Behavioral Health Changes Nationwide

What changed. OHA filed temporary order BHS 25-2026 on October 23, 2026, amending OAR 309-035-0170 effective October 23 through November 25, 2026 and suspending the temporary version adopted under BHS 13-2026. OHA says the change adds a reason licensed residential treatment facilities and residential treatment homes may issue less than 30 days' notice of move: a resident whose behaviors seriously threaten the health or safety of others. The rule text requires at least 24 hours' advance written notice, prior approval from the Division and notice of the resident's right to an administrative hearing.

What it means. If you operate a mental health residential treatment facility or home, update your transfer and discharge policy and staff guidance to match the amended OAR 309-035-0170, including the 24 hour minimum, prior Division approval and hearing rights language. Calendar November 25, 2026, when this temporary rule ends, and watch for the permanent 309-035 rule that OHA's filing ties to its fall 2026 public comment.

What changed. An October 16, 2026 OHA memo tells CCOs to report Tier 2 care coordination data on Healthier Oregon members moving to OHP Open Card on January 1, 2027, due November 6 and December 8, 2026 and January 7, 2027, and to hold warm handoff meetings with Acentra Health. Priority populations CCOs must identify include members approved for or receiving mental health or SUD residential services, mental health crisis intervention, IIBHT or MST, EASA and Assertive Community Treatment.

What it means. If you treat Healthier Oregon members in residential, crisis, IIBHT, MST, EASA or ACT services, confirm with each CCO that it has your current care plans and contacts before its November 6 report. Plan for these members' care coordination to move from the CCO to Acentra Health under OHP Open Card on January 1, 2027.

What changed. Clackamas County RFP 2026-76 seeks a contractor to provide school-based Screening, Brief Intervention, and Referral to Treatment and family navigation services for youth in up to three middle and high schools, as directed by the Clackamas County Juvenile Department, including Gladstone High School and Gladstone Middle School. The county lists an estimated project total of $970,000 and a contract term through June 30, 2029. Proposals close November 12, 2026, at 2:00 PM Pacific, and clarifying questions were due October 29.

What it means. If you run a youth outpatient or SUD program in the Clackamas County area, read the RFP on OregonBuys and plan to submit by 2:00 PM Pacific on November 12, with a not-to-exceed price, because price is a scoring factor. Check the insurance terms before you bid, since the RFP requires professional liability and an abuse and molestation endorsement of at least $1,000,000 per occurrence.

What changed. Arkansas DHS issued notice dated October 2, 2026 of a state plan amendment creating a Behavioral Health Services and Support eligibility category under 42 CFR 435.219 for people aged nineteen and over who meet its income and resource rules and are eligible for the state's 1915(i) home and community-based services, with coverage delivered through the PASSE. Family Centered Treatment would be added as a new PASSE service, and the Adult Behavioral Health Services for Community Independence portion of the 1915(i) plan would be repealed, with a transition period anticipated from January 1, 2027 to on or about March 1, 2027, or later as CMS determines. The proposed effective date is January 1, 2027, and written comments are due November 2, 2026.

What it means. If you deliver ABHSCI or other 1915(i) behavioral health services, read the proposed amendment and send comments to ORP@dhs.arkansas.gov by November 2, 2026. Plan for the January 1, 2027 start and the ABHSCI transition, including PASSE contracting for adults who move into the new category and whether you will offer Family Centered Treatment.

What changed. Arkansas DHS issued notice dated October 2, 2026 of a five-year renewal of the Provider-Led Arkansas Shared Savings Entity (PASSE) 1915(b) waiver, with a projected effective date of January 1, 2027 if approved. The renewal adds Family Centered Treatment as a PASSE service, adds the 219 Group eligibility category so adults with serious mental illness who need higher-level community mental health services can enroll in a PASSE, and adds vision services to the PASSE excluded services under Act 142 of 2025. DHS lists a fiscal impact of $118,500,000 for State Fiscal Year 2027 and takes written comments through November 2, 2026.

What it means. If you contract with a PASSE or treat adults with serious mental illness, review the renewal and send comments to ORP@dhs.arkansas.gov by November 2, 2026. Program leads should weigh whether to add Family Centered Treatment and confirm PASSE contracts and authorization rules ahead of the January 1, 2027 projected start.

What changed. DBH published a proposed rule in the October 9, 2026 DC Register that sets one Community Support limit of 100 units per 180-day authorization period, plus 50 supplemental units, for consumers scoring 3.1 to 5.0 on the DLA-20 or 50 to 110 on the CAFAS/PECFAS, replacing the current 200-unit tier. Supplemental units would require two documented clinical services in the prior 90 days, a decline in two or more functional areas, and a significant event such as a hospitalization or loss of housing in the prior 30 days. Written comments are due within 30 days of publication to dbh.policy@dc.gov.

What it means. If you bill Mental Health Rehabilitation Services Community Support in DC, pull your consumers above 100 units per period and plan for clinical services and documentation that would meet the new supplemental criteria. Send comments to DBH within 30 days of the October 9 publication, and calendar the final rule, which DBH says can follow in not less than 30 days.

What changed. DBH announced FY27 Place-Based Outreach and Behavioral Health Engagement funding for outreach, overdose prevention, warm handoffs and linkage to treatment in designated high-need catchment areas. Up to three awards of up to $250,000 each are expected, eligibility is limited to DC 501(c)(3) community-based organizations, and applications are due November 6, 2026 at 12:00 PM ET.

What it means. If you are a DC nonprofit doing street or community outreach, get the RFA from DBH and confirm your UEI, tax ID and SAM registration now. The window is short because DBH says it accelerated the competition, so plan to submit before noon on November 6.

What changed. DMHA final rule LSA Document #25-797, filed October 1, 2026 and posted October 28, takes effect 30 days after filing and amends 440 IAC 10 for opioid treatment programs. It lets an existing OTP open up to two medication units, located within 100 miles of the OTP and outside a 25-mile radius of any other OTP or medication unit, and mobile medication units operating within 150 miles, each with DMHA, DEA, SAMHSA and Board of Pharmacy approval. It also requires each program physician to be physically present at least 10 hours per week and lets an OTP close on Sundays and federal holidays.

What it means. Indiana OTPs should update staffing schedules, holiday coverage and take-home policies against the amended 440 IAC 10 sections. If you plan a medication unit or van, check the siting limits and line up DMHA certification, a separate DEA registration and Form SMA-162 before opening.

What changed. NC Medicaid said on October 23, 2026 that the Community/Behavioral Health taxonomy 251S00000X requires an active Service Type and Service, and that providers without one had until October 1, 2026 to add one to their NCTracks record. Organizations without an active Service or a submitted and pending MCR or reverification application by October 30, 2026 will have the taxonomy end-dated effective November 2, 2026. If it is the only active taxonomy for a service location, the location terminates, and if that is the only service location, the enrollment record terminates; the bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.

What it means. If you are enrolled with NC Medicaid under taxonomy 251S00000X, open your NCTracks record now and confirm at least one active Service Type and Service, or submit an MCR or reverification application by October 30, 2026. Check every service location, because a location whose only active taxonomy is 251S00000X terminates on November 2, and a record left with no service location terminates too.

What changed. A Department of Health notice in the October 28, 2026 State Register proposes a Medicaid State Plan amendment, effective on or after November 1, 2026, that raises Part 820 OASAS residential services fees by 10.0% for stabilization, 8.0% for rehabilitation and 8.0% for reintegration. It also proposes a 6.38% increase to the Part 822 Ambulatory Patient Group conversion factor for community-based providers in the Upstate region and a 1.00% increase for the Downstate region. The estimated net increase in gross Medicaid spending is $1,584,938 for state fiscal year 2026-2027 and $3,803,853 for 2027-2028.

What it means. If you run an OASAS Part 820 residential or Part 822 outpatient program, check that Medicaid payments for services on or after November 1, 2026 reflect the new fees and the conversion factor for your region. Send questions or comments to spa_inquiries@health.ny.gov and watch the Department of Health state plan status page for the amendment text.

What changed. The Oklahoma Health Care Authority circulated proposed changes on October 1, 2026 to OAC 317:30-5-95.34, active treatment for children, to clarify discharge and transition planning for children receiving inpatient psychiatric care, including collaboration with outside practitioners and agencies and the documentation required. The draft says the discharge plan must address follow-up and aftercare, including referrals for medication management, outpatient behavioral health counseling and case management, and must include specific appointment information when available and a summary of the member's condition at discharge. Comments and the public hearing are both set for November 2, 2026, the OHCA Board date is December 10, 2026 and the proposed effective date is September 1, 2027.

What it means. If you run an Acute, Acute II or PRTF program serving SoonerCare youth, compare your discharge planning documentation with the draft and send comments through OHCA's comment box or to federal.authorities@okhca.org by November 2. Calendar September 1, 2027 to have updated discharge plan templates and outpatient appointment workflows in place.

What changed. SCDHHS bulletin MB# 26-041 (October 6, 2026) says the Clinic Services Manual will be updated for dates of service on or after December 1, 2026 to clarify service definitions, clinical criteria and billing guidelines, including additional information for opioid treatment programs. A draft manual is posted for review, and feedback is due by email to MedicaidStatePlan@scdhhs.gov by November 2, 2026. SCDHHS will hold webinars on the changes on November 12 and December 8, 2026.

What it means. If you run an opioid treatment program that bills South Carolina Medicaid, read the OTP sections of the draft Clinic Services Manual and send feedback by November 2. Plan for the updated manual to govern OTP claims for dates of service on or after December 1, 2026, and confirm with each MCO how it will apply the changes for its members.

What changed. South Dakota Medicaid State Plan Amendment 26-0012 adds marriage and family therapists working toward a mental health designation to the list of other licensed practitioner services allowed to provide and bill for mental health services. The SPA also makes minor edits to the PASRR Categorical Determinations page at the request of CMS. The listed effective date is October 15, 2026, and the public comment period runs October 5 to November 4, 2026.

What it means. If you employ marriage and family therapists who are working toward a mental health designation, review SPA 26-0012 on the DSS Medicaid State Plan page and comment by November 4. Hold off on billing for these practitioners until DSS confirms CMS approval and any enrollment steps.

What changed. Regulations directed by Item 292 QQ of the 2025 Appropriations Act take effect November 5, 2026 and make the Appeals Information Management System (AIMS) the only way DMAS accepts and processes provider appeals unless a good cause exception is requested and granted, and Chapter II of all provider manuals is revised with the same effective date. DMAS will keep accepting appeals by mail, delivery, email and fax through the end of 2026, but items sent those ways and received on or after January 1, 2027 will not be processed without a granted good cause request. Exception requests must be sent before the appeal deadline by mail or to appeals@dmas.virginia.gov with the subject "Exception Request for Portal Filing."

What it means. Register every staff member and contractor who files Virginia Medicaid appeals for an AIMS account now, because DMAS must verify each person's affiliation before access is approved. Update your appeal procedures so that anything reaching DMAS on or after January 1, 2027 goes through AIMS unless you hold a granted exception.

What changed. Global Commitment Register proposal GCR 26-098 (September 30, 2026) sets final state fiscal year 2027 daily rates for Department of Mental Health residential programs, Intensive Residential Recovery programs and crisis beds, built from fiscal year 2025 expenditures with expected occupancy of 80% for crisis and IRR programs and 90% for residential programs. The rates apply retroactively to July 1, 2026, with a reconciliation against the temporary rates set in GCR 26-073, while Washington County Mental Health Services rates take effect October 1, 2026, when it joined the CCBHC demonstration under GCR 26-100. Comments are open through October 30, 2026.

What it means. If you operate a DMH residential, IRR or crisis bed program, find your program's rate in the GCR 26-098 chart and prepare for the reconciliation against payments made under the GCR 26-073 temporary rates. Send any comments to AHS.MedicaidPolicy@vermont.gov by October 30, 2026.

What changed. AB 1598 was approved by the Governor on September 27, 2026 and chaptered as Chapter 528, Statutes of 2026. Associate marriage and family therapist, associate clinical social worker and associate professional clinical counselor registrations may be renewed up to six times and for no more than seven years from the last day of the month of issuance, and an associate applying for or holding a subsequent registration number may request a one-time, two-year hardship extension, granted by the Board of Behavioral Sciences for good cause, to be employed or volunteer at one private practice or professional corporation. Applicants, registrants and trainees must give each client the name of their employer or volunteer entity along with the existing disclosure that they are unlicensed and under supervision, and licensure applicants must obtain their experience and pass their examinations within seven years before the board receives the application.

What it means. California group practices and agencies that employ BBS associates should add the employer or volunteer entity name to client disclosure scripts and intake forms, and recheck each associate's registration expiration under the new six renewal, seven year limit. A practice keeping an associate on a subsequent registration number should file the hardship extension application jointly signed by the associate, supervisor and, where required, an employer representative, because work cannot begin or continue until the board approves it.

What changed. SB 874 was approved by the Governor on September 27, 2026 and chaptered as Chapter 655, Statutes of 2026, adding Welfare and Institutions Code Section 14132.561. By July 1, 2027, DHCS must ensure that every entity enrolled as a Medi-Cal provider of behavioral health treatment (BHT) services conducts, or has a third party conduct, a state and national criminal background check on its employees who interact with patients, and providers must keep documentation of compliance available to DHCS on request or in a state or federal audit. DHCS must also use existing stakeholder forums to seek feedback on BHT coverage and billing policy, including applied behavior analysis, treatment plan hours, center-based services and supervision of unlicensed and uncertified staff, and publish BHT utilization data and a coverage policy synopsis on or before January 1, 2029.

What it means. California ABA and other BHT providers enrolled in Medi-Cal should confirm that every patient-facing employee has a state and national criminal background check on file and that the records can be produced in an audit. Follow the DHCS stakeholder forums on treatment plan hours, center-based billing and supervision, and comment before the coverage and billing policy changes.

What changed. AB 1556 was approved by the Governor on September 29, 2026 and chaptered as Chapter 779, Statutes of 2026, adding Health and Safety Code Sections 11999.45 and 11999.50. To be eligible for state funding, a recovery housing program must meet the core components of Housing First, may not treat relapse as grounds for eviction unless there is another lease violation, must support residents' access to prescribed medications including buprenorphine, methadone and naltrexone, must provide emergency preparedness and overdose prevention and response training and keep overdose reversal medication onsite, and must adopt a written return-to-use policy approved by a National Alliance for Recovery Residences affiliate or a similar entity. Applicants for state homelessness funding for recovery housing must also show that a range of interventions, including harm-reduction-focused permanent housing, is available in the jurisdiction.

What it means. California recovery residences that receive or plan to seek state homelessness funding should review house rules, leases and medication policies against the 12 eligibility conditions and get a written return-to-use policy approved by a NARR affiliate or similar entity. Keep overdose reversal medication readily accessible onsite and document staff and resident training before your next funding application.

What changed. AB 2233 was approved by the Governor on September 27, 2026 and chaptered as Chapter 591, Statutes of 2026, amending Health and Safety Code Section 1374.73 and Insurance Code Section 10144.51. A health care service plan or health insurer may not restrict the use of authorized behavioral health treatment hours for pervasive developmental disorder or autism within the six-month authorization period, including weekly caps or limits that cause unused hours to be forfeited, when the use is reasonably consistent with the treatment plan and clinical guidelines and is documented in the treatment plan and progress reports.

What it means. California ABA providers billing commercial plans and insurers should review authorization letters and payer contracts for weekly hour caps or terms that forfeit unused hours, and raise them with the plan. Record any shift of authorized hours between weeks in the treatment plan and progress reports, because that documentation is the condition for the protection.

What changed. On October 22, 2026, as part of a Los Angeles health care fraud takedown, the Justice Department announced charges against Nathan Young, David Young, Honey Phipps and Cody Phipps in United States v. Young, et al., alleging they used body brokers to bring patients to Southern California for sham substance abuse treatment billed to private insurers for over $1.6 billion. The indictment alleges free flights, money, apartments, hotel stays and drugs as inducements, recycling patients through the facilities regardless of medical necessity, coaching patients to fabricate symptoms to qualify for detox, and billing Zoom sessions with more than one hundred attendees as therapy; charges include health care fraud, wire fraud and violations of the Eliminating Kickbacks in Recovery Act (EKRA). Nicholas Moore, an area manager for several of the facilities, pleaded guilty to conspiracy to commit health care fraud and wire fraud and admitted helping submit $199 million in fraudulent claims.

What it means. Review every referral source, marketing contract and patient benefit (travel, housing, gift cards) against EKRA and your state's patient brokering rules, and document medical necessity for each detox admission and readmission. Check that billed group therapy reflects real attendance and active participation, because the indictment alleges Zoom sessions with more than one hundred attendees, who only had to turn on their cameras, were billed to insurers as therapy.

What changed. BHA's laws and rules page lists the First Read of its Commissioner Rules, 2 CCR 502-5, on October 27, 2026 and the Second Read on November 3, 2026 at 10:00 a.m., with in-person and virtual options, and says the community feedback period is closed. BHA's rulemaking packet sets a proposed effective date of December 1, 2026 and would establish a statewide behavioral health safety net continuum, including crisis care, outpatient, residential and recovery supports, that prioritizes low-income, uninsured and other vulnerable populations. The packet also removes Section 20.100 on gambling addiction grant procedures and drops the time and distance network adequacy standards from the earlier draft.

What it means. If you are a safety net provider, a BHASO or a program that serves BHA priority populations, read the proposed redline on BHA's laws and rules page and join the November 3 Second Read, in person or online, to follow the rules before adoption. Calendar December 1, 2026, the proposed effective date, and check your safety net service definitions, care coordination and reporting against the adopted text.

What changed. Connecticut DSS posted a notice of intent on October 13, 2026 to amend sections 17b-262-522 to 17b-262-533 so that all providers rendering services to clients of the Connecticut Medical Assistance Program, including Medicaid, waiver programs and CHIP, are enrolled by signing a provider enrollment agreement, as 42 CFR 455.410 requires. The proposal also adds electronic visit verification for certain providers and requires all claims to be filed electronically. The notice says DSS will implement and operate under the proposed policies effective November 16, 2026 while it adopts them, and comments are due November 16, 2026.

What it means. If your clinicians render HUSKY services under a group or facility billing number without their own enrollment, check which staff would need a signed enrollment agreement and start that paperwork. Send any comments through the eRegulations System or to the DSS contact named in the notice by November 16, 2026.

What changed. Idaho DHW is taking applications for one FY 2026 to 2027 Projects for Assistance in Transition from Homelessness subgrant of up to $195,000 per year to deliver outreach, engagement, case management and referral services to adults with serious mental illness, or co-occurring serious mental illness and substance use disorder, who are homeless or at imminent risk, in any Idaho county except Kootenai. Applicants must be nonprofits in good standing with the Idaho Secretary of State with a UEI and EIN. Applications are due by email by 5:00 PM Mountain Time on November 16, 2026, with awards expected December 7 and a January 1, 2027 start.

What it means. If you are an Idaho nonprofit serving adults with serious mental illness outside Kootenai County, confirm your UEI, EIN and Secretary of State standing and pick the counties you would serve before the November 16 deadline. Budget for a PATH program manager of 0.5 to 1.0 FTE and note that priority goes to veterans, people who are chronically homeless and people leaving state psychiatric hospitals.

What changed. The Ohio Department of Behavioral Health has filed new rule O.A.C. 5122-29-32, which creates a certifiable adult crisis service with three levels of care, Behavioral Health Urgent Care, Crisis Receiving and Observation, and Crisis Stabilization, and lets a provider implement one, two or all three. The rule was revised after earlier comment periods, cleared the Common Sense Initiative Office and was filed with JCARR. A public hearing is set for November 16, 2026 at 10:00 a.m. in the Lobby Hearing Room of the Rhodes State Office Tower, 30 East Broad Street, Columbus, and written testimony may be emailed to crisisrules@dbh.ohio.gov.

What it means. If you run or plan an urgent care, crisis receiving or crisis stabilization program in Ohio, read the filed rule and decide which of the three levels you would seek certification for. Send written testimony to crisisrules@dbh.ohio.gov by the November 16 hearing, and email ahead if you plan to testify in person.

What changed. OHA filed a notice on October 28, 2026 proposing Medicaid Work or Activity Rules under section 71119 of the One Big Beautiful Bill Act for the MAGI Adult Program, the Healthier Oregon Adult Group and Young Adults with Special Health Care Needs, starting with new applications on or after January 1, 2027 and for existing members with renewal dates of March 31, 2027. Proposed new OAR 410-200-0221 excludes people participating in a drug addiction or alcohol treatment and rehabilitation program, people with a substance use disorder not in sustained recovery (defined as at least five years) and people with a disabling mental disorder. A hearing is set for November 19, 2026 and comments are due November 21, 2026 at 5 p.m.

What it means. If you serve OHP adult members, plan how your intake and case management staff will help clients attest to SUD treatment participation or a qualifying condition, since OHA proposes to check state data first, including 12 months of claims and encounter data for the health condition exclusion, and to ask for more documentation in some cases starting January 1, 2028. Send comments by November 21, 2026 if the exclusions or verification steps would leave your clients at risk of losing coverage.

What changed. OHA filed a notice on October 27, 2026 proposing to amend OAR 410-120-1380, under which submitting an OHP claim counts as the provider's representation of compliance with listed laws, to add ORS chapter 659A and SB 729 (2025). OHA says SB 729 prohibits providers from denying any individual access to mental health assessment, treatment or services on the basis that the individual has an intellectual or developmental disability. A hearing is set for November 17, 2026 and comments are due November 21, 2026 at 5 p.m.

What it means. Review your mental health admission and exclusion criteria and intake scripts for any screen-out based on an intellectual or developmental disability, since each OHP claim would represent compliance with SB 729. Send comments to OHA by November 21, 2026 if the wording needs clarification for your services.

What changed. CareOregon posted on October 22, 2026 that a new 'ABA Assessment' service type, effective August 7, 2026, sits in the Connect portal Behavioral Health Template for CareOregon/Health Share, Jackson Care Connect and Columbia Pacific CCO members, separate from the 'ABA Applied Behavioral Analysis' treatment type. Assessment requests use CPT 97151 and 97152; approved assessment requests are valid for 365 days, while treatment authorizations are typically approved for no more than six months.

What it means. If you provide ABA to these CCO members, submit the initial or returning patient assessment under 'ABA Assessment' and ongoing care under the treatment type in Connect, using fax only if you cannot reach the portal. Track the 365 day assessment approval and the shorter treatment authorization periods separately so renewals go in on time.

What changed. ODE filed a notice on October 20, 2026 to restructure OAR 581-015-2571, the eligibility, application and approval rule for Long-Term Care and Treatment (LTCT) education programs in day and residential treatment. The proposed text requires eligible day treatment programs to contract with OHA and residential programs to contract with OHA, ODHS or the Oregon Youth Authority, sets a January 15 application deadline with eligibility decisions by March 16 and lets approved programs begin funding on July 1. ODE says it is committing $4.2 million to 10 new LTCT sites for the 2026 to 2027 school year; a hearing is set for November 17, 2026 and comments are due December 10, 2026 at 9 a.m.

What it means. If you run a youth psychiatric day or residential treatment program without an on-site LTCT classroom, check whether your state contract meets the proposed eligibility terms and calendar January 15 for the next application. Send comments to ODE by December 10, 2026 if the timeline or contract requirements would keep your program out.

What changed. The Office of Substance Use and Mental Health filed a repeal and reenactment of Rule R523-5 (Filing ID 58275, Utah State Bulletin, October 15, 2026) that moves the family resource facilitator provisions of Rule R523-6 into a single peer support certification rule, renames certification types, adds a dual certification so adult peer support specialists can also work with parents, updates certification, renewal and continuing education requirements, and adds out-of-state reciprocity. New Section R523-5-9 lets a mental health therapist, a substance use disorder counselor with at least two years of experience, or a certified peer support specialist with division-approved supervisor training and at least two years of continuous certification supervise, requires supervision at least weekly, and caps each supervisor at eight peer support specialists. Comments are accepted until November 16, 2026, and the rule may become effective November 23, 2026.

What it means. If you employ certified peer support specialists in Utah, check that each one receives documented supervision at least weekly and that no supervisor oversees more than eight. Send comments by November 16, 2026, and plan certification renewals and continuing education under the new requirements.

What changed. HCA's Substance-Using Pregnant People (SUPP) Program Billing Guide dated October 1, 2026 adds a note that, effective January 1, 2027, clients who have delivered cannot enroll in the SUPP program during the postpartum period. The current guide still lets a client who could not enter a SUPP bed before delivery be admitted within 1 week after discharge from the postpartum floor if the referral and consultation steps are met. HCA says clients who need withdrawal management after delivery may qualify for services in its Inpatient Hospital Services Billing Guide under the postpartum substance use disorder withdrawal management section.

What it means. If your hospital runs a SUPP unit or refers pregnant patients to one, update intake and referral workflows so postpartum patients who need care after December 31, 2026 are checked for the inpatient postpartum SUD withdrawal management benefit, since HCA says they may qualify there. Billing staff should read that section of the Inpatient Hospital Services Billing Guide and calendar January 1, 2027 for the switch.

What changed. Since October 23, 2026, the Department of Commerce Behavioral Health Facilities Program has taken applications through ZoomGrants for capital repairs and upgrades that keep existing behavioral health facilities open, first come, first served until the $9.7 million is used, with applications open until midnight June 30, 2027. Nonprofits, for-profit businesses, public entities, Tribes and Indian Health Care Providers, community hospitals and community behavioral health providers may apply for licensed, operating facilities serving publicly funded people, including crisis, residential and inpatient mental health or SUD treatment, peer respite, opioid treatment and outpatient services. Applicants must show the facility is at significant risk of closure within two years without state investment; funds cannot be used for expansion, the facility must keep its contracted use for at least 10 years, and grant funds must be spent by June 30, 2027.

What it means. If a Washington facility you run needs repairs or licensing-driven capital work to stay open, gather the evidence of closure risk within two years and apply early, because awards go out in the order applications arrive. Check that the work can be finished and paid by June 30, 2027, and that you can commit to 10 years of contracted use, and consider the November 5 webinar.

What changed. Optum's September/October 2026 Top of Mind says that for services on or after October 1, 2026, network providers no longer need administrative authorization for Opioid Treatment Program and Office-Based Opioid Treatment bundled services billed as weekly codes H0020, H0033, G2067 and G2068 or monthly codes H0047 and G2073. The waiver covers Medicare Advantage, Commercial and Individual Exchange plans as shown on provider fee schedules, but prior authorization is still required for members covered by UMR for H0020, H0033 and H0047.

What it means. If you run an OTP or OBOT program in the Optum network, update your intake and billing workflow so these bundled codes go out without an administrative authorization for dates of service from October 1, 2026. Keep requesting authorization for UMR members on H0020, H0033 and H0047, and check each plan type against your Optum fee schedule before you drop the step.

What changed. HHS-OIG issued an updated Health Care Fraud Self-Disclosure Protocol on October 15, 2026, making additional clarifying changes to the version amended on November 8, 2021. A disclosing party now has 90 days from the date of its initial submission, instead of 90 days from acceptance into the protocol, to submit the findings of its completed internal investigation and damages calculation. OIG keeps a general minimum multiplier of 1.5 times single damages and minimum settlements of $20,000, or $100,000 for kickback-related matters.

What it means. If your compliance team is weighing a self-disclosure, such as claims for services by an excluded staff member or an improper referral arrangement, plan to finish the internal investigation and damages calculation within 90 days of the day you submit, not the day OIG accepts it. Update your compliance and overpayment policies to cite the October 15, 2026 protocol so the timeline your staff follow matches it.

What changed. OJJDP's FY 2026 Opioid Affected Youth Initiative will fund prevention, intervention and treatment for children, youth and families affected by opioid, stimulant and other substance use disorders, with about $8,920,000 for 12 awards of up to $750,000 over 36 months starting January 1, 2027. States, counties, cities, federally recognized Tribal governments and nonprofits other than institutions of higher education may apply, and no match is required. The SF-424 is due on Grants.gov by 11:59 p.m. ET on November 16, 2026, and the full application in JustGrants by 8:59 p.m. ET on November 23.

What it means. If you are a nonprofit treatment provider working with youth and families, start or renew your SAM.gov registration now, since the NOFO says to begin it no later than October 30, and calendar both the November 16 Grants.gov and November 23 JustGrants deadlines. Line up partnerships with law enforcement, justice, school, child welfare and mental health agencies, because the NOFO expects applicants to collaborate with them.

What changed. OJJDP's FY 2026 Family Treatment Court Program will fund new family treatment courts (5 awards up to $850,000) and enhancements to courts operating at least one year (6 awards up to $750,000) for parents with substance use disorders involved with child welfare, about $9,020,000 in total over 48 months. Applicants are state, county, city and federally recognized Tribal governments, with a 25 percent match of total project costs. The SF-424 is due on Grants.gov by November 16, 2026, and the full application in JustGrants by November 23.

What it means. Treatment providers cannot apply directly, so if you serve parents in a family treatment court, ask the court or county now whether it will apply and whether your program will be named as a subrecipient. Have your SUD service scope, staffing and budget ready for the court's application before the November 16 Grants.gov deadline.