In 2024, behavioral health providers faced scrutiny from lawmakers, states planned big investments in behavioral care and agencies announced new payment policies and regulations in the industry.
Here are the 10 biggest behavioral health developments in 2024:
- UnitedHealthcare's policies for autism treatment and mental healthcare were the subject of two ProPublic investigations in 2024. A December report alleged the nation's largest insurer is "strategically limiting" access to applied behavior analysis for children with autism.
A spokesperson for Optum, UnitedHealth Group's health services arm, told Becker's the article "grossly misrepresents our efforts to ensure the people we serve are getting the most effective, evidence-based care for their needs."
A previous ProPublica investigation found the company uses an algorithm that has been subject to legal scrutiny to manage behavioral health costs. - In November, President-elect Donald Trump nominated Secretary Robert F. Kennedy Jr. to lead HHS. Mr. Kennedy has been outspoken about providing more resources to substance use treatment, but is critical of medication treatments for mental health conditions. If confirmed, Mr. Kennedy will oversee the agency's 13 divisions, including the Substance Abuse and Mental Health Services Administration.
- CMS will add Medicare reimbursement for additional behavioral health services in 2025, including FDA-approved digital therapies for mental health and allowing providers to bill for creating patient safety interventions.
- Acadia Healthcare has seen its patient volumes dip as a result of media scrutiny, CFO Heather Dixon told investors in November. The Franklin, Tenn.-based company has been the subject of multiple New York Times investigations in 2024, including a piece alleging Acadia detained patients beyond medical necessity and blocked patients from leaving.
After the Times investigation was published, Acadia disclosed that it was being investigated by Justice Department offices in Missouri and New York related to its admissions, length-of-stay and billing practices.
The company is also being investigated by the Department of Veterans Affairs for possible fraud, according to the Times. - King of Prussia, Pa.-based Universal Health Services expects its operations and capital resources to be "materially adversely impacted" by multimillion dollar verdicts against the company. In October, a jury found Cumberland Hospital for Children and Adolescents, a UHS subsidiary, liable in alleged inappropriate sexual contact at the facility. A judge awarded a total of $360 million in damages in the case.
Separately, in March, a jury ruled that negligence on the part of Champaign, Ill.-based Pavilion Behavioral Health Services, a UHS subsidiary, was the proximate cause of the rape of a 13-year-old patient by another patient. The jury awarded $60 million in compensatory damages to the plaintiff, the victim's mother, and $475 million in punitive damages. A judge later reduced the settlement award by $355 million. - In September, the Biden administration finalized rules requiring insurers to cover mental healthcare at the same level as other health services. The White House said the rules are intended to strengthen the 2008 Mental Health Parity and Addiction Equity Act, and will bar health plans from using more restrictive prior authorization requirements for mental health than for other forms of care and require plans to study the outcomes of their mental health policies.
- The Joint Commission updated its accreditation manual for behavioral health and human services providers to include an updated definition of "restraint," among other changes.
- Three Retreat Behavioral Health inpatient facilities in New Haven, Conn., Ephrata, Pa., and Palm Beach, Fla., abruptly closed in June, following the death of the company's CEO and COO by suicide. The closures left 750 employees at the organization without pay for the time they worked.
- Texas is investing $1.5 billion in seven new behavioral health projects. The initiatives include the construction of two new psychiatric hospitals, replacement of existing hospitals and the expansion of three other behavioral health facilities in the state.
- Children are frequently harmed in residential treatment facilities, a report from the Senate Finance Committee alleged. The report, published in June, was the result of investigations the committee opened into behavioral residential facilities operated by four providers — UHS, Acadia, Devereux Advanced Behavioral Health and Vivant Behavioral Healthcare.
Lawmakers have called for further investigation into youth residential treatment facilities.