Anticipated Regulatory Landscape in Behavioral Health for 2024
The Strain of 'Payor Ghosting' on Health Plan Relationships, Parity Battles, and Telehealth Changes
The Strain of 'Payor Ghosting' on Health Plan Relationships
The recent article from Behavioral Health Business brings "payor ghosting" to the forefront, likening it to dating, only this time, the insurers abruptly stop communication on claim reimbursement. Umm… hello?
Unlike typical payment issues, ghosting leads to confusing recourse.
The behavioral health industry's lack of parity, along with slim profit margins, leaves providers struggling to address financial shortfalls. Payors may assume providers lack the resources to challenge their actions, or maybe it’s due to profit-driven incentives for large health plans, or perhaps they’re understaffed… regardless of their ‘why,’ the need for strengthened parity enforcement must be emphasized.
Organizations are advised to reach decision-makers, explore legal options, and review contract rights. It’s even been suggested that we eliminate private health insurance altogether.
While more news will be shared, experts will provide valuable insight, and facilities will hire legal teams, we feel strongly that the biggest impact will come from us coming together, as cliche as it sounds. With that, if you haven’t yet joined our monthly ‘Masterminds’ discussion, we welcome you with open arms. ROC aims to connect and align organizations while elevating the two R’s - Relationships and Reimbursement.
The second Tuesday of every month - same place, same time: 11:00 AM PST on Zoom.
Join us on Tuesday, December 12th, to hear Kevin Taggart speak on:
Mindful Mergers 2024: Navigating Trends for Financial Gains, Business Growth, and a Better Future
The Expected Future Regulatory Landscape
The BHB article outlines the key regulatory issues in behavioral health for 2024, with a primary focus on the anticipated impact of the Biden administration's parity rule. Other pending concerns include the lapsed SUPPORT Act, EHR adoption challenges, potential reforms in patient privacy regulations, and forthcoming DEA regulations on telehealth and controlled substances.
In closing, as we underscore the need for more comprehensive regulatory considerations, the digital divide in behavioral health, particularly in marketing standards, is highlighted, along with legal challenges and warnings regarding data sharing.