Disparities Widening in Coverage of Behavioral Health Care Versus Physical Health Care

U.S. employees are far more likely to go out of network and see lower reimbursement for behavioral health services than for physical health services. Despite a nationwide push for parity, those equality gaps are widening, according to a new study. The report — published by Seattle-based actuarial and consulting firm Milliman Inc. and commissioned by […]

Beneficiaries Likely to Spend More, Go Out of Network for Behavioral Health Services

Despite the push for parity, Americans are more likely to go out of network and pay higher out-of-pocket costs for behavioral health care treatment than for treatment of chronic conditions such as diabetes and congestive heart failure.  That’s according to research out of Ohio State University published in JAMA Network Open.  The findings illustrate the […]

Low Reimbursement Exacerbating the Behavioral Health Worker Shortage

With minimum wage on the rise and unemployment rates at the lowest they’ve been in 50 years, it’s no surprise that a number of industries — from home care to education — are facing labor shortages. Behavioral health care is no exception. However, low reimbursement from payers for behavioral health services is only exacerbating the […]

CMS Expands Medicare Coverage for Treatment of Opioid Use Disorder

The Centers for Medicare & Medicaid Services (CMS) has expanded coverage for treatment of Medicaid beneficiaries with opioid use disorder (OUD). The recently finalized 2020 Physician Fee Schedule creates a new enrollment category and benefit for providers who offer OUD treatment programs. The rule also establishes payment codes for bundled payments, which include medication-assisted treatment […]

D.C. Medicaid Program Granted First IMD Waiver Specifically for Mental Health

A first-of-its-kind Medicaid demonstration project aimed to improve care for beneficiaries with serious mental illness (SMI) and/or serious emotional disturbance (SED) has been approved in Washington, D.C. The Centers for Medicare & Medicaid Services (CMS) announced the approval of D.C.’s Section 1115 Medicaid waiver Wednesday. It quite literally waives federal rules that typically prevent Medicaid […]

Montana Sees Boom in Medication-Assisted Treatment Availability

The number of doctors in Montana prescribing medication-assisted treatment (MAT) has increased about 650% in just two years, according to the Montana Department of Health and Human Services (MDHHS). Back in January, 2017, the state had just over 20 MAT providers — but today, it has more than 130. MDHHS released those numbers in conjunction […]

Medicaid Presents Growing Opportunity for Behavioral Health Providers

As payers continue to recognize the importance of and the demand for behavioral health care, coverage for those services is expanding like never before. While that’s true across the board, the Medicaid program could present special opportunities for behavioral health care providers in the years to come, according to some legal experts. “Medicaid is an […]