When a treatment center draws grant oversight, auditors look for a predictable pattern. Leah Kendall breaks down the six FWA red flags that trigger OIG and state auditor scrutiny, plus the internal controls behavioral health operators need before the post-award monitoring letter arrives.
A Texas businessman, a Kentucky physician, and a Kentucky administrator are heading to federal prison after fraudulently billing Medicare and Kentucky Medicaid $4.8 million through a chain of opioid treatment clinics. Leah Kendall breaks down what every SUD operator should audit right now to avoid the same exposure.
HHS-OIG is hunting a Brooklyn rehab owner over $18.4M in fraudulent Medicare and Medicaid claims. For behavioral health operators, the case is a working manual on what a real compliance program, chart audit cadence, and FWA controls need to look like right now.
The Department of Justice sentenced Done Global’s founder and clinical president in July 2026 for a $90 million Adderall distribution and health care fraud scheme. Behavioral health operators, particularly PE-backed platforms scaling telehealth, should read this as a direct signal on prescriber oversight and utilization review.
A behavioral health compliance officer walks through what it actually takes to launch an Intensive Outpatient Program: state licensure, ASAM Level 2.1 alignment, accreditation sequencing, EKRA exposure, and the capital math most consultants skip.
CareSource’s retroactive Medicaid clawbacks in Ohio have pulled ODM, JMOC, and state lawmakers into the conversation. For behavioral health operators, this is a leading indicator of tightening post-payment audits. Here is what to do in the next 30, 60, and 90 days.
A federal grand jury in the Eastern District of Kentucky just indicted Addiction Recovery Care founder Tim Robinson on wire fraud and money laundering counts. Leah Kendall breaks down what SUD operators, boards, and PE sponsors should do this week to avoid being next.
Partial Hospitalization sits at ASAM Level 2.5 in the 4th Edition, renamed High-Intensity Outpatient. Leah Kendall walks operators through the 20-hour threshold, CMS 42 CFR 410.43, Wit v. UBH fallout, and the state licensure overlays that drive PHP denials and recoupment.
Arizona’s AHCCCS reported a 92% collapse in suspect behavioral health billing after suspending hundreds of providers in the American Indian Health Program sober-living scheme. Operators in 1115-waiver states should harden patient-brokering controls, credentialing files, and ASAM documentation now, before enforcement spreads.
Hantavirus is not a behavioral health crisis, but it is a useful stress test. If your residential SUD or eating disorder facility cannot answer how it would screen, isolate, and report a suspected case, your emergency operations plan has gaps that Joint Commission and state licensure surveyors will find first.
