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.
Massachusetts MassHealth’s retroactive recoupment against ABA providers is not an isolated event. It is a preview of how states will use post-payment review as a budget lever. Here is what behavioral health operators need to lock down now, and how AHS helps multi-state platforms respond.
Laurel Ridge Treatment Center’s CMS provider agreement termination and the resulting 648 layoffs is the clearest warning shot behavioral health has had in years. Here is what likely drove it, and how operators build the compliance infrastructure to never be next.
Substance use disorder is a chronic condition, but most programs are still built around episodic admissions. Here is how operators and PE-backed buyers should rethink feasibility, pro formas, and licensure to build continuums that payers actually want to contract with.
The DOJ’s FOCUS initiative changes the False Claims Act math for behavioral health. Claims data is public, data miners are filing qui tam suits without insider relators, and UR, level-of-care, and lab billing patterns are sitting in plain sight. Here is what operators need to do now.
Joint Commission behavioral health core measures look simple on paper. In practice, they sink surveys. Here is what AHS sees in chart audits, where the HBIPS and SUB measures break down, and how to fix the gaps before a surveyor finds them.
Atlantic Health Strategies Delivers the Embedded Executive Expertise That Behavioral Health and Addiction Treatment Programs Need, Without the Six-Figure Salary That Comes With It There is a category of problem that does not show up on a census report…
Electronic medical record decisions in behavioral healthcare are no longer routine IT projects. They are strategic operational events. As mergers, acquisitions, and private equity investment accelerate across the treatment landscape, organizations are increasingly forced to reconsider the technology infrastructure that…
