DOJ’s newly resourced National Fraud Enforcement Division puts behavioral health operators back in the crosshairs. Sariah Hopkins translates the announcement into concrete actions for CEOs and compliance leads: medical necessity tightening, UR rebuilds, billing audits, and pre-close diligence that holds up under federal scrutiny.
Behavioral health M&A is no longer a quiet corner of healthcare deal flow. DOJ, HHS-OIG, and state AGs are reading deal documents. Here is what operators and sponsors should expect on diligence, integration, and post-close enforcement risk.
The Horizon Behavioral Health data breach is another reminder that HHS OCR and state AGs are not grading on a curve. Here is what behavioral health operators should pull from the incident, and what we are telling AHS clients to fix this quarter.
Single case agreements with United Behavioral Health are not a billing trick. They are a clinical-financial negotiation with real regulatory exposure. Here is how operators should approach SCAs given recent federal scrutiny, parity enforcement, and the OptumRx and UBH litigation history.
A behavioral health advisory board is not a board of directors. It is the operator-level early warning system that catches regulatory drift, billing risk, and marketing arrangements before the DOJ, OIG, or state surveyors do.
CMS published its Behavioral Health Strategy and operators keep treating it like a press release. It is not. It is the framework CMS, OIG, and state Medicaid agencies are already using to shape audits, rate decisions, and enforcement priorities. Here is what to do about it.
ASAM level of care decisions are no longer a clinical footnote. They are the single most scrutinized data point in behavioral health, and CMS, DOJ, and state Medicaid SIUs are reading your charts more carefully than you are.
Iowa’s behavioral health system is mid-overhaul. For operators eyeing entry, expansion, or acquisition, the licensure framework under Iowa HHS demands the same operational discipline we apply across every state we work in. Here is how we think about it.
Atlantic Health Strategies Shares Real-World Survey Intelligence Every Behavioral Health and Addiction Treatment Program Needs Right Now There is a category of accreditation knowledge that only comes from being in the room. Reading the standards, running mock surveys, and training…
Arizona behavioral health licensure is one of the most procedurally specific in the country. Drawing from AHS engagements across Arizona, Florida, California, and Tennessee, Sariah Hopkins breaks down what operators consistently miss with AZDHS and where timelines actually break.
