Behavioral Health Care

Stites & Harbison's Behavioral Health Care Industry Group has highly-specialized experience advising clients on legal issues affecting healthcare providers in the behavioral health and addiction medicine field, including:

Certificate of Need, Service/Facility Licensing, Accreditation, and Certification

• Certificates of Need applications and hearings, including, but not limited to, Hospitals, Psychiatric Residential Treatment Facilities and Psychiatric Hospital Beds, Intermediate Care Facilities for Individuals with Intellectual Disabilities, and Chemical Dependency Treatment Centers
• Licensing of healthcare services and facilities, including, but not limited to, Behavioral Health Services Organizations, Alcohol and Other Drug Treatment Entities, Ambulatory Infusion Agencies, Personal Care Homes, Adult Day Health Centers, Community Mental Health Centers, and Residential Crisis Stabilization Units
• Policies and procedures for operation of behavioral health and addiction medicine clinics and facilities
• Certification standards and process for Medicaid Waiver Providers
• Clinical Laboratory Improvement Amendments (CLIA) certification for screening and reference laboratories
• Accreditation of behavioral health clinics and facilities

Reimbursement

• Medicare, Medicaid, and commercial payor enrollment and credentialing
• Government and commercial payor appeals, internal and external dispute resolution proceedings, overpayment allegations, and administrative hearings
• Compliance with commercial and government payor reimbursement and utilization guidelines
• Client self-pay policies and guidance

Corporate Mergers and Acquisitions

• Mergers and acquisitions involving behavioral health and addiction medicine providers, including structuring deals, drafting transaction documents, managing and implementing due diligence, and navigating compliance and change of ownership issues

Federal Compliance

• Compliance with federal reimbursement and referral statutes, including the Federal Anti-Kickback Statute, the Stark Law, the Federal Beneficiary Inducement Statute, and the Eliminating Kickbacks in Recovery Act (EKRA)
• Compliance with and implications of the Mental Health Parity and Addiction Equity Act
• Emergency Medical Treatment and Labor Act (EMTALA) and the psychiatric patient
• Federal investigations

Privacy and Security

• Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Compliance
• 42 CFR Part 2 Compliance
• Breach response

Professional Licensure

• Compliance with licensure, scope of practice, and supervision requirements for mental health professionals
• Professional Board licensure hearings

Patient Treatment Issues

• Informed consent issues
• Tele-behavioral health issues
• KRS 202A and 202B hearings
• Admission and discharge policies

Stites & Harbison attorneys are frequent thought leaders, speakers, and writers on behavioral health care topics and issues. The Group has immeasurable experience when it comes to healthcare legal matters and is routinely ranked by the American Bar Association’s Health Law Section as a top Regional Health Care Law Firm in the South Region. The Group’s members are involved in the American Bar Association Health Law Division, the American Health Lawyers Association, Kentucky Medical Association, the Kentucky Academy of Hospital Attorneys, Medical News, and the International Association of Privacy Professionals.