2024 Payor Changes in Mental Health and Substance Abuse Treatment

Contact Us

2024 Payor Changes in Mental Health and Substance Abuse Treatment


2024 Payor Changes | What You Should Know

Insurance company’s criteria are constantly evolving – requiring businesses to adapt to policy alterations that impact operations and patient treatment plans. That is why we keep a close watch on these changes, reporting them to you as soon as possible. Hansei Solutions is committed to the partnerships we have with our clients. A part of that commitment is keeping our clients informed and up-to-date on the latest payor policy changes, which are anticipated during the new year. A closer look at the payor rules introduced in 2023 reveals the groundwork for the changes coming during 2024.

Why do insurance companies make yearly changes?

This is a common question our clients ask – and there are plenty of reasons, including:

  • Cost Control
  • Medical Advances
  • Regulatory Changes
  • Market Competition
  • Risk Management
  • Data Analysis
  • Customer Feedback
  • Medical Necessity

Amerigroup & Wellpoint Partnership

As of January 2024, Amerigroup will become Wellpoint in the following states:

Amerigroup & Wellpoint Partnership

The change requires no action by Amerigroup/Wellpoint care providers, and there will be no changes to agreements/contracts, reimbursements, or level of support. This brand change will not cause any changes in coverage or access to care for members.

bcbs logo

Blue Cross Blue Shield

Members enrolled in BCBS of ALL Alabama Exchange policies must select a Primary Care Physician (PCP) to be eligible for coverage. Referrals are not required.

health net logo

Commercial Health Net & MHN

Effective January 1, 2024, MHN’s affiliate, Health Net of California, will take over the administration of behavioral health benefits. 

The new addresses and contact information for this change, with distinctions for Individual and Family Plans (IFPs) and Employer Commercial Plans, can be found in the MHN Transition Update.

oscar health logo

Oscar Health

Oscar Health left Covered California in 2024 for financial reasons. Patients enrolled in an Oscar plan can select a new plan during a special enrollment period. They can also choose a new health insurance provider during the regular enrollment period.

2024 Payor Changes in Mental Health and Substance Abuse Treatment

Sharp-Magellan Partnership

Sharp Health Plan is partnering with Magellan on mental health and substance use disorder services for members with Commercial (HMO/PPO/POS), Exchange, and Medicare Advantage plans during 2024.

  • Magellan began managing benefits for members in Medicare Advantage plans on January 1, 2024. Commercial (HMO/PPO/POS) and Exchange plan member benefits management began on February 1, 2024.
  • There are no changes to benefits, copays, or additional costs for members utilizing mental health and substance use disorder services.
  • To receive plan benefits, members are required to see an in-network medical provider. If a provider is not part of the Magellan/Sharp network, Magellan will extend an invitation for them to join. If the provider opts out of joining the network, members can contact Magellan for continuity of care or choose an in-network provider by calling 1-866-512-6190.
  • For additional information, visit https://www.sharphealthplan.com/news-center/sharp-health-plan-to-partner-with-magellan.
CTA background pattern

Ready to focus on providing healthcare? Let us lighten your load.

Schedule a Demo

We’re here to address your pain points and create growth opportunities for your organization. We’re passionate about what we do, and it shows in every interaction. Learn what makes us tick and schedule a demo today.

Service Interested In?*