Healthcare Regulatory Consulting
From state and federal regulatory guidance to self-disclosures, whistleblower risk, and false claims analysis — we provide expert support in navigating audits, billing reviews, investigations, and pre-acquisition regulatory due diligence. Stay ahead of watch & change alerts and safeguard your organization with proactive oversight.
Proactive Strategies for High-Risk Compliance Issues in Behavioral Health
In today’s regulatory environment, even minor billing issues can carry serious consequences. Our team helps behavioral health and addiction treatment providers navigate complex regulatory waters—especially when facing potential overpayments, whistleblower risk, or government scrutiny. Whether you’re preparing for an audit, planning a voluntary disclosure, or conducting internal risk assessments, we provide strategic guidance in coordination with your counsel every step of the way.
We work hand-in-hand with your legal team to mitigate False Claims Act exposure, support documentation of good-faith compliance efforts, and ensure your facility is prepared to respond to enforcement trends and payer scrutiny. With deep expertise in behavioral health billing and clinical operations, our advisors use both regulatory knowledge and data analytics to help you make defensible decisions.
Targeted Support Areas Include:
Data-Driven Analysis:
Keeping up with constantly shifting regulations is one of the biggest challenges behavioral health providers face. From changing Medicaid guidelines to evolving payer requirements, even small policy shifts can impact operations, reimbursement, and compliance. That’s why our team delivers real-time insights and plain-language interpretations of the rules that matter most to your facility.
Regulatory Watch & Change Alerts
We monitor and break down upcoming changes to Medicaid, Medicare, and commercial insurance regulations—so you’re never caught off guard. Whether it’s a new rule from CMS, a billing update from a state Medicaid plan, or a shift in medical necessity guidelines, we provide timely updates tailored to behavioral health providers.
State & Federal Regulatory Guidance
When new policies are released, we translate the legal and regulatory language into clear, actionable summaries. Our team focuses on what the rule changes mean for your day-to-day operations—helping you avoid confusion, prepare staff, and stay compliant without needing to decode dense legal documents.
Whether you’re expanding through acquisition or facing a government investigation, regulatory risk can derail even the best-laid plans. Our experienced team provides the specialized support behavioral health providers need to evaluate liability, protect investments, and respond effectively during periods of scrutiny.
Pre-Acquisition Regulatory Diligence
We conduct a deep-dive review of billing practices, compliance protocols, and regulatory history to identify hidden risks before you close a deal.
Our diligence process includes:
Review of billing and documentation practices
Evaluation of past or pending regulatory enforcement actions
Licensure and accreditation status verification
Analysis of compliance program effectiveness
Recommendations for post-acquisition remediation
Support During Investigations
We stand by your side during payer audits, state inquiries, or federal investigations—helping you respond quickly and accurately while minimizing exposure. We also serve as impartial third-party investigators in high-risk internal matters such as allegations of sexual misconduct, abuse, fraud, or ethical breaches, ensuring your organization meets legal and ethical obligations while protecting staff and patients.
Our investigation support includes:
Liaising with legal counsel and regulatory agencies
Preparing documentation and narratives for government or payer inquiries
Conducting third-party investigations into allegations of sexual misconduct, abuse, or fraud
Interviewing involved parties and reviewing relevant evidence impartially
Delivering written investigation reports with findings and recommended actions
Supporting corrective action planning and HR coordination when needed
With Atlantic Health Strategies, you gain the expertise of a seasoned regulatory and compliance team without the overhead of full-time hires. We help behavioral health and addiction treatment providers stay audit-ready and fully equipped to navigate complex federal, state, and payer requirements. Our team works seamlessly alongside your legal counsel to support a coordinated, defensible response in high-risk situations.
Why Providers Choose Us:
Proven cost savings compared to building in-house regulatory teams
Experienced in working collaboratively with legal counsel during audits and investigations
Full-spectrum support across licensing, regulatory risk, and accreditation readiness
Contact Us for a Free Consultation
Ready to strengthen your compliance program? Contact us today for a no-obligation consultation and discover how we can support your regulatory needs.
