Providers Beware: Behavioral Health Fraud Investigations, Recoveries on the Rise

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, […]

Co-Founder of Addiction Center Pleads Guilty for Role in $100M Fraud Scheme

The co-founder of a Pennsylvania addiction rehab center has pleaded guilty to conspiracy to commit health care fraud for his role in an “elaborate” insurance scheme, according to the U.S. Department of Justice (DOJ). The scheme fraudulently billed insurers for more than $100 million, local newspaper The Intelligencer reported. Defendant Branden Coluccio entered the plea […]

Digital Substance Abuse Treatment Startups Captivate Investors, Payers

In America today, the need for more substance use disorder (SUD) interventions is clear. In 2017, more than 70,000 people died from drug overdoses, and the alcohol-related death rate was twice what it was 20 years earlier. Those statistics don’t include nearly 20 million others who did not die but still battled SUD that year. […]

Newly Introduced Bills Aim to Improve, Expand Behavioral Health Insurance Coverage

Lawmakers in one state have introduced two new bills designed to improve and expand insurance coverage for behavioral health services. The legislation was proposed Tuesday in California, a state that frequently sets legislative trends known to catch on nationwide. The bills in question — Senate Bill 854 and Senate Bill 855 — target private insurance […]

NABH’s New CEO Tackles Lofty Goals in Year, Decade Ahead

The National Association for Behavioral Healthcare (NABH) is kicking off the new decade with a new leader. Shawn Coughlin took over as president and CEO of the trade association Jan. 1, following the retirement of the organization’s long-time leader Mark Covall, who headed up NABH for the past 24 years. With Coughlin at the helm, […]

‘Rehab Mogul’ Pleads No Contest in $175M Billing Scheme; Outpatient Mental Health Provider Settles False Claims Suit

The one-time owner of more than a dozen Los Angeles-area substance abuse treatment centers has been indicted on charges he operated a massive $175 million billing scheme. Robert Bathum, who has called himself the “Rehab Mogul,” pleaded no contest Monday in Los Angeles County Superior Court to 14 felony counts of grand theft, insurance fraud, […]

Health Insurers Get Creative to Tackle Behavioral Health Conditions

As the opioid epidemic rages on and the behavioral health workforce shortage persists, stakeholders are getting creative when it comes to tackling addiction and other behavioral health conditions. That includes insurers, some of whom are piloting and pioneering creative approaches designed to curb those problems. America’s Health Insurance Plans (AHIP) highlighted some of those strategies […]

Feds Aren’t Proactively Checking for Parity Compliance — But Advocates Say They Should Be

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 […]

Contract Language Key to Successful Insurer-Behavioral Health Provider Relationships

For behavioral health providers, working with commercial payers can be easier said than done. Those relationships are often fraught with coverage disputes and low reimbursements, prompting many providers to opt to remain out of network for self-preservation. However, that often means higher costs for the patients who require their services.  For behavioral health providers willing […]