Behavioral Provider Pays $273K to Settle Improper Billing Allegations

A Hartford, Connecticut-based behavioral health care practice and its owners have agreed to a civil settlement with federal and state governments to settle allegations they improperly billed Medicaid. The U.S. Department of Justice (DOJ) announced Tuesday that Maurice Stuckey and Joyce Anderson, as well as their company Today’s Youth LLC, will pay $273,000 to resolve […]

Senators Introduce Legislation to Boost SUD Funding, Make Telehealth Flexibilities Permanent

A bipartisan group of U.S. senators has introduced legislation to increase the amount of federal funding aimed at combating the nation’s opioid epidemic, which has worsened since the onset of the coronavirus pandemic. On top of that, the new bill aims to make some COVID-19-era telehealth flexibilities permanent, among other changes. The legislation — the […]

Behavioral Health Industry Saw ‘Marked Uptick’ in FCA Settlements in FY 2020

Whistleblower lawsuits filed under the False Claims Act (FCA) were up last fiscal year, with the increase hitting the behavioral health industry especially hard. Those are just a couple takeaways from Bass, Berry & Sims’ recent 2020 Healthcare Fraud & Abuse Review. The law firm publishes the report annually to document health care fraud and […]

Oscar Health, One Medical Execs: Regulatory Changes Necessary to Close Behavioral Health Care Gaps

Behavioral health is in higher demand than ever before, with the pandemic, an economic downturn and social unrest causing nationwide spikes in anxiety and depression. Amid the chaos, one bright spot has emerged: Regulatory flexibilities have made telehealth services commonplace, giving behavioral health providers another tool to treat patients who might otherwise be unable to […]

DOJ Hasn’t Prosecuted Any Body Brokering Cases Since 2018 Law Passed

In spite of massive bipartisan legislation passed by Congress in 2018 to address the nation’s opioid use disorder (OUD) epidemic and cut down on illegitimate practices, the Department of Justice (DOJ) hasn’t prosecuted a single “body-brokering” case. In the addiction treatment industry, body-brokering occurs when people — body brokers — seek out individuals with substance […]

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, […]

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 […]

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 […]