Arkansas Officials Cited CMS Against New Autism Evaluators. The Toolkit Leaves It to States.

LITTLE ROCK, ARKANSAS – Two Arkansas human services officials told the state’s autism task force on November 10, 2026, that its first-listed proposal for next year’s legislative session conflicts with CMS guidance on ABA and would require a change in state law, according to the legislature’s recording of the meeting.

The proposal would let evaluations by licensed psychological practitioners count toward autism eligibility for two Medicaid programs. One is the Autism Waiver, which pays for intensive intervention for young children. The other is the Community and Employment Supports Waiver, which pays for home and community services for people with developmental disabilities. Applicants must still meet each program’s other eligibility rules.

Arkansas created the master’s-level license in 2025, and the law that created it already lets these practitioners diagnose developmental disabilities as part of their training. Medicaid’s ABA coverage rules rest on the same diagnosis rule as the waivers, as BreakingNewsABA reported in October.

It is the first of seven priorities in the report the Legislative Task Force on Autism sent to legislative leaders on August 31, 2026. Both officials serve on the task force.

Melissa Weatherton, the Department of Human Services’ director of specialty Medicaid services, told the panel the idea “is in direct conflict with the ABA toolkit that CMS recently put out.” Jennifer Brezée, who directs the department’s Division of Developmental Disabilities Services, said CMS guidance still supports a diagnosis from a doctoral-level psychologist or a physician. She said the new practitioners hold a master’s degree and that not all have a specialty in testing.

Brezée also said the change would require amending state law. For the Autism Waiver, the statute requires a diagnosis from at least two qualified professionals “of different types” and limits that term to a licensed physician, a licensed psychologist, or a licensed speech-language pathologist.

What the CMS Toolkit Says

The passage in the toolkit on who should diagnose autism sets no degree level. It says a diagnosis “should be completed by qualified and licensed medical providers.” It gives developmental pediatricians, pediatricians comfortable using the DSM-5-TR, pediatric neurologists, child psychologists, and psychiatrists as examples, then ends the list with “other clinical providers as specified by a state.” The same passage calls it best practice to start comprehensive ABA only after “a qualified, independent clinician” has confirmed the diagnosis.

The passage does not mention master’s-level clinicians, and the toolkit sets no degree level for clinicians who diagnose anywhere in its 173 pages. A later section on reviewing ABA requests says a diagnosis should be “made by a qualified provider acting in the scope of their practice.” CMS said when it released the toolkit in August 2026 that the document “does not establish new federal requirements.” Weatherton did not say during the meeting which part of the toolkit she meant.

A December Deadline May Apply

No one presented a draft bill. Sen. Justin Boyd, the Fort Smith Republican who co-chairs the task force, asked legislative staff to determine whether the proposal would change a profession’s scope of practice, meaning what its license allows. He said the window for a scope change has passed unless an interim study proposal is already on file or a member of the public health committee takes it up, and that a deadline falls in December.

The legislature’s 2027 session calendar says that if a bill expands a health profession’s scope of practice, the House or Senate public health committee must have started a feasibility study by December 11, 2026. Without the study, the bill can move only if two-thirds of that committee’s members vote to allow it.

Boyd asked Rep. Denise Jones Ennett, the Little Rock Democrat who is the panel’s other co-chair, to follow up with two parent members on the report’s insurance and out-of-pocket cost proposals, and said she will work on legislation. Bills can be pre-filed as early as November 16, 2026, and the session convenes January 11, 2027.

The Vacant BCBA Seat

Boyd committed to one bill, on the task force’s own membership, with Ennett as the House sponsor. State law gives the panel a seat for a BCBA appointed by the Arkansas Psychology Board, and the seat is vacant. The same law says vacancies among non-legislator members are filled by a vote of the task force. Which rule governs this seat was not settled at the meeting.

Boyd said a candidate had come forward, but the board did not make the appointment. He said he will ask the board why before deciding whether to move the appointment to another authority.

Boyd told staff to draft a bill removing one of two education department coordinator seats now held by the same person. He also told them to draft a bill removing a clinical geneticist seat that the University of Arkansas for Medical Sciences has not filled, unless someone offers a better idea before the bill passes.

As of November 12, 2026, the legislature’s website listed no upcoming task force meeting. No answer to Boyd’s scope-of-practice question was announced before the meeting adjourned. If the answer is yes, the bill would need a committee study started by December 11, 2026, or a two-thirds committee vote to proceed without one.

AT A GLANCE

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