Medicaid ABA Benefit
Unfortunately, families are struggling accessing ABA treatment because of a very narrow practitioner type approved to provide ABA treatment, as explained below. The below link to the Help! I can’t access ABA through Medicaid document will provide easy steps parents can use to file a compliant or appeal with Medicaid. Our founder, Marla Root, is a parent of a child with autism and can answer any questions you have at our contact page. Please feel free to reach out.
New Medicaid ABA Benefit: HFS Announced the Benefit would begin November 2020, Update February 2021
During the last state budget process, the Governor signed the new state budget into law on June 5, 2019 which included funding families successfully advocated for in Medicaid for a benefit to cover applied behavior analysis (ABA) treatment for Medicaid recipients. Approximately $42 million was dedicated to the Department of Healthcare and Family Services (HFS) budget to cover the benefit.
In September 2019, HFS submitted a state plan amendment which was approved by Federal Medicaid (CMS) January 2020. However, the benefit offered a very narrow, limited practitioner type stating BCBAs (certified behavior analyst) would also have to be credentialed as either a licensed clinical social worker (LISW) or a licensed clinical psychologist (LCP). This created an immediate access issue for Medicaid eligible children ages 0 to 21 all around that state.
In October 2020, HFS released further guidance on the continued efforts to get the benefit started. Our Coalition hired a Medicaid billing and credentialing specialist to help us navigate the challenges and we are very thankful for HFS’ openness to work with us and to collaborate on trainings for ABA providers.