The Importance of Putting Patient Care Above Profits

Erica A. Erman recently authored the article, “The importance of putting patient care above profits,” for Physicians Practice. The article discusses the case Wit v. United Behavioral Health and highlights eight principles that the court found to be generally accepted standards of care among behavioral professionals. “The importance of accessible quality behavioral health services is …

Still Not Being Paid? Here Is Why and What Can Be Done! Eight New CPT Codes for Applied Behavioral Analytics Services Became Effective January 1, 2019

The American Medical Association CPT Editorial Panel released eight standardized and permanent codes for billing applied behavioral analytics (ABA) therapy services that became effective January 1, 2019. For the first time, adaptive behavior services are standardized for the purposes of billing and payment for those services by CMS and other third-party payors. This should be …

Understanding the HIPAA Security Rule and Tailoring Policies to Fit Your Business

Purpose and Practicality The HIPAA Security Rule[1] was designed to protect the confidentiality, integrity, and availability of a patient’s protected health information (PHI) while allowing flexibility for each covered entity based on their size, complexity, technological capabilities, cost constraints, and the likelihood of potential risks to the electronic PHI (ePHI) they house. To make the …

Court Rules UBH Coverage Guidelines a Monumental Fixer-Upper

Earlier this month, on March 5, 2019, the U.S. District Court in the Northern District of California filed a 106-page Findings of Fact and Conclusions of Law in the class action Wit v. United Behavioral Health (“UBH”). Here are the highlights: Under ERISA, Plaintiffs asserted two claims against UBH based on UBH’s Level of Care …

So Your Resident Wants to Leave Against Medical Advice? A Few Guidelines for Skilled Nursing Facilities

When your resident first expresses a desire to leave against medical advice (“AMA”), take it seriously. Step 1: Verbal Prevention Your first line of defense to ensure your resident’s wellbeing (and consequently, to reduce your risk of liability) is prevention – attempt to understand, to the extent possible, the reason for the resident’s desire or …

May Highlights: National Healthcare Law News

-Earlier this month, on May 7, 2018, the Senate passed bipartisan S.B. 1732, entitled the “Improving Access to Behavioral Health Information Technology Act.”  The bill, which is currently in the House of Representatives, aims to provide “incentive payments to behavioral health providers for the adoption and use of certified electronic health record technology…to improve the …

Costs Down; Quality Up

How can providers increase quality of care while reducing cost to patients?  The answer is through innovation, creativity, increased patient responsibility, partnership, and real-time flow of information.  Here are just a few ideas to consider in reaching this overarching goal.  While none of the ideas articulated below are novel or groundbreaking on their own, they …