Providers Beware: Behavioral Health Fraud Investigations, Recoveries on the Rise

Most behavioral health providers agree it’s a good thing: The federal government continues to funnel more money into behavioral health initiatives, such as fighting the opioid epidemic and funding certified community behavioral health clinics (CCBHC). But as providers find themselves with more federal dollars, they’re also more likely to face increased scrutiny over their practices, […]

Co-Founder of Addiction Center Pleads Guilty for Role in $100M Fraud Scheme

The co-founder of a Pennsylvania addiction rehab center has pleaded guilty to conspiracy to commit health care fraud for his role in an “elaborate” insurance scheme, according to the U.S. Department of Justice (DOJ). The scheme fraudulently billed insurers for more than $100 million, local newspaper The Intelligencer reported. Defendant Branden Coluccio entered the plea […]

National Council CEO Hopes to Expand CCBHC Program, Strengthen Medicaid in 2020

After years of being neglected, behavioral health issues are finally getting some attention in Washington, D.C. The Centers for Medicare and Medicaid Services (CMS) has opened new up reimbursement opportunities for behavioral health services; the Substance Abuse and Mental Health Services Administration (SAMHSA) continues to roll out additional grants; and a growing number of state […]

NABH Chief: CMS’ Plan to Streamline Psychiatric Hospital Compliance Misses Mark

Psychiatric hospitals that participate in Medicare will soon see changes to the way they’re surveyed for compliance. Currently, providers are surveyed twice to ensure compliance with two different sets of guidelines, or conditions of participation (CoPs). But starting in March, those surveys will be consolidated into one, the Centers for Medicare & Medicaid Services (CMS) […]

UnitedHealth Group Temporarily Avoids Parity Lawsuit

UnitedHealth Group avoided a parity fight Monday, when a California federal judge dismissed a lawsuit claiming the insurer unfairly denied a man his right to receive coverage for addiction treatment. However, the insurer isn’t in the clear just yet, according to Law 360. The class action suit, originally filed last July, stated that the lead […]

‘Rehab Mogul’ Pleads No Contest in $175M Billing Scheme; Outpatient Mental Health Provider Settles False Claims Suit

The one-time owner of more than a dozen Los Angeles-area substance abuse treatment centers has been indicted on charges he operated a massive $175 million billing scheme. Robert Bathum, who has called himself the “Rehab Mogul,” pleaded no contest Monday in Los Angeles County Superior Court to 14 felony counts of grand theft, insurance fraud, […]

CCBHC Demonstration to be Extended Through May

The Certified Community Behavioral Health Clinic (CCBHC) demonstration program is set to be extended through May 2020. That’s thanks to the fiscal year 2020 funding package President Donald Trump is set to sign by midnight on Friday, Dec. 20. Congress passed the legislation earlier this week. Without the package, funding for the program would run […]

Feds Aren’t Proactively Checking for Parity Compliance — But Advocates Say They Should Be

Federal agencies may not be doing enough to ensure behavioral health parity within health plans, according to a recent report from the United States Government Accountability Office (GAO). In response, advocates are calling for more extensive oversight of employer-sponsored group plans. The report found that the vast majority of federal reviews and investigations into parity […]

Law Change Leads to Boom in Rural Medication-Assisted Treatment Access

Rural areas have seen an explosion in access to medication-assisted treatment since 2017, largely due to the passage of a law that allows nurse practitioners (NPs) and physician assistants (PAs) to prescribe buprenorphine-naloxone. The boom could have applications in other areas of behavioral health care, too. That’s according to a recent study published in the […]