Essential Benefit Determinations

Throughout the United States, Behavioral Health Care is carved out of the mainstream medical health care system in terms of delivery of care, providers, and reimbursement. For nearly 30 years, Clark Hill’s Behavioral Health Care lawyers have been involved in the psychiatric rehabilitation evolution together with the legal implications of managed behavioral health care. Clark Hill has assembled an experienced, dedicated team of lawyers, paralegals, psychiatrists, nurses, and claims assessment specialists devoted to serving behavioral health care recipients, providers, and managed care companies. One of Clark Hill’s Behavioral Health Care lawyers and a consulting psychiatrist recently published an article regarding cutting edge issues involving the “Collision of the Behavioral Health Recovery Model with the American Legal System.”

"No right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his/her own person, free from all restraint or interference of others, unless by clear and unquestioned authority of law.”

- United States Supreme Court

Intangibles

Our clients have the luxury of choosing from many accomplished law firms that deliver high quality and cost effective legal services. What distinguishes Clark Hill’s Behavioral Health Care Team, however, are intangible factors – factors that benefit our clients. For example, the Clark Hill lawyers enjoy their work. The lawyers enjoy the challenge of meeting and exceeding an unbalanced burden of proof in representation of the behavioral health care clients. In civil litigation, the recognized burden of proof is a “preponderance of the evidence” (more than 50%). However, due to negative stigma and hindsight bias to be successful in civil litigation, the burden of proof, in reality, is “clear and convincing.” These challenges, generated through the behavioral health delivery system, create excitement, and trigger the talents and creativity of the Clark Hill’s Behavioral Health Care team.

The ultimate goal of each member of the Behavioral Health Care Team is to become more than just a lawyer for our clients. Our goal is to become a trusted counselor and advisor for all aspects of our clients’ work.

Hands On Experience Translates Into Expertise

Clark Hill’s Behavioral Health Care Team represents behavioral health care providers in numerous states related to procurement, administrative law, contract disputes, licensing, claims disputes, Medicaid reimbursement matters, government regulatory compliance, malpractice defense, Centers for Medicare and Medicaid Services (“CMS”) sanctions, fraud and abuse, qui tam actions, healthcare financing, creation and operation of managed care organizations, labor and employment law services and corporate compliance program development, education and maintenance. The lawyers at Clark Hill are familiar with government managed care contracts and the issues affecting all providers generated through ongoing governmental regulation.

Clark Hill’s Behavioral Health Care Team participates in the policy development groups that focus on creating methodologies to integrate the delivery of medical and behavioral health care. At Clark Hill you will find that the Behavioral Health Care lawyers supply value added services to clients because their experience in the Behavioral Health Care arena has been hands on.