When The Rate Doesn’t Work

Medicaid reimbursement for applied behavior analysis (ABA) is in flux across the country –;in terms of rates, documentation, and compliance requirements.;And because Medicaid is primarily a state responsibility, approaches to managing Medicaid ABA services vary.;

Minnesota has been at the center of changes to Medicaid autism service oversight;with federal intervention in response to claims of fraudulent;billing (see; Minnesota Medicaid Autism Treatment Authorization Backlog Reaches 1,000 Treatment Plans). By mid-August, approximately 1,000 autism treatment plans were awaiting authorization, delaying care for families and preventing provider organizations from billing Medicaid . . .