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 […]
Category: Medicare
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 […]
Opioid treatment programs (OTPs) are the door to evidence-based medication for patients with opioid use disorder (OUD). Current regulations may not be strong enough to keep these facilities in compliance with requirements that prevent overpayment for services and ensure that patients receive the most appropriate treatment. An audit conducted by the Department of Health and […]
Fee-for-service reimbursement models incentivize behavioral health providers to deliver more services – in some instances, even when medically unnecessary, some would point out. Value-based care – paying for quality and outcomes instead of volume – has been heralded as the behavioral health industry’s path away from fee-for-service models. Challenges, including tension between health plans and […]
Transcranial magnetic stimulation (TMS) is becoming a more viable option for the treatment of depression in youth and adults, providing hope for those with treatment-resistant depression. Of the roughly 22 million American adults who experienced a major depressive episode in 2023, about 30% have treatment-resistant depression, meaning that multiple medications have failed to alleviate their […]
Many behavioral health providers have traditionally operated in silos, leaving patients to navigate a fragmented system of care for substance use disorders (SUDs), mental illnesses and other co-occurring conditions. SUD providers are now working to break down these barriers and offer more comprehensive, holistic treatments that address the full spectrum of a patient’s needs by […]
America continues to grapple with a persistent behavioral health workforce crisis, with just over a quarter of the national mental health needs met. The situation is particularly dire in psychiatry, with projections estimating a 20% decline in the number of adult psychiatrists by 2030, even as demand continues to rise. The U.S. Department of Health […]
Ghost networks remain a major problem in health care – and behavioral health is no exception. Broadly, ghost networks create barriers for individuals trying to access behavioral health services through their payer. There are many reasons why ghost networks exist, with payers and providers both contributing to the problem. In this BHB+ TALKS conversation, senior […]
Nonprofit health plan Point32Health has instituted a new care navigation program to meet unprecedented behavioral health demands. As part of the program, Point32Health has created a new employee role specifically designed to connect members to behavioral health care. This allows the payer and its provider network to foster a “symbiotic relationship.” “The missing piece that […]
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