Centene CEO: Behavioral Health ‘Has to Be Integrated’

Days after Centene Corporation (NYSE: CNC) announced its plan to acquire Magellan Health (Nasdaq: MGLN), leadership is doubling down on the insurer’s commitment to behavioral. Those services will play an important role in the company’s future, according to Centene CEO Michael Neidorff, who is also president and chairman of the company. “It has to be […]

Top Audit Warning Signs for Behavioral Health Providers

As the behavioral health industry draws more government funding, it’s also getting newfound scrutiny from state and federal regulators. Enforcement actions against behavioral providers are on the rise, especially for those organizations that participate in Medicare and Medicaid. Consequently, compliance planning is more important than ever — and so is identifying warning signs that suggest […]

Oklahoma, Maine Granted IMD Medicaid Waivers for SUD Patients

The Centers for Medicare & Medicaid Services (CMS) has approved section 1115 Medicaid demonstration waivers for Oklahoma and Maine.  As a result, both states may now bypass the IMD exclusion for substance use disorder (SUD) patients. Plus, Oklahoma can also bypass the rule for patients with serious mental illness (SMI) and/or serious emotional disturbance (SED). […]

With Enforcement Actions on the Rise, Behavioral Providers Must Improve Compliance Plans for Protection

The nation is finally starting to realize the importance of behavioral health care. As a result, providers have more reimbursement options than ever. Commercial payers have become a bigger part of the picture thanks to parity requirements, and Medicaid and Medicare reimbursement opportunities continue to grow. But with more money comes more problems, especially on […]

Google-Affiliated In-Home Care Provider Moves into Behavioral Health Space

Amid the coronavirus pandemic, new entrants have flooded the behavioral health space, especially in the digital realm. The newest player moving in on the opportunity is a Google-affiliated house-call company that’s taking a slightly different approach. Ready — an on-demand, in-home health service — is now offering behavioral health visits for patients in certain markets, […]

OIG Recommends CMS Make It Easier for Medicaid Beneficiaries to Get Naloxone

The Office of Inspector General (OIG) says Medicaid beneficiaries deserve better access to naloxone, a medication that rapidly reverses opioid overdoses. In a new report, OIG called on the Centers for Medicare & Medicaid Services (CMS) to implement changes to help make it happen.  An OIG study of state-reported Medicaid data and manufacturer-reported sales data […]

Nearly 40% of Behavioral Providers on Brink of Financial Collapse

Nearly 40% of behavioral health organizations say they can only survive six months or less given the current financial situation they are facing. At the same time, more than half of all providers have seen an increased demand for services since the pandemic hit. Those are just a few key takeaways from the National Council […]

Amid Growth, Pinnacle CEO Pushes for Methadone MAT Flexibilities

The last five months have been hard for behavioral health providers to weather, with many being forced to cut back services as a result of COVID-19-related financial strain. Some are even facing the risk of closure. Then there’s Pinnacle Treatment Centers, which has actually been expanding. Pinnacle is one of the largest substance use disorder […]

National Council CEO: Behavioral Health Providers Need Dedicated Funding Stream to Survive COVID-19

Amid the COVID-19 emergency, all eyes have been on skilled nursing facilities (SNFs) and hospitals — and for good reason. SNFs have accounted for more than 40% of the nation’s COVID-19 deaths, while hospitals have grappled with bed and personal protective equipment (PPE) shortages. As a result, the U.S. Department of Health and Human Services […]