A D.C. Community support worker just pleaded guilty to billing D.C. Medicaid for therapy sessions that never happened. Leah Kendall breaks down the control gaps operators must close: pre-payment edits, documentation reconciliation, dual verification, and a working corrective action plan tied to 42 CFR § 438.608.
A working CARF accreditation checklist from an operator’s seat. What surveyors read first, how the Behavioral Health Standards Manual maps to 42 CFR Part 2 and HIPAA, what the fees actually run, and where operators lose the three-year award.
A licensed North Carolina addiction specialist was sentenced to four years for a $1.9M Medicaid fraud scheme tied to phantom drug tests and psychotherapy. Here is how behavioral health operators should read the DOJ, HHS-OIG, and NC MID signal and rebuild claim validation now.
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.
