“Kaiser has refused to disclose the technology underpinning the E-visit triage system, but whether or not it technically employs AI, there is no question that it uses digital algorithms to replace the clinical judgment of Kaiser’s human therapists,” she said.
Kaiser disputed the union’s characterization. The health system said in a statement that the E-visit tool was developed with input from therapists and NUHW representatives, offers an additional path to care rather than the only one, and gives patients a phone number on every screen to reach a live person. Kaiser said the tool does not use AI to diagnose patients, make clinical decisions or determine medical necessity, and that clinical decisions remain with licensed professionals.
The company pointed to more than $2 billion invested in mental health services, staffing and facilities since 2020, and said it currently meets the state’s timely access standards, with members getting non-urgent appointments in an average of six days and urgent appointments within 48 hours.
Kaiser also cited an AI governance framework it reached with the Alliance of Health Care Unions — recognized by the MIT Sloan School of Management — and said it has proposed a similar joint labor-management committee to NUHW.
The Department of Managed Health Care confirmed it received the union’s complaint and is currently investigating the matter.
The complaint is the latest flashpoint in an ongoing dispute between Kaiser and its unions over AI and automation in patient care, following a 2024 union complaint over automated therapy-necessity reviews at contracted network Rula Health and a July 13 protest by California Nurses Association-represented nurses outside the American Hospital Association Leadership Summit in Denver over Kaiser’s AI strategy.
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