Mental Health, substance use disorder, and behavioral health compliance information for facilities and providers.
Carelon, CVS/Aetna, and Blues plans are quietly building the attribution, measurement, and data plumbing for value-based behavioral health contracts. Here is what treatment center operators should demand, refuse, and measure before signing a downside-risk deal in 2025 or 2026.
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.
When Aurora Mental Health and Recovery cut staff in response to Colorado Medicaid and grant pressure, it surfaced a problem facing CMHCs nationally. Sariah Hopkins breaks down what operators should be modeling now, before reactive cuts force decisions that damage clinical capacity.
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.
The Talkspace evidentiary exposure should put every behavioral health operator on notice. AI scribes, telehealth recordings, and chat transcripts are discoverable. AHS walks operators through 42 CFR Part 2, HIPAA, BAA scrutiny, and the retention policy revisions needed before plaintiffs’ attorneys or regulators force the issue.
Aliya Health Group’s recent layoffs and site closures follow a familiar arc in PE-backed behavioral health: new leadership, hard look at unit economics, footprint reset. Here’s what triggers these moments and how operators stress-test before crisis hits.
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.
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.
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.
