Behavioral Health Regulatory Outlook: Fight Over Parity, Changes to Telehealth Spill into 2024

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. […]

SAMHSA: Only 8 States Have ‘Well-Developed’ Value-Based Care Initiatives for Addiction Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) finds that meaningful development of value-based care policies for addiction treatment among the states is a rarity. Only eight states have “well-developed and ongoing” initiatives for addiction treatment, according to a new report released Monday. Twenty-four states had quality performance initiatives in their Medicaid programs, while […]

CMS Finalizes Expanded Behavioral Health Medicare Policies, Including Payment Bumps for Crisis Care and SUD Treatment

The Centers for Medicare & Medicaid Services (CMS) is prioritizing whole-person health and behavioral health care in its finalized physician payment rule for 2024. Specifically, the new rule – released Wednesday – allows marriage and family therapists (MFTs) and mental health counselors (MHCs), including substance use disorder (SUD) counselors, to enroll in Medicare for the […]

New Bill Aims to Cut Down on Behavioral Health ‘Ghost Networks’

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 […]

Legal, Regulatory Uncertainty Could Slow Down Behavioral Health Dealmaking

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 […]

‘Mental Health Is the Bipartisan Issue of Our Time’: Senators Launch Mental Health Caucus

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 Settles Behavioral Health Access Violations for $200M

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 […]

DEA Extends Telehealth Flexibilities Another Year

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 […]

Eager for Parity Reform, Outpatient Mental Health Should Expect to ‘Step Up’ Care Quality

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 […]