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 …
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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 …
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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 …
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Mental Health Parity Really Does Mean Equal Benefits
In Danny P. v. Catholic Health Initiatives, 891 F.3d 1155 (9th Cir. 2018), the Ninth Circuit clarified the full extent of the “parity” required in the federal mental health parity law1 which has been in place since 2008. The Case In Danny P., the Ninth Circuit held that a particular group health plan (the Catholic …
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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 …
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