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Reimbursements Mental Health

DLA Piper

Proposed CY 2026 Medicare Physician Fee Schedule Rule Signals Support for Digital Health Advancement

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On July 14, 2025, the Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2026 Medicare Physician Fee Schedule (MPFS) Proposed Rule (Proposed Rule). This client alert focuses on the proposed...more

Fox Rothschild LLP

Child Support Guideline Update: Psychological Expenses Included as Reimbursable Expense

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For a long time, psychological expenses under the Pennsylvania Support Guidelines were treated differently than other medical expenses. While “routine” or “traditional” medical expenses such as surgical, dental, optical, and...more

Dentons

Ep. 59 – Treating Medicare Beneficiaries as a Cash-Based Practice

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Cash-based practices, or providers who neither participate with nor bill insurers, are becoming increasingly common, especially in certain specialties such as primary care, women’s health, and mental health. While providers...more

Davis Wright Tremaine LLP

COVID-19 Telehealth Flexibilities Extending and Enduring

In the wake of an end of year filled with intense negotiations and political wrangling, Congress has successfully enacted the American Relief Act, 2025 ("the Budget Bill" or "legislation"), narrowly averting a government...more

Baker Donelson

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

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On December 9, 2024, the Centers for Medicare & Medicaid Services' (CMS's) Calendar Year 2025 Physician Fee Schedule Final Rule (the Final Rule) was published in the Federal Register. The Final Rule includes noteworthy...more

Cozen O'Connor

Minnesota AG Settles with Blue Cross Blue Shield over Mental Health Parity

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Minnesota AG Keith Ellison has reached a settlement with BCBSM, Inc. d/b/a Blue Cross and Blue Shield of Minnesota, and HMO Minnesota d/b/a Blue Plus (collectively, “Blue Cross”) to resolve allegations that the insurer...more

McCarter & English, LLP

New Jersey Statutory Update Part II

Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more

ArentFox Schiff

Mental Health Parity: Recent Ninth Circuit Ruling Bolsters MHPAEA and ERISA Protections, Clarifying Pleading Standards

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In a win for plaintiffs, the US Court of Appeals for the Ninth Circuit recently reversed a district court’s dismissal of key claims in the case of Ryan S. v. UnitedHealth Group, Inc. The case provides useful guidance for...more

McDermott Will & Emery

[Event] Physician Practice Management and ASC Symposium 2024 - May 15th - 16th, Nashville, TN

The Physician Practice Management (PPM) and ASC Symposium 2024 is the destination event for PPM and ASC industry leaders and health industry investors. Join us as we deliver actionable insights on the state of the market and...more

Mintz - Health Care Viewpoints

CMS Announces New Model for the Delivery of Integrated Behavioral and Physical Health Care

With the goal of enhancing health care quality and outcomes for individuals with moderate to severe behavioral health conditions and substance use disorders (SUD), the Centers for Medicare & Medicaid Services (CMS) recently...more

Benesch

2024 Outlook: Behavioral Health Trends

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Healthcare systems are facing significant challenges in recruiting and retaining talent within the burgeoning field of behavioral health services, primarily due to competition from telehealth providers and inconsistent...more

Bass, Berry & Sims PLC

Pushing a Balloon Into or Against the Jet Stream? Key Takeaways from the J.P. Morgan Healthcare Conference

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The 42nd annual J.P. Morgan Healthcare Conference started with clear skies and overall optimism from investors. But with Jamie Dimon’s prediction of a recession in 2024 on Tuesday morning, the climate shifted to an on-again,...more

Ankura

What Is the Role of the Health System in Addressing the Behavioral Health Epidemic?

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One in five U.S. adults experienced mental illness in 2021. This represents 57.8 million people. However, only 47.2% of U.S. adults with mental illness received treatment in 2021. The country is deep in a behavioral health...more

McDermott Will & Emery

Remote Monitoring and Digital Therapies: CMS Updates Coverage and Payment Policies

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In recent years, the Centers for Medicare & Medicaid Services (CMS) has expanded payment for remote monitoring services in an effort to pay for non-face-to-face services that improve care coordination for Medicare...more

Proskauer - Law and the Workplace

New York City Adopts Final Rule Regarding Amendments to the Earned Safe and Sick Time Act

On September 15, 2023, the New York City Department of Consumer and Worker Protection (“DCWP”) published a Final Rule adopting amendments to portions of the city’s Earned Safe and Sick Time Act (“ESSTA”). Employers will have...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | August 2023 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for August 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act...more

J.S. Held

AHLA Takeaway: Healthcare Executives, Is Your House In Order?

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Walking away from the American Health Law Association’s annual conference, I’m feeling energized from (re)connecting with friends and colleagues, inspired by the complex and transformational work being done throughout the...more

McDermott Will & Emery

Top Takeaways | 2023 PPM-ASC Symposium | Specialty Spotlight: Behavioral Health

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In this session, panelists provided an in-depth look at focus and sub-focus areas within the behavioral health industry. Our panel also discussed supply and demand imbalances, merger and acquisition (M&A) transaction...more

Proskauer - Health Care Law Brief

The Future of Health Care Reform is Top of Governor Hochul’s State of the State Address

On January 10, New York’s Governor, Kathy Hochul, delivered the 2023 “State of the State” address. The address featured a number of health care reform initiatives—a strong indication that New York will prioritize health care...more

Holland & Knight LLP

Holland & Knight Health Dose: June 22, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include ...more

Foley & Lardner LLP

Behavioral Health Trends for 2022

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Over the last two years, behavioral health (BH) has been one of the biggest growth areas in the health care ecosystem, fueled by the Public Health Emergency (PHE) but in many ways an ignored, overlooked, understaffed, and...more

Goodwin

CMS Continues to Modernize by Expanding Reimbursement for Digital Health Services

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The COVID-19 Public Health Emergency (“PHE”) fundamentally changed the healthcare industry, forcing healthcare providers and patients onto their computers and phones to enable continuation of care when patients were mandated...more

Arnall Golden Gregory LLP

Ninth Circuit Sides With Plaintiff, Reviving $8.6M Reimbursement Suit

AGG Healthcare attorneys Matthew M. Lavin and Aaron R. Modiano recently secured a revival of an $8.6 million reimbursement suit against Cigna Health and Life Insurance. In Bristol SL Holding, Inc. v. Cigna Health and Life...more

Rivkin Radler LLP

Proposed Physician Fee Schedule Includes Expanded Telehealth Reimbursement

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The proposed 2022 Medicare Physician Fee Schedule, released on July 13 by the Centers for Medicare & Medicaid Services (CMS), includes expanded reimbursement for behavioral health services delivered by telehealth, including...more

Faegre Drinker Biddle & Reath LLP

Departments Release FAQs on Implementing the Mental Health and Substance Use Disorder Parity Requirements under the Consolidated...

As described in a recent blog post, the Consolidated Appropriations Act, 2021 amended the Mental Health Parity and Addiction Equity Act (MHPAEA) to require group health plans and health insurance issuers (collectively, “group...more

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