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 […]
Category: Compliance
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 […]
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 […]
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, […]
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 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 […]
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 […]
Historically, many behavioral health providers have operated on a cash-pay basis out of necessity. But as reimbursement options continue to increase for mental health and substance abuse treatment, that no longer has to be the case. Parity requirements have brought commercial payers more substantially into the mix, while opportunities for providers to be reimbursed by […]
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