A new class action lawsuit alleges Carelon Behavioral Health, its parent company Elevance Health (NYSE: ELV) and Anthem Health Plans were involved in fraudulent business practices related to ghost networks. This marks the third class action case filed in under a year against these entities over ghost networks, which are effectively “misleading directories” of providers. […]
Nebraska’s state government announced steep cuts to Medicaid reimbursements for applied behavior analysis (ABA) services, the cornerstone therapy within the autism therapy industry, that many expect to stifle access to services and undo years of investment in the state. While the cuts range in percentage, one of the most drastic and most impactful is the […]
A united front of leaders from Acadia Healthcare (Nasdaq: ACHC) and Geisinger Health System are pressing for the annulment of Medicare’s longstanding 190-day lifetime coverage cap for inpatient psychiatric treatment. Acadia Chief Strategy Officer Andrew Lynch, CEO Chris Hunter and Chief Medical Officer Stephanie Eken, as well as Imad Melhem, chair of psychiatry and behavioral […]
The hotly contested One Big Beautiful Bill Act was passed by the U.S. House of Representatives for a second and final time with a vote of 218–214. It will now move to President Donald Trump’s desk for signing. The legislation will make deep cuts to Medicaid and changes to the Affordable Care Act (ACA) and […]
Since the COVID-19 pandemic, there has been a significant increase in the number of individuals seeking behavioral health services. The increase in demand has put pressure on both payers and providers. Over the last few years, several payers have cited the rise in demand for behavioral health services as a pressure on their bottom line. […]
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. […]
This is an exclusive BHB+ story Substance use disorders (SUDs) are often treated episodically, but unlike other conditions, patients’ needs can persist indefinitely after they move into recovery. Even though higher needs are theoretically more lucrative for providers, the lifetime value of an SUD patient is routinely undervalued in current reimbursement models, industry leaders told […]
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 […]
This is an exclusive BHB+ story Medicaid is the No. 1 payer for youth mental health care in the nation. Yet, with proposed cuts on the chopping block as part of the Trump administration’s budget reconciliation, behavioral health providers face an uncertain path ahead. Possible cuts to the federal health coverage program could exacerbate staffing […]
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