A Florida federal court ruling issued last month could lead to a “massive sea change” in what lawsuits can be brought against behavioral health companies. That is the interpretation of Gregory Jones, a principal at the law firm Polsinelli’s Los Angeles office, who represents health care companies, including in False Claims Act (FCA) cases. FCA […]
Category: Medicaid
Youth behavioral health residential treatment facilities could face more scrutiny following additional public pressure by a powerful federal lawmaker. On Wednesday, Senate Finance Committee Chair Ron Wyden (D-Oregon) publicly called on the U.S. Department of Justice (DOJ) to investigate four major behavioral health providers to determine if their youth residential treatment programs committed Medicaid fraud. […]
Opioid use disorder (OUD) disproportionately impacts Medicaid beneficiaries, yet structural barriers – including lack of available clinicians – often keep this population from receiving treatment. Virtual OUD treatment provider Ophelia has expanded its Medicaid reach by inking new reimbursement contracts that cover the lives of 3 million New Jersey residents. “We’ve been live and treating […]
More innovative solutions around autism diagnostics are starting to gain momentum. The latest example of this idea: Wyoming’s Medicaid program will cover Cognoa’s Canvas Dx product. According to a Sept. 26 announcement, Wyoming is now the first state to cover Cognoa’s tool for early-autism diagnosis. Dr. Sharief Taraman, CEO of Cognoa, described the move as […]
Virtual pediatric behavioral health company Brightline has transformed its go-to-market strategy. The shift involves shutting down the company’s operations in 45 states, nixing its enterprise commercial functions and planning to create hybrid care models in five states. The change was also accompanied by significant layoffs announced on Tuesday. “It’s been a hard week for Brightline,” […]
Behavioral health care giant Acadia Healthcare (Nasdaq: ACHC) will pay $19.85 million to the U.S. and several states’ governments to resolve allegations that it knowingly billed for medically unnecessary behavioral health services and endangered patients. The U.S. Department of Justice (DOJ) alleged that Acadia falsely billed Medicare, Medicaid and TRICARE for inpatient behavioral health services […]
A federal audit released last week found that, despite changes in the law, Medicare and Medicaid enrollees may not have access to medications for opioid use disorder (OUD). In assessing why swaths of the country have spotty or nonexistent access to the federally approved medications methadone and buprenorphine, the U.S. Department of Health and Human […]
Behavioral health providers are increasingly expanding care continuums to include teenagers and meet the growing need for age-specific care. Virtual behavioral health provider Brightside Health is the latest to do so. Announced Tuesday, its expansion into care options for teens aims to address what Brad Kittredge, founder and CEO of Brightside, calls a “teen mental […]
Medicaid reimbursement rates are largely trending upward for autism therapy providers, but burdensome regulations still pose significant hurdles to growth. To overcome these challenges and improve rates, all players in the autism therapy industry, including private equity firms, must become involved in advocacy work, industry insiders said at the Behavioral Health Business Autism & Addiction […]
Universal Health Services (NYSE: UHS) is looking to get its behavioral health margins back to pre-COVID times. Reductions in labor costs, enhanced productivity and a bump in patient volume are among the factors that will support that goal, according to Steve Filton, the company’s chief financial officer. “We had originally set a target for [2024] […]
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