Mental Health Counselor | The Health Law Firm Blog

New Mexico’s Largest Mental Health Providers Accused of Defrauding Medicaid Out of $36 Million

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

For months now, 15 New Mexico behavioral health agencies have been the subject of a Medicaid fraud investigation. The state’s largest mental health providers had their Medicaid funding frozen by the New Mexico Human Services Department (HSD) due to credible allegations of fraud, according to KUNM News. The behavioral health agencies are accused of collectively defrauding Medicaid of $36 million over three years. The findings in an audit conducted in 2012, by OptumHealth, the contractor that handles Medicaid payments for New Mexico’s behavioral health system, alarmed state officials to the point that they hired Public Consulting Group (PCG), a firm that specializes in Medicaid fraud, to conduct another audit in June 2013.

These behavioral health agencies […]

By The Health Law Firm|2024-03-14T10:01:50-04:00May 15, 2018|Categories: Medicaid audit, Medicaid fraud, Mental Health Counselor, Mental Health Counselor Law|Tags: Attorney General (AG), behavioral health agencies, defense attorney, defense lawyer, Department of Justice (DOJ), false billing, false claims, false claims act, legal representation, medicaid, medicaid audit, Medicaid false claims, medicare, medicare audit, Medicare false claims, Medicare fraud, mental health providers, Public Consulting Group (PCG), qui tam, qui tam lawsuits, settlement agreement, the health law firm, whistleblower, whistleblower attorney, whistleblower lawyer, whistleblower protection|Comments Off

Legally Speaking: Psychologists, Mental Health Counselors, Social Workers and Therapists

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Supervised by the Board of Psychology and the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling, psychologists, Licensed Mental Health Counselors, Clinical Social Workers and Licensed Marriage and Family Therapists are responsible for an important component of patient care: mental health.

Insuring the mental health of a patient does not come without risks. For this reason, every mental health professional should carry professional liability insurance that includes professional license defense coverage (sometimes called disciplinary defense, license defense, administrative hearing coverage or broad coverage). Most often this type of insurance coverage is included in most professional liability policies; however, if it is not, it can often be added as a rider to the insurance policy for a […]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Categories: Clinical Social Worker, Intern, Marital and Family Therapist, Mental Health Counselor, Psychology, Resident|Tags: Department of Health (DOH), psychologist, social worker, therapists|Comments Off

Department of Health and Human Services Announces Mental Health Parity Final Rule

By Lance O. Leider, J.D., The Health Law Firm

On November 8, 2013, the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the promulgation of the agency’s final rule related to parity of coverage of mental health and substance use treatment. According to Sebelius: “For way too long, the healthcare system has openly discriminated against Americans with behavioral health problems.”

The purpose of the regulations is to close the gaps in coverage that permit insurance carriers to treat mental and substance-abuse related treatment different from traditional medical and surgical benefits.

Among the key provisions of the regulations are the elimination of separate mental health deductibles, co-insurance, etc.; elimination of limits on lifetime benefits; as well as several other measures insuring that mental health benefits are treated on par with traditional medical and surgical benefits.

Compliance with the final rule will be required […]

By The Health Law Firm|2024-03-14T10:01:51-04:00May 15, 2018|Categories: Mental Health Counselor, Mental Health Counselor Law, Psychology|Tags: ACA, administrative complaints, Affordable Care Act, behavioral health, civil complaints, defense attorney, defense lawyer, Department of Health and Human Services, Final Rule, health law firm, hhs, insurance coverage, mental health, mental health and substance use disorder parity rule, mental health audit, mental health deductibles, mental health insurance treatment, mental health services, mental health treatment, mental healthcare, Obamacare, substance abuse, substance abuse treatment, the health law firm|Comments Off