Garfunkel Wild's Applied Behavioral Analysis and Medical and Education Services (BAMES) Practice Group is constantly evolving due to an extensive and ever-changing regulatory landscape, increasing demand for services, evolving care coordination and delivery elements, legislative mandates regarding reimbursement and licensure, and health plan enrollment, reimbursement and denial issues.
The BAMES team consists of subject-matter experts who understand the market, the continuum of care, and the complex regulatory and reimbursement environment. Uniquely positioned as a name known throughout the health care sector for excellence, Garfunkel Wild can work with your management team to achieve efficient business solutions and implement cohesive, comprehensive, and compliant delivery models.
The BAMES team works with client providers who offer a continuum of services that span a full array of coordinated program options for infants, toddlers, youth, teens, adults and seniors, including:
Applied Behavior Analysis and Care Management Services
Early Intervention/Special Education Programs
Developmental Disability Centers and Hospitals
Specialized Schools
Mental Health and Substance Abuse Clinics
Housing and Group Homes
Social, Recreational and Therapeutic Services
Federal and State Educational Support and Programs
Home and Community Based Waiver Services
Children's Camps
The BAMES team often collaborates with other Garfunkel Wild Practice Groups to work with all types of healthcare providers, private equity funds, and industry investors to facilitate M&A transactions, real estate development and transactions, and public finance work related to the BAMES sector, and routinely:
Assists providers and their investors to establish and build delivery models from the ground up.
Helps clients respond to government and payor audits, investigations and compliance matters.
Assists with all types of credentialing and reimbursement issues.
Assists with licensure applications with state Department of Health agencies, Medicare, and Medicaid.
Negotiates all of types agreements and arrangements, including acquisition agreements, operating or shareholders’ agreements, equity issuance documents, and employment agreements that are necessary to take our clients’ programs from concept to implementation and beyond.
Garfunkel’s Compliance Webinar Series rolls on with an examination of the 2024 Work Plan published by the New York State Office of Medicaid Inspector General (OMIG).
On Tuesday, April 23, 2024, the Federal Trade Commission (FTC) promulgated a final rule banning most non-compete agreements, in any industry, and is set to become effective 120 days after its publication in the Federal Register (the “Final Rule”).
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
The New York State Office of the Medicaid Inspector General (OMIG) released its 2024 work plan in furtherance of its mission to coordinate and conduct activities to prevent, detect and investigate medical assistance program fraud, waste and abuse, and to recover improperly expended Medicaid funds.
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
This week, the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) fulfilled its annual statutory obligation by releasing its jointly-authored Health Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal Year 2022.
The OIG fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. Providers should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
The Board proposed new regulations regarding the practice of ABA therapy in New Jersey, including, for example, licensing standards for applied behavior analysts and assistant applied behavior analysts, reciprocity requirements, scope of services, business practices, and telehealth requirements.
Garfunkel Wild’s Debra Silverman and John Martin will present the webinar “Federal No Surprises Act – One month in. What have we learned? What questions remain?" on February 1, 2022, from 12:00 pm – 1:00 pm (EST).
Garfunkel Wild Partner Terence Russo will present at Behavioral Health News Webinar “This Will Only Hurt a Little – Stoicism in the Face of EHR Implementations” on October 13, 2021 from 1:00 pm – 2:00 pm EDT.
On January 13, 2020, Governor Phil Murphy signed the “Applied Behavior Analyst Licensing Act” (the “Act“) into law, which becomes effective on July 11, 2020. The Act creates the State Board of Applied Behavior Analysts (the “Board“) within the New Jersey Department of Law and Public Safety, Division of Consumer Affairs.
On November 8, 2019, the New York State Legislature passed an amendment positively impacting the reimbursement made by Medicaid managed care plans and managed long-term care plans to behavioral health providers.
