Michael Desposito

Behavioral health providers, particularly professional counselors, face unique challenges in navigating the insurance landscape. One of the less-discussed but critical barriers is antitrust law. Antitrust laws are federal regulations designed to prevent price-fixing and anti-competitive behavior in the marketplace. In practice, this means independent counselors are legally prohibited from collectively negotiating reimbursement rates with insurance companies. Even discussing specific...

One of the most common questions I hear from counselors is, “Why don’t we just unionize like nurses?” It is a fair question, but the legal and structural realities are very different. Let’s break it down. Most nurses work as employees within hospitals, health systems, schools, or large organizations. Because they are employees, they may have rights under federal labor law, such as the National Labor Relations Act, to organize unions and collectively bargain over wages, working conditions, and...

If the problem is structural, the response must also be structural. One promising pathway within the current legal landscape is the development of Clinically Integrated Networks (CINs). A CIN is a formally organized network of providers who collaborate around shared clinical standards, governance, and measurable quality improvement. Because the collaboration focuses on improving quality and efficiency of care, it can operate within federal antitrust guidance. A well-structured CIN can...