Arizona's Draft ABA Rule: Certified Techs by April 30, 2027, Justify Over 25 Hours

On September 17, AHCCCS posted a proposed exempt rule that writes ABA into Arizona's Medicaid rules for the first time as its own covered service, for acute care, ALTCS and KidsCare members. The comment period closed on October 17. If you meant to comment, that window has passed. No final rule is posted yet, and the notice doesn't state an effective date. Two of its own dates are already running anyway.

The turn: the clock on your current staff may have started on November 1

The rule requires criminal background and registry screening for every ABA supervisee: technicians, trainees, assistant behavior analysts and BCBAs awaiting Arizona licensure. An organization whose current supervisees weren't screened “on or before November 1, 2026” gets “a 180-day grace period from November 1, 2026 to comply.” That ends on April 30, 2027. The same date is the technician-certification deadline, so both requirements land on one day.

AHCCCS estimates the rule saves about $46.5 million a year in total funds: $17.8 million in AHCCCS Complete Care, KidsCare and the Children's Health Plan, and $28.7 million in the ALTCS developmentally disabled population.

What the proposed rule requires

• Technician certification. An active certification from a nationally recognized ABA technician certification organization “within 180 days of hire or by April 30, 2027, whichever is later.” A new hire who isn't certified must have started the certification process before serving any member. Exemptions cover a technician whose exam isn't offered in the language they'll deliver services in, and a disability the testing body can't accommodate. Either one must be documented.
• Screening. A nationwide criminal background check at hire and every three years, plus DCS Central Registry and Adult Protective Services registry checks at hire and annually. A fingerprint clearance card satisfies the criminal check but not the registry checks.
• Supervision. At least one hour of LBA case supervision for every ten hours of direct ABA by a supervisee, documented in the member's record.
• Prior authorization. Requests need an assessment and treatment plan dated within 30 days. Authorizations run six months at most, and services must start within 30 days of approval.
• Hours. A request for more than 25 direct hours a week, or more than 15 outside school for a full-time student, needs four added items: symptom-specific justification, the goals that address it, step-down goals, and caregiver-training and supervision plans. For a child aged 5 or older whose school attendance is deferred for ABA, the LBA must also document the barriers, the milestones for returning to school, and a parent's signed informed consent.
• Assessment and caregivers. Reassessment at least every six months, with assessment time capped at 12 hours unless medical necessity is documented. Caregiver training is at least two hours a month unless a clinical rationale or documented barrier supports less.
• Continuing services. Delivering under 80% of authorized hours requires documented reasons and the efforts made to address them. Requests to maintain function must show the clinical basis and any earlier attempts to step down.
• Diagnosis. A comprehensive diagnostic evaluation (CDE) by a psychiatrist, neurologist, psychologist, developmental pediatrician or specially trained pediatrician. Members without one must complete it by November 1, 2027, or within 12 months of enrollment, whichever is later. Services can't be cut solely for a missing CDE when an appointment or waitlist place is documented.

The limits

This is the proposed text. AHCCCS can change it before adoption, and under its exemption (Laws 2026, Ch. 132, § 19) there's no oral proceeding and no Council review. The notice doesn't say when the rule takes effect, or whether health plans will enforce the grace period and certification date before a final rule is posted.

What you must know or do

• Owners and HR: list every supervisee and record three dates for each: last nationwide background check, last DCS registry check and last APS registry check. Anyone with a gap needs it closed by April 30, 2027. Plan for the registry checks to repeat every year.
• Owners: list every technician without an active certification and their hire date. For anyone hired before November 1, 2026, the deadline is April 30, 2027. From now on, start each new hire's certification process before their first session.
• LBAs: for each client, divide this month's case-supervision hours by the supervisees' direct hours. Anyone below 1:10 is short under the proposed rule.
• Intake: flag every member without a CDE by one of the five listed clinicians, and book the evaluation or document the waitlist place now.
• Clinical directors: for each child authorized above 25 hours a week (or above 15 outside school for a full-time student), check that the next renewal packet will carry all four justification items.