How to Avoid Getting Wiped Out by the Wave of Commercial Payor Behavioral Health Audits: Medical Necessity and Waivers of Co-Insurance and Deductibles

, John A. Mills
Webinar (ET)

Watch the Video on YouTube or Here:

Download the Slides or View via Slideshare:

Presented by:
Paul D. Gilbert – Member, Epstein Becker Green
John A. Mills – Partner, Nelson Hardiman

There is a confluence of national and local public policy developments regarding mental health, substance use disorders, and treatment. The federal government, working in partnership with states, addresses behavioral health issues and establishes and enforces minimum standards. States, however, have significant power in making decisions—mental health regulations and available services can look very different from state to state, and even from county to county.

Please join the Behavioral Health Association of Providers, Epstein Becker Green, and Nelson Hardiman for a fall webinar series that will address topics highlighting the accelerating legal and policy issues for the behavioral health industry.

Topics for the October 4 session:

The number of commercial payor audits of behavioral health facilities has been steadily rising, forcing closures of multiple treatment facilities, straining resources, and setting up an increasingly contentious conflict between treatment providers and payors.

This webinar will examine the most common issues arising in payor audits (including medical necessity; patient financial responsibility; and other issues asserted to constitute fraud, waste, or abuse) and the common arguments used as grounds for the nonpayment or recoupment of fees by insurers. The presenters will also review responsive strategies in commercial payor audits and examine defensive strategies and best practices to avoid fraud, waste, and abuse.

Learn more about the full "first Thursday" series.

Have questions? Please contact the presenters or David Stone at [email protected].

Behavioral Health Association of Providers (BHAP) is a national trade membership organization that provides education and advocacy for behavioral healthcare providers and related entities.

Epstein Becker Green is a national law firm with a primary focus on health care and life sciences; employment, labor, and workforce management; and litigation and business disputes.

Nelson Hardiman is a law firm focused exclusively on healthcare and life sciences. Business clients in California and throughout the U.S. turn to us for market-leading counsel on healthcare transactions, litigation, regulatory compliance, and strategy.