Latest / Becker's Healthcare Behavioral Health / Proposed Bill Would Protect Oregon Mental Health Workers from Insurance Audits; Honolulu Addiction Treatment Center to Pay $450K for Illegal Pay Practices

Transcript

Proposed Bill Would Protect Oregon Mental Health Workers from Insurance Audits; Honolulu Addiction Treatment Center to Pay $450K for Illegal Pay Practices · Becker's Healthcare Behavioral Health

• 0:00
  This is Randy Homan with Becker's Behavioral Health Podcast.
• 0:04
  Here's your daily industry news free for March 20th.
• 0:09
  First,
• 0:10
  a proposed bill would restrict how insurers and coordinated care organizations
• 0:15
  can audit mental health providers in Oregon House Bill
• 0:19
  2 4 55 would also limit these entities ability to demand
• 0:25
  reimbursements flagged by audits.
• 0:28
  It would no longer allow auditors to receive incentives based on how many
• 0:33
  overpayments they find.
• 0:36
  It would additionally require insurers and coordinated care organizations.
• 0:40
  To give detailed information to providers about audits,
• 0:44
  they would have to notify providers within 30 days about changes to audit
• 0:48
  requirements.
• 0:50
  They would also need to complete an audit within 180 days and allow providers to
• 0:55
  fix errors.
• 0:56
  Sponsors of the bill say current auditing practices discourage mental health
• 1:01
  providers from continuing to work in Oregon.
• 1:04
  Bill opponents fear it conflicts with federal auditing requirements of Medicaid,
• 1:10
  and it may lead to overbilling patients.
• 1:15
  Second,
• 1:15
  the federal government is suing inspired behavioral health for forfeiture for
• 1:20
  fraudulently billing, millions to Medicaid.
• 1:23
  Those named in the lawsuit include the organization,
• 1:26
  its board members associated individuals and entities,
• 1:30
  as well as IB h's. Owner Brandi Castillo.
• 1:34
  The facility allegedly hired unqualified individuals to work there
• 1:39
  and bill Medicaid for $111,000 in services that were never
• 1:44
  provided. I B H was the highest billing mental health provider in Texas.
• 1:49
  While having less than 60 residents,
• 1:52
  it billed an average of 1.8 million in services per patient.
• 1:57
  It also billed for patients who are no longer staying at the facility.
• 2:02
  I B H also, allegedly required patients to sign over social security benefits,
• 2:07
  food stamps, and other benefits to pay for their stay. Texas counties,
• 2:11
  Cameron and Fort Bend were lobbied to send arrested individuals with mental
• 2:16
  illness to the facility for treatment instead of jail time.
• 2:19
  Cameron County paid I B H A daily fee for each person from 2018 to
• 2:24
  2022. Ms.
• 2:26
  Castillo and former Vice President and founding I B H Board member Robin Mathias
• 2:31
  have also been accused of using a web of bank accounts to hide the Medicaid
• 2:35
  funds. Ms.
• 2:37
  Castillo and other IBH associates allegedly purchased real estate for the
• 2:41
  purpose of money laundering.
• 2:44
  A pretrial hearing will take place in July 3rd,
• 2:48
  Klein Welsh Behavioral Health Foundation based in Honolulu.
• 2:52
  We'll pay over $450,000 in back wages to over 30 staff
• 2:57
  members. Klein Welsh operates Sand Island Treatment Center.
• 3:02
  The labor department finds that the organization was not paying minimum wage or
• 3:06
  overtime even when the employees worked between 41 and 63 hours per week.
• 3:11
  In some cases, it only paid staff members $400 per month.
• 3:16
  Kline Welsh will also have to pay $10,000 in civil money penalties
• 3:21
  and submit a compliance action plan to the wage in our division of the Labor
• 3:25
  department. Thanks for listening.
• 3:28
  Do more of the latest info and behavioral health delivered directly to your
• 3:31
  inbox. Subscribe to the Becker's Behavioral Health Report,
• 3:34
  eNewsletter on our website at www dot becker's behavioral
• 3:38
  health.com.