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Issue 3 |
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👋 Hey there!
Nobody in Austin was thinking about behavior analysts. Texas wrote an AI law for technology companies, and one subsection of it reaches any practice running an AI system anywhere in its clinical path. It has been in force since January, the attorney general's complaint form opened on September 1, and nothing in it mentions your profession — which is exactly why it caught you. The rest of the week is about proof, and it is unusually literal-minded. New York wants two face-to-face supervisions a month and will not accept a phone call as one. Oklahoma will pay for a technician living fifty miles past its border, but not one living fifty-one. Pennsylvania's regulations cite a task list the BACB has retired, leaving the rule a version behind the standard it points at. Arkansas wants two diagnoses, from two different professions, before anyone begins. Colorado looks like the money story — $42.6 million to refund, $112.5 million more to review. It isn't. One recommendation asks the state to check how its own prior-authorization contractor verified the diagnostic evaluations, which means a provider can hold a valid authorization and still be inside the finding. Everywhere else this week, the demand for proof arrived as a rule. In Colorado it arrived as an invoice.
⭐ Featured This Week
Texas Made AI Disclosure a Duty in January. The Complaint Form Opened September 1. Texas HB 149TRAIGA's health care subsection reaches private practices, not just state agencies, and Sec. 552.051(c) requires the disclosure even where the use would be obvious. Penalties run $10,000 to $200,000 per violation after a 60-day cure window. Read Full Article → 🎧 Listen
⚖ Legislation Tracker
Florida's ABA Task Force Turned to Schools, and Asked Where the Numbers Came From Florida AHCANewly published minutes show Florida's ABA Task Force asked first about school-based ABA at 30 or more hours a week, and questioned where AHCA's expenditure and utilization figures came from. Meeting 2 on August 31 was a Department of Education presentation reporting 71,688 ASD-eligible students. Three of ten appointments were still pending. Read more → 🎧 ListenColorado Was Told to Refund $42.6M. The Bigger Number Is the $112.5M Behind It. HHS OIG report A-09-24-02004OIG found at least $77.8M in improper Colorado Medicaid ABA payments ($42.6M federal share) and a further estimated $207.4M potentially improper ($112.5M federal share) that the state must review for recovery. One recommendation targets the prior-authorization contractor's verification of diagnostic evaluation requirements. Read more → 🎧 ListenMichigan Proposed Removing an ABA Access Barrier. Every Other State Added One. Michigan Department of Health and Human ServicesMichigan's proposed BHT policy update removes the pre-service physical examination requirement, widens the accepted diagnostician list, and aligns ABA language with generally accepted standards of care — stating the purpose as removing barriers causing waitlists. Adoption could not be confirmed. Read more → 🎧 ListenNew York Requires Two Face-to-Face Supervisions a Month. Phone and Text Don't Count. New York State Medicaid UpdateSince October 1, 2025, NYS Medicaid — fee-for-service and managed care — requires LBAs to supervise unlicensed technicians for a minimum of 5% of monthly service hours, including two face-to-face real-time contacts that may not be telephonic, email or text. CPT 97155 counts toward the minimum only when the LBA joins the patient and technician to direct a new or modified protocol. Read more → 🎧 ListenUtah Doesn't Pay for ABA in Schools, the Drive There, or the Charting After Utah Medicaid Provider ManualUtah Medicaid will not reimburse fee-for-service ABA in school-based settings, apart from a behavior analyst's participation in a care plan development meeting; school services run through a separate School-Based Skills Development benefit. Travel time and charting done away from the member are non-covered, and ABA is non-covered where progress has plateaued with no further protocol modifications made. Read more → 🎧 ListenArkansas Won't Accept One Autism Diagnosis. It Needs Two, From Different Professions. Arkansas Medicaid Provider ManualArkansas Medicaid requires an autism diagnosis from at least two qualified professionals of different types — physician, psychologist or speech-language pathologist — each concluding the child fully meets DSM criteria. Provisional RBTs are prohibited from providing ABA after six months without certification. Read more → 🎧 ListenOklahoma Won't Pay an RBT Who Lives More Than 50 Miles From the Border Oklahoma Administrative Code 317:30-5-311 and 317:30Oklahoma's ABA rules impose a residency test on the individual, not the agency: all contracted providers must live in the state or within 50 miles of its border, and every tier delivering services must be contracted with OHCA separately. RBT supervision is a 5% monthly minimum and the FBA is capped at 32 units. Read more → 🎧 ListenNevada Gives ABA a Floor and a Ceiling, and Caps Supervision at 20% Nevada Medicaid Provider Type 85 Billing GuideNevada Medicaid authorizes ABA in two bands rather than under a single cap: 15-25 hours a week for focused treatment and 25-40 for comprehensive, both measured across combined units of 97153, 97155 and 0373T. Supervision is capped at 20% of treatment hours, assessments are limited to one every 180 days, and BCaBA and RBT claims require modifier UD. Read more → 🎧 Listen
💼 Industry News
Georgia's CareSource Measures ABA Progress in Standardized Assessments, Not Notes CareSource Medical Policy Statement MCD-MM-0212CareSource's Georgia Medicaid ABA policy sets a twelve-month discontinuation test measured by standardized assessments rather than clinical narrative, caps comprehensive behavioral assessments at eight hours per six months, requires an independent practitioner to complete the assessment and plan of care before services begin, and warns that certain services sit in non-carryover 28-day allocations. Read more → 🎧 ListenPennsylvania's IBHS Rules Cite a Task List the BACB Has Retired Pennsylvania OMHSASOMHSAS has told IBHS providers that Pennsylvania's regulations contain outdated language referring to the retired RBT Task List, and that it will enforce current BACB standards. Training certificates dated before January 1, 2026 are considered outdated, 3rd edition certificates must carry specific BACB wording that licensing staff will review, and staff have one year from their 2nd edition certificate date to update. Read more → 🎧 Listen📤 Pass it on Know someone in ABA who should be reading this? We will send them one invitation from you — and nothing else unless they subscribe. Invite a colleague →
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