The federal government could begin scrutinizing private equity-owned behavioral health practices. The Biden-Harris administration announced new initiatives to thwart anti-competitive mergers and practices that could increase health care costs for patients. Private equity firms, health insurers and health systems will be subject to additional surveillance to foster competition in the behavioral health sector. Although still […]
Category: Compliance
Parity will likely be the defining regulatory issue of 2024 as the behavioral health industry braces for the impact of the Biden administration’s to-be-finalized rule. Still, there is plenty to sort out with just 44 days left in 2023. This includes other pending regulatory issues that could be addressed before the end of the year. […]
Almost half of Medicare Advantage online provider directories have at least one inaccuracy – with issues often related to behavioral health services. A new bipartisan bill would protect seniors from the consequences of these inaccuracies, if passed. And by doing so, the bill could also lead to MA plans strengthening their provider networks, which could […]
Several regulatory and macroeconomic shifts created a new era of heightened scrutiny in behavioral health investing. Higher interest rates, workforce challenges and inflation have made investors and acquisitive companies more thoughtful about where they place their bets. On top of the market force headwinds, the Biden administration and some state governments have signaled that they […]
A bipartisan group of 10 lawmakers has launched the Senate Mental Health Caucus to continue work on regulatory reform and help diminish the stigma surrounding mental health treatment. On Tuesday, Sens. Alex Padilla (D-Calif.), Thom Tillis (R-N.C.) and Tina Smith (D-Minn.) announced the caucus’ early strategic efforts to ensure appropriate implementation of the Bipartisan Safer […]
Kaiser Permanente has agreed to pay a record-setting fine over its mismanagement of behavioral health benefits. In total, Kaiser Permanente must pay $200 million. This includes a $50 million fine, the largest the California Department of Managed Health Care (DMHC) has ever issued, as part of a settlement agreement. Kaiser Permanente has also committed to […]
The federal government will extend COVID-era telehealth flexibilities until December 2024, dramatically extending the runway for the Drug Enforcement Administration (DEA) to establish new rules for using telehealth and controlled substances. The DEA and U.S. Department of Health and Human Services released a new temporary rule on Oct. 6 after conducting two days of listening […]
Parity reform may heighten clinical and administrative requirements for outpatient mental health providers. These laws may make in-network agreements simpler and more profitable, as many providers hope. Yet talk of parity is often one-sided, focused on perceived payer wrongs. This overshadows the role of clinicians and their organizations in increasing access to and improving care […]
There’s a big problem with measurement-based care in behavioral health that few are talking about: the fact that many clinicians are highly skeptical of payers. While most therapists use clinical assessments to care for patients, many are concerned about privacy and how health plans will use the data that’s shared with them. These attitudes come […]
Key Drug Enforcement Administration (DEA) leaders said little last week during the roughly 11 hours of live presentations heard over two days of listening sessions regarding the future of telehealth and prescribing controlled substances. What they did say, however, helps clarify what is top of mind for the DEA as the agency considers re-approaching how […]
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