New data from the federal government found that only a slim majority of behavioral health providers are able to take on new patients covered by Medicare or Medicaid in a timely manner. The data also revealed that telehealth is not an extender of providers’ availability. The latest in a series of reports by the U.S. […]
Only 17% of Medicaid-enrolled children with autism receive genetic testing, despite national guidance recommending these tests be given to all children with the condition or an intellectual disability. That’s according to a recent study published in Genetics in Medicine, where researchers from the University of California Los Angeles reviewed health records linked to 241,060 children […]
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 […]
As Congress works to finalize its budget reconciliation package, changes to Medicaid are at the forefront of discussions. Leadership in the U.S. House of Representatives has continued to affirm that the Medicaid policies under consideration ensure that no “deserving” Medicaid beneficiary will lose coverage for which they are legally eligible; instead, they have expressed their […]
There’s a strong case to be made that the payer and reimbursement landscape for substance use disorder (SUD) treatment providers is the most challenging in all of behavioral health care due to several deeply entrenched and overlapping issues. For starters, SUD treatment has, in the past, been viewed as less legitimate than other forms of […]
In the early hours of Thursday morning, the U.S. House of Representatives passed the One Big Beautiful Bill Act after approving an amendment intended to mollify opponents to the bill, especially on the Republican side of the aisle. The changes include moving up the rollout of federal work requirements for Medicaid, among other tax-related reforms. […]
Medicaid programs offer a unique venue for behavioral health providers to push the industry toward greater adoption of value-based care. Often, leaders across the industry note that they see the most receptiveness and make the most progress on payment innovation in their alliances within the realm of Medicaid. Still, there is palpable frustration at the […]
The Republican-led House Committee on Energy and Commerce released budget reconciliation documents that show the GOP has walked back from direct cuts to Medicaid spending, as many in the health care world have feared. Instead, the documents released late on May 11 include several provisions that would eliminate spending on health care programs overseen by […]
Behavioral health is in the political crosshairs. This series tracks the Trump administration’s proposed policy changes, funding cuts and structural overhauls that could reshape behavioral health care in the U.S. From HHS reorganizations to Medicaid shifts, we’re following what matters — and what’s at stake — for providers, payers and investors. (Last update: May 8, […]
Trump administration health care officials on Wednesday revealed further information about plans to create an autism spectrum disorder (ASD) data bank – a project that has sparked a mix of support, skepticism and alarm from autism-community stakeholders. On May 7, the U.S. Centers for Medicare & Medicaid Services (CMS) announced a new “landmark” partnership with […]
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