Managed Care Friday

Nov 17, 2023 | Managed Care Friday

12.6: The percentage of high schoolers who reported they used tobacco products in 2023, down from 16.5% in 2022 according to the CDC’s National Youth Tobacco Survey. E-cigarette usage also decreased from 14.1% to 10%. The trend mimics a similar drop in length of stay for SUD cases in hospitals, down from 10.1 to about 7.5 from ’21 to ’22 according to one commercial plan. The trends are promising but given the potential for so many high costs and recurrence in SUD, the “work is far from over” according to experts at the CDC. GLP Changing Employer Policies: More union plans are starting to...

Q3 Compliance Developments

Nov 16, 2023 | BRG Publications

BRG Quarterly Compliance and Program Integrity Developments: The Departments of Justice and Health and Human Services announced several enforcement actions. Click here to read more.

OIG Releases Modernized General Compliance Program Guidance

Nov 16, 2023 | BRG Publications

OIG released new guidance for compliance programs and included an overview of risks specific to private investors.  New investors risk not understanding the unique regulations and business constraints that apply in the health care industry or within expanded business lines Compliance programs critical to: Prevent and identify problematic payment incentives Guide private equity and other investors involved in operational oversight Click here to read more. 

Weekly Medicaid Update

Nov 15, 2023 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: IL: Increases reimbursement rates for certain behavioral health services MA: Attorney General reaches settlement with two ABA providers over Medicaid fraud allegations NY: Governor’s office fines five Medicaid MCOs over inadequate coverage of specialty behavioral health services Click to read more.