SURPRISE! NEW LAWS IMPACT PATIENT BILLING

Since last year, certain providers (e.g., anesthesiologists, radiologists, surgeons, etc.) in Michigan have had to navigate Michigan’s Surprise Medical Billing Law (“Michigan Act”). Starting January 1, 2022, those same providers have also had to comply with the Federal No Surprises Act (“Federal Act”). Generally, both statutes prevent nonparticipating providers from balance billing patients when the …

SEPTEMBER 2020 ARIZONA BEHAVIORAL HEALTH LEGAL UPDATES

(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 …

New Case Law on When a Behavioral Health Professional May Testify as an Acquaintance Witness in a Commitment Proceeding

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 …

Gregory Moore Appointed Vice Chair – Educational Programming of the Behavioral Health Task Force for the American Health Law Association

Dickinson Wright PLLC is pleased to announce that Gregory W. Moore (Member, Troy) has been appointed Vice Chair – Educational Programming of the Behavioral Health Task Force for the American Health Law Association (AHLA). The appointment is effective July 1, 2020. The Behavioral Health Task Force is committed to advancing the understanding of laws impacting …

SUD Program Privacy Rules Modified by CARES ACT

In this country, people who need Substance Use Disorder (SUD) treatment often choose not to pursue professional treatment, not because of the cost, but because there is a societal negative stigma attached to the disease.  In 1975, the federal government acted to eliminate the stigma and simultaneously encourage people suffering from SUD to voluntarily ask …

There is a New Sheriff in Town: Class Action Enforcement and Implementation of the 2008 Parity Act

In 2008, Congress enacted the Paul Wellstone and Pete Domenici Mental Health Parity and Addition Equity Act (“Parity Act”). In essence, the Parity Act necessitates that financial requirements and treatment limitations imposed on mental health and substance use disorder benefits cannot be more restrictive than the financial requirements and treatment limitations that apply to medical/surgical …

Why you need to integrate behavioral health into your primary care practice

Russell Kolsrud and Gregory Moore recently authored the article, “Why you need to integrate behavioral health into your primary care practice,” for Physicians Practice. The article discusses the continuous debate regarding various health insurance reform addressed in the ACA and the effects it has had on the behavioral health industry. Kolsrud and Moore also discuss …

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 …

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 …