New government findings add details to the lack of availability of behavioral health services for America’s poor and elderly. The Office of Inspector General (OIG) for the U.S. Health and Human Services Department found that about one-third of behavioral health providers in selected counties serve patients in the Medicare, Medicare Advantage, or Medicaid programs. “Despite […]
The federal government could begin scrutinizing private equity-owned behavioral health practices. The Biden-Harris administration announced new initiatives to thwart anti-competitive mergers and practices that could increase health care costs for patients. Private equity firms, health insurers and health systems will be subject to additional surveillance to foster competition in the behavioral health sector. Although still […]
The state of New York fined five Medicaid managed care plans a total of $2.6 million for denying claims or failing to pay for specialty behavioral health services. Other states may start to follow New York’s example. The enforcements were filed after New York’s office of mental health conducted a comprehensive examination of behavioral health […]
Accountable care organizations (ACOs) have become the “de facto” strategy for traditional Medicare. Their incentives for proactive care were designed to improve quality and access to care by aligning incentives among clinicians, hospitals and behavioral health providers. But a new Health Affairs study found that being enrolled in an ACO was not associated with any […]
Behavioral health integration will play a major role in The Centers for Medicare & Medicaid Services’ (CMS) latest cost control initiative. On Tuesday, CMS unveiled the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model). It is an 11-year total cost-of-care reduction model meant to give state governments the tools to reduce spending […]
Kentucky and California are the latest states to join the federal government’s Medicaid mobile crisis intervention initiative. The Centers for Medicare & Medicaid Services (CMS) announced the addition of Kentucky and California to the federal program on Thursday. The participants bring the number of states partnering with the federal government to provide community-based mobile crisis […]
The U.S. Centers for Medicare & Medicaid Services (CMS) revealed a series of important behavioral health proposals on late Thursday afternoon. First, in its proposed 2024 Medicare Physician Fee Schedule, the agency pitched changes that would allow marriage and family therapists (MFTs) and mental health counselors (MHCs), including substance use disorder (SUD) counselors, to enroll […]
The U.S. Centers for Medicare & Medicaid Services (CMS) unveiled a new primary care alternative payment model on Thursday – giving behavioral health care a key shoutout in the process. The Making Care Primary (MCP) Model will test advanced approaches to primary care in eight initial states: Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New […]
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 […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has released a 2024 proposed rule for prospective payments and policies for Medicare-reimbursed inpatient psychiatric facilities. On Tuesday, CMS proposed to increase the pool of total payments doled out for all inpatient psychiatric facilities by a net of 1.9%. The agency also said it will pursue […]
By continuing to use the site, you agree to the use of cookies. more information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.
