1. Medicaid ABA Benefit An Update
Rebecca (Becky) Peters
ABA and Mental Health Clinical Program Manager
Clinical Quality Care Transformation (CQCT)
November 3, 2017

2. The Beginning 2012 – 2013 ABA benefit established and implemented
Recruitment of qualified COE’s for diagnostic assessment
Recruitment of qualified ABA providers
Everyone is fee for service

3. The Beginning Continued
Process established linking families to ABA providers after COE evaluation
Data collected manually and through Provider One

4. The Middle
2015 – 2016
Change procedure codes for ABA services and created new fee schedule
Continued to build provider network for ABA and COE
Continue refining requirements for intensive day treatment

5. The Middle Continued 2015 - 2016 ABA transferred to managed care plans
Process change with HCA regarding how children with ABA orders transitioned from COE to ABA

6. The Present 2017 TPL children moved to managed care
New DOH credentials for ABA providers start date July 1st. Applications started in May
Fee for service for Native Americans, dual eligible and exempted clients (15% Medicaid eligible children)

7. Now - Future Review MCO data and network information
Evaluate MCO access to ABA
Rates analysis underway
Explore ABA service in schools as a Medicaid service
Verifying all fee for service providers using the ABA taxonomy are credentialed appropriately

8. Now – Future continued
Explore communication strategies to keep everyone informed
Developed a process and schedule for updating COE and ABA lists on website for fee for service providers
Continue COE recruitment and training
Continue provider training and expansion of intensive day treatment

9. Questions? More Information:
Rebecca (Becky)Peters
ABA Clinical Program Manager
CQCT
HCA
Tel: