Autism Learning Partners will leave the Texas market in March, citing low Medicaid rates and problems with how those benefits are administered. The Monrovia, California-based autism therapy provider said in a news release that “the combination of the significantly lower rate (when compared with most other states in the U.S.) and process issues with authorizations […]
The Centers for Medicare and Medicaid Services has launched a new payment model focused on giving Medicare beneficiaries with chronic conditions, including behavioral health conditions, greater access to technology. Historically, Medicare did not reimburse for many digital health and technology services. The new ACCESS model (Advancing Chronic Care with Effective, Scalable Solutions) enables Medicare-enrolled provider […]
This is an exclusive BHB+ article For years, payers and providers stood on opposite sides of the aisle — one providing care and advocating for services, the other paying for that care while demanding proof of outcomes. But I have seen that as integrated care has grown in popularity, so too has the concept of […]
There may be more demand than ever for youth behavioral health services, but the segment continues to face financial challenges, making sustainable operations a headache. Amid rising rates of depression and anxiety among adolescents, providers are navigating high costs associated with care while simultaneously operating through ongoing clinician shortages across the industry. The growth of […]
Aetna, the insurance arm of CVS Health (NYSE: CVS), is launching an inaugural neurodiversity navigation program for its commercial customers beginning in January 2026. There has already been widespread demand and interest in a navigation component; Miriam Ferreira, vice president of mental well-being at Aetna, told Behavioral Health Business. The company plans to focus on […]
Autism therapy providers and industry advocates in two states have taken the fight over state austerity measures to court. In one, advocates secured a notable early win in protecting against cuts to funding for autism therapy services. Over the past few weeks, state governments have sought to grapple with budget shortfalls associated with Medicaid funding […]
Autism therapy providers in Idaho are facing a potentially foundation-rattling change in the state’s Medicaid program. On Oct. 31, the Idaho Department of Health & Welfare informed organizations that provide “behavior modification and consultation” that such services would no longer be offered through its behavioral health managed care organization, Magellan Healthcare. Rather, the services would […]
Centene Corp. (NYSE: CNC) reported progress on tamping down what it sees as problematic spending on behavioral health, namely applied behavior analysis (ABA). However, the managed care titan reports that it still has work to do to get its Medicaid spending back in line with previous expectations. Centene CEO Sarah London said on the company’s […]
Ghost networks and inadequate behavioral health network directories continue to plague Medicare Advantage (MA) and managed Medicaid plans. That’s according to a recent report from the Office of the Inspector General (OIG), which found that on average, 55% of providers listed in Medicare Advantage plans networks were inactive. OIG analysts found that 72% of inactive […]
Medicare could have saved $301.5 million if bundled payments for opioid use disorder (OUD) treatments were better matched to the services actually provided to patients. That’s equivalent to 53% of the total payments in this space of $564.6 million, according to an audit by the Office of Inspector General (OIG). For the audit, the OIG […]
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