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.
Utah’s regulatory mitigation agreement with Legion Health is the first real template for how state agencies will license and supervise AI-driven psychiatric workflows. AHS unpacks what the guardrails likely look like and what operators in Florida, New York, and Pennsylvania should expect 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.
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.
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.
