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Articles by Legal Department Staff

The Legal Department articles are not intended to serve as legal advice and are offered for educational purposes only. The information provided should not be used as a substitute for independent legal advice and it is not intended to address every situation that could potentially arise. Please be aware that laws, regulations and technical standards change over time. As a result, it is important to verify and update any reference or information that is provided in the article.

 

This article will explain what an association health plan (AHP) is and why legal constraints prevent CAMFT from establishing one for its members.

Regarding the Release of the DSM 5 TR

This article discusses a variety of issues that therapists commonly encounter involving fees, payments and insurance. The article points out key legal and ethical issues which are relevant to fee setting, reduced fee agreements, collecting copayments, billing insurance, and other topics, and offers suggestions to clinicians which are intended to avoid problems in such areas.

This final installment of the three-part series called Practice Guidelines for School-Based Psychotherapists discusses scenarios psychotherapists who are working in schools frequently encounter and ideas about how to address those issues based on the application of FERPA, HIPAA, CA laws and/or ethical codes.

Members often ask this question or ask for a resource to guide them in understanding what is insurance fraud and what is not insurance fraud.  The information you need is in this article.

Health plans and health insurers have been required to publish and maintain online and printed provider directories with information about providers who offer services to enrollees or insureds. Providers and provider groups who are contracted with plans and insurers to offer behavioral health services must be aware of, and responsive to, plans and insurers attempts to verify their information in accordance with California’s provider directory laws.

This article will give providers the information they need to assist consumers as well as themselves with pursuing complaints against health plans.

Insurance Update: Summary of Department of Managed Health Care's Consumer Provider Plan Agency Meeting.

The subset of ICD-10 codes, which concern mental health disorders, are used in billing procedures to indicate the mental health diagnosis of a patient.

Insurance Updates