New State Laws Could Complicate Behavioral Health Dealmaking

State governments are casting an increasingly critical eye on health care dealmaking, likely making it harder for the behavioral health industry to transact deals. The impact of these laws will be uneven across the U.S. as some state legislatures take up or resist these laws. Today, about a dozen states have some form of disclosure […]

FTC Noncompete Ban Presents Several Trade-Offs For Behavioral Health

In case you missed it, Behavioral Health Business has launched a new specialty publication for professionals in the substance use disorder space. You can subscribe to Addiction Treatment Business here: Subscribe today! Behavioral health providers and investors must prepare to lose noncompete agreements as a tool in their arsenal following the Federal Trade Commission’s expected ban on […]

‘There’s Not a Business Case’: Lack of Parity Hinders Transition to Value-Based Care

Value-based care and parity go hand-in-hand as the behavioral health industry continues to evolve beyond the fee-for-service paradigm. The interrelatedness of the two concepts often means that progress on one indirectly impacts the other. Moving toward either comes with several hurdles that require cash to fuel efforts to surmount them. Where things stand now, patients […]

HHS Privacy Rules for Addiction Treatment May Add Headache for Providers

Want to read more content like this? Subscribe to Addiction Treatment Business today! The newly finalized 42 CFR Part 2 rule, focused on the privacy rights of patients seeking addiction treatment care, creates new opportunities and risks for behavioral health providers. The federal government released the finalized rule at the beginning of the month. It’s intended to […]

Supreme Court Rejects UnitedHealth Appeal, Boosting Behavioral Health Providers’ Standing with Insurers

In case you missed it, Behavioral Health Business has launched a new specialty publication for professionals in the substance use disorder space. You can subscribe to Addiction Treatment Business here: Subscribe today! The U.S. Supreme Court rejected a request by United Behavioral Health to hear a behavioral health claim denial case. The case, titled D.K. […]

‘Payer Ghosting’ Further Straining Behavioral Health-Health Plan Relationship

Dating slang is helping behavioral health professionals describe a troubling evolution in payer relations. Payer ghosting. In dating, someone “ghosts” another person when they abruptly stop communicating despite previous interest. In this context, payer ghosting occurs when payers stonewall providers on claim reimbursement. This can be a trickier challenge for providers than the typical payer […]

Giving Teeth To Parity: New York Paves the Way for More Medicaid Managed Care Oversight

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 […]

Legal, Regulatory Uncertainty Could Slow Down Behavioral Health Dealmaking

Several regulatory and macroeconomic shifts created a new era of heightened scrutiny in behavioral health investing. Higher interest rates, workforce challenges and inflation have made investors and acquisitive companies more thoughtful about where they place their bets. On top of the market force headwinds, the Biden administration and some state governments have signaled that they […]

Behavioral Health Industry Flexes Lobbying Muscles to Shape Policy

Behavioral health providers don’t have to accept the status quo when it comes to challenging state markets. Savvy operators can change fundamental aspects of the markets in which they operate through lobbying and advocacy. This is a right — and even civic obligation — for members of the public to push officials to make changes. […]

‘I Don’t Want to Say It’s Easier’: Despite Dire Need, Behavioral Health Operators Continue to Face Pushback on New Constructions

Behavioral health providers continue to face headaches while trying to get new facilities through local zoning processes. The American drug overdose crisis and the wide-reaching impacts of a once-in-a-generation pandemic have shredded the pretense that any given community doesn’t need behavioral health care. Despite this reality, prejudice against those with behavioral health issues, especially substance […]