Sen. Ron Wyden, the chairman of the Senate Finance Committee, is calling on the Biden administration to use existing authority to beef up regulations on residential treatment facilities that care for vulnerable youth. The lawmaker did so via a Sept. 3 letter addressed to the Centers for Medicare & Medicaid Services (CMS) and the Administration […]
The Centers for Medicare & Medicaid Services’ latest proposed fee schedule includes codes for providers to bill Medicare for certain digital therapeutics. On July 10, CMS released its proposed 2025 Physician Fee Schedule (PFS) rule. It contained several behavioral health-related provisions, including changes to how intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) will […]
Five U.S. states are now allowed to provide incarcerated people with coverage for substance use disorder (SUD) care and other services before their release. Medicaid traditionally does not provide SUD treatment to otherwise eligible people who are incarcerated in jails, prisons or youth correctional facilities. Now, the U.S. Department of Health and Human Services (HHS) […]
An ambitious federal trial to curb opioid-related deaths by using community interventions came up short. Despite the implementation of public education campaigns, increased naloxone distribution and improved access to medications for opioid use disorder (MOUD), as well as many other interventions, the trial failed to demonstrate a statistically significant reduction in overdose deaths. The large-scale […]
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 […]
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