This is an exclusive BHB+ story States may begin to take a more active role in enforcing mental health parity laws. Late last week, the Georgia Office of the Commissioner of Insurance and Safety Fire announced $20 million in fines would be levied on dozens of payers for violations of the state’s parity law, passed […]
Wit v. United Behavioral Health has reemerged after additional action at the district-court level affirmed two core legal contentions for the case. The recent order, issued on Aug. 5, keeps the case alive and heading in a favorable direction for the plaintiffs, who alleged profit motivations inappropriately tainted how United Behavioral Health, a part of […]
This is an exclusive BHB+ story Behavioral health spending has ballooned since the COVID-19 pandemic – and payers are taking note. This, combined with rising hospital costs and the high cost of GLP-1 medications, has prompted payers to reassess their premiums. One of the main factors driving this change is the trend that therapy has […]
A new class action lawsuit alleges Carelon Behavioral Health, its parent company Elevance Health (NYSE: ELV) and Anthem Health Plans were involved in fraudulent business practices related to ghost networks. This marks the third class action case filed in under a year against these entities over ghost networks, which are effectively “misleading directories” of providers. […]
Preventing unnecessary care and medication prescriptions is the primary purpose of prior authorization. Instead, it has all too often led to slower, burdensome delays to critical care for mental health and substance use treatment, but that could soon change. A group of major insurers – including UnitedHealthcare, Aetna, Cigna Group, Humana, Blue Cross Blue Shield […]
UnitedHealth Group’s (NYSE: UNH) CEO Andrew Witty has announced his plans to step down after leading the health care giant through a period of turmoil, citing “personal reasons.” The company’s former CEO, Stephen Hemsley, will return to the role effective immediately. In addition to his leadership role, Hemsley will remain the chairman of UnitedHealth Group’s […]
Another Elevance Health (NYSE: ELV) entity has been sued over allegations that it is operating a harmful “ghost network” of behavioral health providers in the state of New York. The law firms Pollock Cohen LLP and Walden Macht Haran & Williams LLP have filed suit against Carelon Behavioral Health in the U.S. District Court for […]
Payers could be better aligning their incentives with behavioral health patients and providers by giving parity more room to breathe within their organizations. Payers often bury the duty of ensuring behavioral health-physical health parity in a compliance or legal department. Such a structure prevents the necessary cultural and strategic alignment that payers need to establish […]
This is an exclusive BHB+ story Value-based care has been the great white whale of behavioral health for nearly a decade. Yet there has been very little movement in the space. The vast majority of behavioral health providers rely on fee-for-service models of care. In a recent Behavioral Health Business survey, 65% of respondents reported […]
Not-for-profit behavioral health care provider Rogers Behavioral Health and for-profit workforce mental health provider Lyra Health have forged an alliance. The collaboration, announced Tuesday, gives Lyra access to Rogers’ health plan networks while allowing Rogers to scale its virtual services using Lyra’s national footprint. For Rogers and Lyra executives, the most important aspect of the […]
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