OIG: Over Half of Medicare’s $1B Spending on Psychotherapy Services Was ‘Improper’

Medicare improperly paid an estimated $580 million for psychotherapy services during the COVID-19 public health emergency (PHE). That’s according to a new audit from the Office of the Inspector General (OIG), which reported that between March 2020 and February 2021, Medicare Part B paid $1 billion for psychotherapy services, including telehealth services. The audit included […]

CMS Code Could Help Clear the Way for VR Cognitive Behavioral Therapy Reimbursement

The U.S. Centers for Medicare & Medicaid Services (CMS) has created a new code for virtual reality (VR) cognitive behavioral therapy (CBT) devices, including pre-programmed therapy software. The new Level II Healthcare Common Procedure Coding System (HCPCS) code could make it easier for Medicare payers to cover virtual reality in the future. While CMS has […]

As UnitedHealth Group Looks to Deploy Capital on Provider Acquisitions, More Behavioral Health Deals Could Be Coming

UnitedHealth Group (NYSE: UNH) is doubling down on its value-based payment strategy and, in turn, further integrating behavioral health services. The company has ramped up its value-based care efforts in its insurance arm, UnitedHealthcare, and health services division, Optum. In UnitedHealth Group’s Q1 earnings call on Friday, it announced that Optum covers roughly 4 million […]

58% of Humana’s MA Behavioral Health Claims Had a Value-Based Link

Health insurer Humana (NYSE: HUM) recently revealed that 58% of its 2.1 million Medicare Advantage (MA) behavioral health claims had a value-based link. In a report released earlier this month, the Louisville, Kentucky-based payer and health care provider noted that primary care doctors using a value-based model are more likely to see “physical and mental […]

The Biden Administration’s FY2024 Budget Dedicates $656M to ‘Transforming Behavioral Health’

The White House appears to be doubling down on its behavioral health efforts in its new 2024 budget proposal. The proposed budget aims to grow the behavioral health workforce, increase access to services – including crisis care – and advance mental health research. “In response to the current behavioral health crisis and in support of […]

Inside CareFirst’s New SUD-Focused Partnership with Navigator Healthcare

CareFirst BlueCross BlueShield is joining forces with Navigator Healthcare on a new partnership aimed at helping members find appropriate care for substance use disorder (SUD). As part of the deal, CareFirst’s members can call the Navigator Healthcare team 24/7 to help them find the proper, in-network care for their SUD needs. The collaboration reflects the […]

How Point32Health Is Pioneering Autism, Substance Use Disorder Value-Based Contracting

Nonprofit health plan Point32Health is prioritizing integrated care and value-based contracting as part of its overall behavioral health strategy. The payer is doing this through partnerships and in-house integration between mental and physical health providers. Specifically, Point32Health has inked value-based contracts focused on autism and substance use disorder (SUD) care, and it plans to expand […]

CVS Health’s $10.6B Purchase of Oak Street Gives It a Primary Care Innovator with Deep Behavioral Health Ties

CVS Health (NYSE: CVS) announced Wednesday it’s buying senior-focused, multi-payer value-based primary care company Oak Street Health (NYSE: OSH) for $10.6 billion. The acquisition gives CVS – parent company of Aetna – a stronger foothold in primary care while furthering its all-around value-based care strategy. Moving forward, the Woonsocket, Rhode Island-based CVS will be tasked […]

Senators Call Out Aetna, Anthem BCBS, Humana, United Healthcare for Mental Health ‘Ghost Networks’

A bipartisan group of senators has called out large payers for their mental health “ghost networks,” which provide an inaccurate list of in-network providers. “Ghost networks” often list providers no longer in-network, accepting patients, or having closed their practice. The lawmakers noted that ghost networks could lead to mental health access issues and make it […]

UnitedHealth Plans to Further Integrate Behavioral Health Into Value-Based Care Offerings

UnitedHealth Group (NYSE: UNH) is looking to integrate behavioral health care into its continuum of care as it continues its push for whole-person health. “We will serve the patients in clinic settings, in their homes, integrating behavioral care supported by our data driven clinical and next best actions and all coordinated to provide the right […]