Legal and practical healthcare information.
The United States Court of Appeals for the Ninth Circuit recently released an unpublished memorandum decision in the landmark mental parity case of Wit v. United Behavioral Health. In this decision, the Ninth Circuit reversed the district court’s order requiring UBH to reprocess more than 60,000 claims that had initially been denied for not meeting …
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Erica Erman and Gregory Moore discussed some of the top developments in behavioral health during Dickinson Wright’s Health Law Summit. Below is a summary of what was discussed. Click here to view the full webinar. Table of Contents Development #1: New Trends in Parity Enforcement Recent Litigation, Including Wit v. United Behavioral Health Development #2: …
Who are the relevant state entities? The Division of Developmental Disabilities (“DDD”) operates under the Arizona Department of Economic Security (“ADES”).[1] The DDD provides services to qualifying Arizona children with developmental disabilities. The Arizona Long Term Care System (“ALTCS”) is Arizona’s Medicaid program that provides long-term care services to DDD members. ALTCS operates under the …
Continue reading “State Funded Benefits for ASD in Arizona: The Basics”
What is Autism Spectrum Disorder (“ASD”)? Autism spectrum disorder (“ASD”) is a developmental disability.[1] Children with ASD may experience social, communication, learning, and behavioral challenges. The severity of ASD varies and some children require more assistance than others. There is no cure for ASD, but early intervention treatment for children between birth and 36 months …
(1) Clayton v. Hon. Kenworthy et al. This month, the Arizona Court of Appeals issued its opinion in Clayton v. Hon. Kenworthy et al., regarding an unrecorded Rule 35, Ariz. R. Civ. P. neuropsychological examination. Background In Clayton, the mother of a six-year-old child who suffers from bilateral hearing loss and cerebral palsy, among other disabilities, sued her …
Continue reading “SEPTEMBER 2020 ARIZONA BEHAVIORAL HEALTH LEGAL UPDATES”
On June 23, 2020, the Arizona Court of Appeals issued its opinion concerning In Re: MH2019-004895, vacating the trial court’s order for involuntary treatment because the trial court improperly allowed the patient’s clinical liaison to testify about confidential information in violation of the behavioral health professional-client privilege. This opinion has several important changes and clarifications …
You’ve probably heard that every provider’s favorite laws, the Anti-Kickback Statute and its related, strict liability counterpart, the Stark Law (formally known as the Physician Self-Referral Law), are getting a makeover from the Department of Health and Human Services (HHS). Here’s what you need to know. Quick Legal Refresher: (A) What is the Anti-Kickback Statute? …
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 …
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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 …
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 …
Continue reading “Understanding the HIPAA Security Rule and Tailoring Policies to Fit Your Business”