decisionhealth Newsletters, Part B News - 2024 Issue 4 (April)
Lack of behavioral health providers in Medicare and Medicaid impedes enrollees’ access to care
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Article Overview
This article summarizes an OIG review of behavioral health provider participation in Medicare and Medicaid and the effect on enrollee access to outpatient behavioral health services. It is relevant to providers, compliance staff, and health care organizations that follow CMS oversight, network adequacy, and access-to-care issues. The piece also notes the OIG’s recommendations to CMS and CMS’s response.
Why This Topic Matters
The report addresses access-to-care challenges in behavioral health, an area of ongoing interest for Medicare and Medicaid stakeholders. Understanding the findings can help readers track federal oversight priorities and policy directions related to provider participation and beneficiary access.
What You Will Learn
- What the OIG reviewed and why the review was conducted
- How provider participation differed across the selected counties
- What the report says about enrollee access to behavioral health services
- Which policy and oversight areas the OIG recommended CMS address
- How CMS responded to the OIG recommendations
Who Should Read This
- Behavioral health providers
- Medicare and Medicaid compliance staff
- Health system administrators
- Payers and managed care organizations
- Policy analysts
- Coding and reimbursement professionals
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