OIG increases oversight for Medicaid mental health

The Deficit Reduction Act of 2005 (DRA) brought significant changes to reimbursement for medical care and increased scrutiny of healthcare compliance. Included with these changes are new Medicaid rules that mental health professionals must follow.

Not all the changes proposed in the DRA are currently in effect. The rehabilitation requirements presently under legislative moratorium are scheduled to take effect June 30.

The potential cost of failing to comply is huge compared to the penalties of the past. Previously, if CMS detected a billing error, the cost was normally limited to the amount of the error—this is no longer the case, says Terry Haru, chief compliance officer at Heritage Behavioral Health Center in Decatur, IL.