News
Federal Audits of Medicaid-Autism Oversight Are a 'Black Eye,' Likely to Ignite Profound Change
3+ hour, 12+ min ago (1110+ words) The work of federal auditors has shown that at least four states have so far done a poor job of overseeing autism therapy Medicaid spending and documentation compliance. Industry insiders told Behavioral Health Business that sharp corrective actions in the…...
Piece by Piece Autism Centers to Shut Down Following Medicaid Billing Investigation
5+ day, 22+ hour ago (315+ words) Image by Steve Buissinne from Pixabay | CC0 Piece by Piece Autism Centers, an Indiana-based provider of applied behavioral analysis (ABA) that was under scrutiny for receiving some of the highest per-patient Medicaid payments in the nation, will shut down in May....
UnitedHealth Group Settles Case for $1.4M Over SUD, Mental Health Treatment Claim Denials
1+ week, 3+ hour ago (378+ words) Karola G via pexels.com UnitedHealth Group (NYSE: UNH) has settled a class-action lawsuit for $1.4 million over allegations that it wrongly denied coverage for mental health and substance use disorder (SUD) treatment at residential facilities. Judge Mae A. D'Agostino of the…...
Unison Autism Services Entity To Close 2 Facilities, Lay Off Staff
1+ week, 4+ day ago (348+ words) Comprehensive Autism Center will close two of its three clinics, according to public documents. Founded in 2008 by Andrea Macken, the autism therapy provider will apparently continue to operate one clinic in Temecula, California, where the company is headquartered. The company…...
Illinois Considers Reversing Ban on Nonclinician-Owned Autism Clinics
3+ week, 4+ day ago (614+ words) New bills filed in the Illinois legislature may undo a previous effort to bring more regulation to autism therapy ownership that some say has created a major burden for operators in the state. The bills would also add occupational therapists…...
Payers Want More than Access. They Want Results.
3+ week, 5+ day ago (877+ words) Value-based care used to be one of those terms everyone nods along to, but was defined differently by everyone who used it. Last week, the Behavioral Health Business team hosted our annual VALUE conference in Orlando, and the conversations were…...
OIG Report Finds $77.8M of Improperly Documented Claim Payments for ABA
1+ mon, 1+ day ago (607+ words) Image by Vitor Dutra Kaosnoff from Pixabay The federal government released a fourth installment in a series of reports that find that state Medicaid programs have problems with enforcing documentation requirements for applied behavior analysis (ABA). The latest report finds…...
Centene Says Behavioral Health Accounts for Half of Excess Costs
1+ mon, 3+ week ago (380+ words) Centene Corp. (NYSE: CNC) has cited behavioral health utilization and applied behavioral analysis (ABA) therapy as the primary drivers of a substantial portion of the increase in spending in its Medicaid business, similar to trends documented in the company's Q3 and…...
Residential, Inpatient Treatment Are Still Ripe With Opportunity But Location is Everything to Investors
2+ mon, 4+ day ago (758+ words) It has been nearly six years since the pandemic-induced telehealth boom drew attention away from traditional brick-and-mortar behavioral health providers. But residential care is far from being replaced despite the growth of digital and outpatient models. Even with a surge…...
Addiction Recovery Care Fighting Lenders, Allegedly Staring Down $28M DOJ Settlement
2+ mon, 5+ day ago (552+ words) Addiction Recovery Care finds itself in a financial and legal morass after its deal with Ethema Health Corp. (OTCQB: GRST) fell apart. However, court documents show the company's ownership expects a sale to close soon, generating funds to cover its…...