Behavioral health providers face an ever-changing legal, regulatory, and technological environment. For instance, the Affordable Care Act, the Mental Health Parity and Addiction Equity Act, and the mental health parity rules issued by the Centers for Medicare & Medicaid Services have been reshaping the reimbursement landscape. And, because care coverage limits and a shortage of specialists have made behavioral health services (such as mental health care and substance abuse treatment and prevention) harder to obtain than other U.S. health services, more and more psychiatrists, psychologists, social workers, counselors, nurse practitioners, and marriage and family therapists are turning to “telemental health” (i.e., behavioral health services delivered via interactive audio or video, computer programs, or mobile applications) as a way to increase access to such services, especially in rural and underserved areas. However, with new opportunities and innovations come new risks and challenges.
Epstein Becker Green’s Behavioral Health lawyers have extensive experience advising and representing clients in the behavioral health care space. We have worked closely with a broad range of inpatient and outpatient behavioral health facilities and providers, including acute care psychiatric facilities, addiction treatment centers, behavioral health clinics, community mental health centers, rehabilitation facilities, and residential treatment facilities, among others, as well as with behavioral health professionals.
Our seasoned lawyers understand the complicities surrounding reimbursement (we have done extensive work in the area of Medicaid reimbursement, including mental health and substance abuse reimbursement) and mental health parity requirements, ethical and legal concerns relating to telemental health (including telepsychiatry and telepsychology), the integration of behavioral health with physical health, and other legal and regulatory issues applicable to the behavioral health context. We offer strategic advice to behavioral health clients on new opportunities, lead them through daily operational issues and strategic initiatives, and assist them with business, transactional, regulatory, and litigation matters.
Services/Scope of Practice
Epstein Becker Green lawyers regularly provide behavioral health clients with a full range of services, which includes, but is not limited to:
- Advising on the integration of behavioral health services and primary care to manage population health
- Counseling on federal and state mental health parity laws and Medicaid and Medicare reimbursement matters
- Advising on compliance with state licensing, survey and certification, Stark, state and federal anti-kickback, and Emergency Medical Treatment and Active Labor Act (EMTALA) requirements; privacy and security-related federal, and state laws, rules, and regulations, including, among others, the Health Insurance Portability & Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH); and other state and federal laws and regulations affecting behavioral and telemental health care
- Developing effective risk management strategies and corporate compliance programs in accordance with industry best practices and state standards for behavioral health care facilities
- Negotiating contracts with various payors
- Advising on health care financing as well as mergers, acquisitions, divestitures, and joint ventures involving behavioral health care businesses
- Performing privacy and security due diligence for corporate transactions
- Providing advice and counsel on labor and employment issues
- Assisting with data breach preparedness and responses to security breaches
- Informing clients of pending legislation, rulemaking, regulations, and guidance impacting behavioral health
- Providing representation in government investigations/audits; enforcement actions; False Claims Act and qui tam actions; payor, reimbursement, and contract disputes; and other litigation matters
We have handled a variety of matters concerning behavioral health care issues. For example:
- Epstein Becker Green serves as counsel to a national association focused on mental and behavioral health care issues. We have tracked recent and significant federal rulemaking efforts related to mental health parity, prepared summaries of the relevant proposed and final rules upon publication, and delivered webinar presentations for the association’s membership discussing key provisions in the proposed and final rules.
- Our firm advised a clinic in Washington, DC, that provides primary care services to Latino residents of the District. The clinic won a $500,000 grant from a large insurer to implement a regional telepsychiatry program. Epstein Becker Green is currently advising the clinic on a number of regulatory issues regarding the implementation of the telepsychiatry program.
- Epstein Becker Green has reviewed and negotiated managed care agreements for providers with payors involving behavioral health carve-in matters.
Epstein Becker Green will soon release a comprehensive survey on the laws, regulations, and regulatory policies impacting telemental health in all 50 states and the District of Columbia. Epstein Becker Green's 50-State Survey of Telemental/Telebehavioral Health (2016) is the first known survey of its kind focused solely on the remote delivery of behavioral health care.
In addition, Epstein Becker Green lawyers write and speak frequently on issues related to behavioral health care. For example, in March and April 2016, Epstein Becker Green hosted a “Behavioral Health Crash Course Webinar Series” covering such trending topics as investments in behavioral health, mental health parity implementation, managed care and behavioral health, privacy requirements under state and federal law, and corporate behavioral health care.