by Ethan Webb | May 12, 2026 | Regulation
Key Takeaways Fraud prosecutions are reshaping the policy environment: Federal information charges against Smart Therapy LLC and Star Autism Center LLC, both filed in the past year, allege a combined $20+ million in fraudulent EIDBI billing through cash kickbacks to...
by Ethan Webb | May 11, 2026 | Regulation
Key Takeaways Carelon replaced Optum as the Behavioral Health Administrative Services Organization on January 1, 2025: The transition consolidates ABA prior authorization and claims administration under a single carve-out vendor across HealthChoice and fee-for-service...
by Ethan Webb | May 4, 2026 | Regulation
Key Takeaways ABA rates went up April 1, 2026. Kentucky’s revised behavioral health fee schedule raised every ABA code by roughly 8 percent, with 97153 moving from the prior rate of $11.25 to $12.18 per 15 minutes for RBT-delivered services in Column 6. Access...
