Texas Expanded Autism Program Eligibility, Then Proposed Ending Its Funding
The state program funded ABA for 583 children in fiscal year 2026. Contractors report at least 1,000 more waiting.
Policy
The federal and state actions deciding what ABA can bill and who qualifies. Coverage of Medicaid rate cuts, federal HCBS reductions, OIG audits, the new CMS fraud initiative, and state lifetime-hour caps. For BCBAs and operators tracking compliance exposure. Run alongside business, private equity, clinical practice.
Minnesota Asks Dr. Oz to Show the Math Behind a $199 Million Medicaid Hold
The state’s Medicaid chief wants CMS to explain, by Oct. 15, how it selected the claims in its July funding hold.
Florida Lowers ABA Forecast by Nearly $1 Billion
ABA use was 16% below projections in managed care’s first eight months, before the state’s June 2026 anti-fraud initiative.
Centria Wants Every Florida ABA Location Licensed. The State’s Medicaid Agency Is “Very Intrigued.”
The company’s proposal requires a 10% reduction in Medicaid billing reimbursements for any provider site during noncompliance.
Minnesota Lawmakers Want ABA Owners Vetted and a Floor Set on Patient-Care Spending
Sen. Scott Dibble also wants providers to spend a set share of their Medicaid payments on patient care.
House Bill Would Require Electronic Visit Verification of ABA Sessions Starting January 1, 2027
Medicaid ABA providers could face new requirements to electronically verify who delivered each session, who received care, and when and where it occurred.
Four Democratic Bills Target Private Equity in Health Care. Two Name Behavioral Health
All of them sit in committee. Illinois ABA businesses covered by the state’s licensed-owner rule have until January 15, 2027, to comply.
Amerigroup Slashes ABA Technician Payments By 30% Threatening Care for Georgia Children
Clinics warn they may have to reduce care, while Georgia says the insurer must arrange alternatives when its network falls short.
Kansas Law Lets Some Master’s-Level Clinicians Diagnose Autism. Kansas Medicaid Says Not for ABA.
The Nov. 1 policy limits whose diagnoses qualify for treatment coverage, including ABA, with a two-year transition for certain members already receiving care.
Month Caps, Authorization Limits, Billing Standards: What Florida’s ABA Review Could Hand Providers
The state’s task force has until December 31 to send the governor and legislative leaders recommendations on a program that outspends every other state’s.
Indiana Medicaid Writes ABA Rules for Naps and Behavior Assessments in One Day
The Sept. 29 bulletins also specify assessment and referral requirements as ABA coverage ends for members 21 and older.
West Virginia Has Reimbursed Only $9.90 for 15 Minutes of ABA for Years. Thousands of Children Wait.
Fewer than half of the state’s roughly 20 centers take Medicaid, the Mountaineer Autism Project said Tuesday, pressing for a rate study.
RFK Names Leucovorin Startup Co-Founder to Chair Autism Panel. Posted Draft Omits ABA
Dr. John Gaitanis helped launch Meadow Biosciences. The panel’s working draft calls for more leucovorin research but does not recommend the drug for autism and omits ABA.
Labor Department Puts ABA Exclusions and Autism Age Caps on Parity Red-Flag List
Two resolved federal investigations led plans to drop ABA restrictions and offer claim resubmissions or reprocess affected claims.
“Devastating”: New York Slashes ABA Reimbursement For The Third Time Creating An Existential Threat To Access
New York’s third cut in 12 months takes fee-for-service Medicaid reimbursement for technician-delivered ABA to $9.63 a unit, half the original rate.
ABA’s Six New Billing Codes Are Official. A BCBA’s Between-Session Work Finally Gets One.
Starting in the new year, 97180 covers a clinician’s data review, protocol decisions, and technician training. Payers hear the details September 30.
North Carolina Shuts ABA’s Open Door. Medicaid Plans Now Pick Their Providers.
The July budget allows health plans to limit which ABA providers join their networks. A 120-day certification grace period began Aug. 1 for existing uncertified technicians.
Louisiana ABA Operators Now Face Fingerprinting And Hours Review. Healthy Blue, with 290k Members, To Exit
State officials say Medicaid ABA spending rose 41% over three years. Healthy Blue’s exit gives providers a limited window to arrange continued coverage under new plans.
In Bid to Reduce ABA Costs, Colorado Draft Rule Draws 25-Hour Weekly “Cap” for Kids Under 6
Providers could seek more weekly hours if medically necessary but must explain the therapeutic purpose and why the child’s needs exceed 25 hours.
House Committee Asked The Perfect Child Twice for ABA Billing Records. A Subpoena May Follow
A second request set a September 4 deadline after lawmakers said the Brooklyn ABA provider had not answered their July letter.
Nebraska Blue to Cut Weekly ABA Limit From 40 Hours to 25. Retools What Is Required
The Nov. 15 policy also changes supervision and telehealth rules, adding to a year of ABA authorization changes across Blue plans.
Two Weeks to Six: SoonerCare Payment Delays Put Oklahoma ABA Providers Under Pressure
An Edmond provider warns that contracting delays are straining cash flow as OHCA works through its backlog and prepares full ABA quality reviews.
Minnesota’s Autism-Authorization Bottleneck Leaves ABA Families Waiting and Providers Without Cash to Operate
About 1,000 treatment plans were reportedly awaiting action in mid-August, with no public deadline to clear the backlog. Delayed EIDBI approvals are choking off Medicaid billing, forcing clinic owners to borrow money…
Taylor Sanders Wants ABA Fraud Prosecuted Without Cutting Kids Off From Care
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…
Kentucky Reverses 4% Medicaid Cut Before ABA Rates Drop
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…
CMS Hands States a Playbook for Reining In ABA. Arizona Is Already Running It.
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,…
Three Families Lost Care to a System That Is Not Working
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…
Virginia’s ABA Diagnosis Rule Outweighs Its 20-Hour Limit
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…
Utah Makes Automatic ABA Medicaid Rate Increases Permanent
Gov. Spencer Cox signed a bill that lifts autism-therapy reimbursement whenever forecast state revenue growth reaches at least 2 percent.
CMS EPSDT Guide Undercuts ABA Hour Caps and Plateau Denials
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…