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 […]
Category: Reimbursement
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 […]
For decades, behavioral health services have been delivered in facility-based settings, whether those be inpatient psychiatric hospitals or outpatient clinics. But in 2020, that changed. The coronavirus forced telehealth into the mainstream, in turn making remote behavioral health care delivery commonplace. Nearly a year later, industry stakeholders agree there’s no putting the genie back into […]
Centene Corporation (NYSE: CNC) — a managed care organization (MCO) — has entered into a definitive agreement to buy Magellan Health (Nasdaq: MGLN) — an MCO and provider of behavioral health services. The goal of the $2.2 billion deal is to bolster Centene’s behavioral health offerings. The transaction, which is expected to close in the […]
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). […]
The U.S. Department of Health and Human Services (HHS) has increased the amount of money it’s giving to health care organizations as part of its third phase of distributions from the Provider Relief Fund (PRF). It will send $24.5 billion to 70,000 providers, $4.5 billion more than the department originally planned to distribute in this […]
In 2020, the COVID-19 emergency turned the behavioral health industry upside down, impacting everything from reimbursement and revenues to service delivery and demand itself. In the year ahead, the coronavirus will continue to shape the behavioral space. As such, behavioral health executives predict that technology and consolidation will take center stage in 2021. At the […]
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 […]
Tufts Health Plan has rolled out a “pioneering” new in-home substance use disorder (SUD) treatment option for certain clinically eligible commercial members. The coverage will be available through a pilot in Massachusetts, where no other insurers are covering such home-based SUD treatments, according to a press release announcing the news. Tufts is teaming up with […]
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, […]