Latest / Becker's Healthcare Behavioral Health / Illinois Bill Pushes for Insurance Coverage on Annual Mental Health Assessments; $580M in Psychotherapy Improperly Billed to Medicare in 2020, HHS says

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Illinois Bill Pushes for Insurance Coverage on Annual Mental Health Assessments; $580M in Psychotherapy Improperly Billed to Medicare in 2020, HHS says · Becker's Healthcare Behavioral Health

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  This is Randy Homan with Becker's Behavioral Health Podcast.
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  Here's your daily industry news brief for May 8th. First,
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  new legislation in Illinois would offer people with most commercial insurance to
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  have one free mental health diagnosis each year.
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  The bill would also require the Illinois Department of Human Services to launch
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  a public education campaign about the importance of mental health and wellness
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  supporters of the bill.
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  Hope it will catch more cases of severe mental illness early,
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  as well as de-stigmatized mental health opponents of the bill fear.
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  It will make it difficult for individuals who need to make appointments with
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  providers.
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  The free visit would not apply to those with a health savings account. However,
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  the bill will exempt individuals with high deductibles who are eligible for an
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  hsa. Second,
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  integrated medical services is partnering with involved ND to implement
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  behavioral health services at several of its locations
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  evolved.
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  MD is a company that provides behavioral health services at primary care
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  facilities. The partnership is expected to streamline care,
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  reduce mental health stigma, prevent provider burnout,
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  and catch mental health issues before they become severe Arizona,
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  where both companies are based,
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  brings 47th in the nation for access to care and behavioral health awareness.
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  Third,
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  an HHS Inspector General's report shows that 580 million in
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  Medicare psychotherapy provided in less than a year did not comply with Medicare
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  requirements.
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  The millions in improper payments include 348 million for
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  telehealth and 232 million for non telehealth services.
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  Providers frequently failed to properly document the services they provided
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  during the pandemic's first year.
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  The determination was based on a review of a random sample of over 200 claims.
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  It was then extrapolated to reflect the 13.5 million total claims submitted
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  in that period.
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  Improper billing rates were 61% for telehealth and 57% for in-person
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  treatment.
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  Those providing psychotherapy in person failed to document treatment time more
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  often than those providing telehealth. However, for telehealth,
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  psychotherapy providers, treatment plans were more often missing or incomplete.
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  HHS OIG recommends that CMS implement system edits for psychotherapy
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  to prevent payments for incorrectly billed services.
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  Thanks for listening.
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  Subscribe to the Becker Behavioral Health Report newsletter on our website,
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