Mental Health, substance use disorder, and behavioral health compliance information for facilities and providers.
Xylazine, nitazenes, tianeptine, and synthetic benzos are reshaping detox length of stay and acuity, but commercial payer grids and Medicaid MCOs have not caught up. AHS shows operators how to defend medical necessity, win single-case agreements, and stop the denial bleed.
OhioMHAS and the Ohio Attorney General’s Medicaid Fraud Control Unit are using a licensure application freeze as a fraud-enforcement lever in southern Ohio. Kyrstin Corliss and Leah Kendall break down what the pause means for pending applications, acquisitions, and PE-backed compliance programs.
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.
A behavioral health business plan has to satisfy three audiences at once: state licensing agencies, commercial payers, and capital. Sariah Hopkins of Atlantic Health Strategies breaks down the operator-side framework, with named regulators, current EKRA enforcement, and the staffing math that actually survives a survey.
A behavioral health advisory group brings clinical, regulatory, billing, and operational SMEs to the table for treatment center operators. Sariah Hopkins, CEO of Atlantic Health Strategies, breaks down when to engage one, what they should review, and how they differ from a clinical board or compliance consultant.
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.
Curio FZ’s acquisition of Nora Mental Health puts a franchise outpatient therapy network under a digital parent. AHS walks operators and PE buyers through the diligence questions this deal raises, from licensure portability to payer assignability across a multi-state franchisee footprint.
Commercial payers are already adjusting their parity posture in response to the 2024 MHPAEA Final Rule. Brandi Cameron breaks down what behavioral health operators should be pushing for at the contracting table right now, with specific asks on rate, UM, and NQTL transparency.
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.
On May 15, 2025, the DOL, HHS, and Treasury announced they will not enforce the 2024 MHPAEA Final Rule. Brandi Cameron breaks down what the non-enforcement posture means for NQTL complaints, SCA pricing, denial appeals, and rate negotiations at Florida, Pennsylvania, and Tennessee facilities.
