On July 10, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule Proposed Rule (Proposed Rule) for the calendar year 2025. The Proposed Rule would implement certain provisions of the...more
F. Scott Fitzgerald famously declared that “Too much of anything is bad, but too much champagne is just right.” That may be true, but it now appears that it may have been “Special K” that proved the undoing of beloved actor...more
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a proposal to significantly expand behavioral health coverage provided under Medicare. The proposal, presented as a part of the calendar year 2024...more
In April, the Centers for Medicare & Medicaid Services (CMS) finalized new regulations that will make critical healthcare services more accessible and affordable for Americans while expanding opportunities for physicians and...more
Florida Doctor Receives 20-Year Prison Sentence for Substance Abuse Treatment Fraud - Following a guilty plea to conspiracy to commit health care and wire fraud, a Florida doctor was sentenced to 20 years in prison for...more
The U.S. Department of Health and Human Services (“HHS”) has announced proposed changes (the “Proposed Rule”) to 42 C.F.R. Part 2 (“Part 2”). While the Health Insurance Portability and Accountability Act (“HIPAA”) governs the...more
Starting January 1, 2023, Medicare will cover telehealth-based treatment services delivered by federally-accredited opioid treatment programs (OTPs), commonly referred to as “methadone clinics.” This new reimbursement is...more
To protect patients seeking addiction treatment, the federal government passed strict regulations limiting the disclosure of substance abuse patient records. Substance abuse treatment programs must not only comply with the...more
On March 2, 2022, the Department of Health and Human Services (“HHS”) Office of the Inspector General (the “OIG”) issued a new advisory opinion (“AO 22-04”) related to a program through which the Requestor would provide...more
Beginning January 1, 2022, California licensed residential substance abuse treatment facilities will be required to disclose certain licensing information to the public. SB 541 adds Health and Safety Code section 11831.12,...more
Recent psilocybin studies have generated significant interest due to the unparalleled positive results for individuals suffering from major depressive disorders and substance abuse disorders. In an era where once-illicit...more
On June 9, 2021, Arnold Ventures, researchers from the Boston University School of Public Health and Faegre Drinker hosted a virtual event to explore the issue of fraud in substance use disorder (SUD) treatment. In response...more
Editor’s Note: The American Medical Association (AMA) and Manatt Health released a national roadmap in September 2019 to guide policymakers in taking action to help end the nation’s opioid epidemic. Based largely on in-depth...more
Last month, the Eleventh Circuit upheld the conviction and 11-year prison sentence of a physician-Medical Director of two substance abuse treatment centers in Florida who was convicted by a jury of participating in a...more
Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms - New opportunities for investor-backed behavioral health platforms in...more
Over the last 50 years, the use of medication-assisted treatment (MAT) for opioid use disorder (OUD) has evolved from a controversial therapy on the outskirts of accepted medical practice and drug abuse prevention strategy to...more
Amid the United States’ growing opioid crisis, the Equal Employment Opportunity Commission (“EEOC”) issued new guidance on employers’ obligations under the Americans with Disabilities Act (“ADA”) regarding job applicants or...more
Earlier this month, the U.S. Equal Employment Opportunity Commission (EEOC) released two new documents addressing concerns about the employment provisions of the Americans with Disabilities Act (ADA) and opioid use. Employers...more
It is no secret that America is in the midst of an opioid addiction crisis. It has been for quite awhile. A recent study revealed that in 2018 there were 128 deaths from opioid overdose per day in United States. A startling...more
The Equal Employment Opportunity Commission (“EEOC”) has released new informal guidance directed at employees regarding use of opioids and employer obligations under the Americans with Disabilities Act (“ADA”). The EEOC also...more
Florida Doctor Charged in $681 Million Fraud Scheme Involving Substance Abuse Treatment - On July 30, 2020, a criminal complaint was unsealed charging Michael J. Ligotti, D.O., with conspiracy to commit health care fraud...more
...Our prior article discussed federal law barriers to entry for the use of telehealth in substance use disorder (SUD), and specifically, opioid use disorder (OUD) treatment, and highlighted notable opportunities to use...more
In the continued fight against opioid addiction, Pennsylvania enacted a new law, effective November 27, 2019, that requires prescribers in Pennsylvania to implement additional steps prior to treating a patient’s chronic pain...more
Recognizing the huge problems caused by opioid addiction in the United States, Medicare is adding a new outpatient opioid treatment benefit, paying for methadone and related treatment in certain facilities. Under a new...more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more