Policy

Taylor Sanders Wants ABA Fraud Prosecuted Without Cutting Kids Off From Care

August 27, 2026 · 2:30 PM

The BCBA supports aggressive action against Medicaid fraud while advocating for the Autism Families Alliance. She also warns that broad enforcement can sweep ethical providers and families into the fallout, and says…

Continue To Article

Kentucky Reverses 4% Medicaid Cut Before ABA Rates Drop

August 14, 2026 · 2:45 PM

Kentucky will keep its current Medicaid fee-for-service rates after state officials found enough unexpected revenue to stop a 4% provider cut. The immediate threat to ABA reimbursement is gone, but the Department…

Continue To Article

CMS Hands States a Playbook for Reining In ABA. Arizona Is Already Running It.

August 12, 2026 · 9:00 AM

A new federal toolkit gives every state Medicaid agency the same checklist for tightening ABA: supervision, credentialing, utilization, and program integrity. Arizona’s proposed 320-S overhaul shows what it looks like in practice,…

Continue To Article

Three Families Lost Care to a System That Is Not Working

August 5, 2026 · 3:00 PM

Behavior analysis accounted for 64 percent of every provider the state refused to enroll or reenroll last fiscal year. In June, the governor stood in West Palm Beach and announced that every…

Continue To Article

Virginia’s ABA Diagnosis Rule Outweighs Its 20-Hour Limit

August 3, 2026 · 2:00 PM

The word autism appears nowhere in Virginia’s current ABA eligibility criteria, and the new weekly ceiling yields to a federal exception available to every child it touches. Lawmakers booked $58 million in…

Continue To Article

Utah Makes Automatic ABA Medicaid Rate Increases Permanent

July 30, 2026 · 9:00 AM

Gov. Spencer Cox signed a bill that lifts autism-therapy reimbursement whenever forecast state revenue growth reaches at least 2 percent.

Continue To Article

CMS EPSDT Guide Undercuts ABA Hour Caps and Plateau Denials

July 29, 2026 · 3:00 PM

The first rewrite of Medicaid’s children’s coverage playbook since 2014 tells states that flat limits may not stand in for case-by-case decisions. Indiana began counting children’s therapy against a 4,000-hour lifetime allocation…

Continue To Article

Indiana Fixed ABA Medicaid Billing, Now Access Is at Risk

July 27, 2026 · 3:30 PM

The state scrapped a formula that paid providers 40 percent of whatever they billed. The replacement, a fixed fee schedule with rate cuts, a 4,000-hour lifetime cap, and a freeze on new…

Continue To Article

CMS Proposes Six New ABA Codes for 2027

July 23, 2026 · 9:00 AM

The proposed 2027 Medicare fee schedule would recognize multiple-technician services and the clinical work that happens away from the patient. Whether payers cover and price that work is the question the rule…

Continue To Article

Federal Autism Panel Advances ‘Profound Autism’ Designation

July 22, 2026 · 3:00 PM

The newly restructured committee urged new federal Medicaid guidance for autism care, which could affect how high-need services, including applied behavior analysis, are prioritized. The panel meets again July 31.

Continue To Article

House Committee Opens Billing Probe Into ABA Provider The Perfect Child

July 22, 2026 · 11:30 AM

Chairman Tim Walberg and Rep. Rick Allen gave founder Simcha Bendet until July 20 to provide billing records going back to 2020. This move makes official a Wall Street Journal investigation into…

Continue To Article

Nebraska’s New ABA Rules Are Punishing Ethical Providers—and Shrinking Access for Families

July 22, 2026 · 9:00 AM

New Nebraska Medicaid service definitions that took effect July 1, 2026, cap therapy hours, end school-based billing for independent providers, and add supervision requirements. Themis Gomes says the local providers rooted in…

Continue To Article

Kentucky Medicaid Cuts ABA Rates 4% Starting August 1

July 21, 2026 · 9:00 AM

Licensed Behavior Analysts are one of 46 fee-for-service provider types facing this reduction. The state budget also plans a managed-care cut in 2028.

Continue To Article

Advocate Says Oregon ABA Board Left Training Questions Unanswered

July 18, 2026 · 8:30 AM

Christina Williams’ follow-up account of the July 10 meeting in Salem describes an unaddressed attestation concern, fiscal reasoning crowding out client safety, and public comments that drew no response. The regulator reconvenes…

Continue To Article

Insurers Ask CMS to Set National ABA Credentialing Rules

July 17, 2026 · 3:30 PM

The Association for Behavioral Health and Wellness, representing major insurers, wants Medicaid to require licensure checks, background screenings, federal supervision ratios, and technician enrollment rules.

Continue To Article

Oklahoma Medicaid Freeze of ABA Payments to Mirabelle Care Puts 500 Kids’ Therapy at Risk

July 16, 2026 · 1:15 PM

A fraud investigation targets the clinics’ former owner. The payment freeze lands on the new owner who bought the business in January, its 200 employees, and about 500 children in therapy.

Continue To Article

TRICARE Cuts ABA Rates in Most Localities for 2026

July 14, 2026 · 2:00 PM

The Defense Health Agency’s new schedule, effective May 1, lowers assessment pay in 100 out of 116 pricing areas. Providers in Nebraska and Michigan will see the largest cuts, with rates dropping…

Continue To Article

Nebraska Cuts ABA Prior Authorization Threshold to 20 Hours

July 14, 2026 · 8:00 AM

Independent providers can no longer bill Medicaid directly for therapy delivered at school under coverage changes effective July 1, adding to cuts the state began last August. One Omaha clinic owner says…

Continue To Article

Draft Medi-Cal Rule Would Cut ABA Parity Protections

July 13, 2026 · 12:30 PM

DHCS sent managed care plans a tracked-changes rewrite on June 22 and closed comments on July 3. It would expand utilization management for autism therapy and delete the operative order that plans…

Continue To Article

Sensory Kits Help Niles Police Safely Reunite Autistic Man

July 12, 2026 · 9:00 AM

Officer Jessica Zia had carried the new tools for just 20 days when a nonverbal 25-year-old wandered more than 6 miles from a Chicago group home. The nonprofit behind them has trained…

Continue To Article

Alabama Medicaid Pauses New ABA Referral Rule Before July 1

July 10, 2026 · 12:30 PM

Pediatricians had 16 days to request a specialty designation before autism diagnoses stopped qualifying children for therapy. Within 3 days, the agency put the requirement on hold and promised guidance it had…

Continue To Article

North Carolina Agrees to Consent Order in ABA Rate-Cut Suit

July 9, 2026 · 1:00 PM

DHHS affirms it must run Medicaid in compliance with the state’s disability rights statute and that families retain the right to refile. A judge’s signature would remove the September trial from the…

Continue To Article

South Carolina Tightens Medicaid ABA Rules Effective July 1

July 9, 2026 · 8:00 AM

Providers lose telehealth for the 97151 assessment code and face stronger documentation and medical-necessity checks, with a comment window that closed June 1 and a fee schedule the state says it will…

Continue To Article

Illinois Keeps ABA Ownership Doctrine, Adds Key Exemptions

July 6, 2026 · 8:00 AM

A push to repeal the licensed-owner CPOM doctrine stalled in committee. The state practitioner association’s SB 712 passed, exempting schools and nonprofits and expanding licensed practitioner owner types, but leaves for-profit practices…

Continue To Article

Senators Schmitt and Gillibrand Press TRICARE to Cover ABA Permanently

July 3, 2026 · 3:00 PM

A Republican father of a nonverbal autistic son and the Democrat who commissioned the Pentagon’s own study have made autism care a bipartisan cause. Now they want applied behavior analysis written into…

Continue To Article

Five Steps to Illinois ABA Ownership & Business Structure Compliance by 2027

July 1, 2026 · 11:40 AM

An ownership and business structure clause requires that every ABA company in the state be owned solely by licensed practitioners. Licensure law passed in 2022 means providers may need to restructure by…

Continue To Article

The Optum ABA Playbook: How a Medicaid Cost Strategy Became an Ongoing Crisis for Autism Families

June 30, 2026 · 1:15 PM

Eighteen months after the documents surfaced, about 1,000 Arizona children have lost their providers, and their families are in court. UnitedHealth faces that fight from a weaker position, with profits down and…

Continue To Article

Maryland Routes Medicaid ABA Through One Vendor, Carelon

June 28, 2026 · 2:30 PM

Every autism-therapy authorization and claim in Maryland’s Medicaid program clears a single carve-out contractor: the vendor brought in to replace Optum. In its first year, that contractor saw a behavioral-health claims backlog…

Continue To Article

EVV Hard Edits Become a 2026 Billing Risk for ABA Providers

June 26, 2026 · 8:00 AM

Electronic visit verification (EVV) was never part of the federal Medicaid mandate for applied behavior analysis. As a wave of states drops the warning period and switches on automatic claim denials through…

Continue To Article

Georgia Lawmakers Confront CareSource on 20% Therapy Rate Cut. CareSource Executives Absent

June 25, 2026 · 8:00 AM

The remaining incumbent, CareSource slashed rates 20% in 2026. Providers told a General Assembly hearing that families have nowhere else to go, and will lose access to care.

Continue To Article