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Issue 1 |
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👋 Hey there!
Welcome to ABA Weekly. This is issue one, and we're glad you're here. The rules that decide what you can bill, who's allowed to deliver it, and how many hours a child receives change constantly, and rarely with much warning. They arrive as a PDF on a state agency site, a line in a revised fee schedule, a bill that got no coverage. Most weeks you find out because a claim came back denied. That's what ABA Weekly is for. Every Sunday we read the statutes, the provider bulletins, the audit reports and the journals, and send you the part that reaches your clients. About five minutes. Every source is linked so you can check our work, and we'd encourage you to. We won't send you a roundup. If a week has one thing worth your time, that's what you'll get. This week the largest revision to the adaptive behavior code set since 2019 got a landing date, and the only window to say anything about it closes on September 14.
⭐ Featured This Week
The Biggest ABA Code Change Since 2019 Lands January 1. You Have Until September 14 to Say Anything.Six new adaptive behavior codes and revised descriptors land January 1, 2027. They're still placeholders, Medicare still carrier-prices them, and the comment window on the rule that references them closes September 14. Read Full Article → 🎧 Listen
📚 Research Digest
Parents Rated ABA Significantly Less Acceptable Than OT and Speech. The Reasons Were Not About Effectiveness.Canadian parents rated ABA significantly below OT and speech on acceptability. The reasons weren't about whether it works — they were ethics, therapist fit, and how much parents were involved. Those are things a practice can change. Read more → 🎧 ListenTen Autistic Adults, an ABA-Based Crisis Unit, and Improvement That Only Went HalfwayAn ABA-based inpatient program for ten autistic adults in severe crisis produced large-effect improvement in agitation and disorganization. Irritability and stereotypy didn't move at all. The authors report both. Read more → 🎧 Listen
⚖ Legislation Tracker
Indiana Stops Paying for Adult ABA in About Five Weeks. The 4,000-Hour Lifetime Cap Already Started.Indiana restricted Medicaid ABA to EPSDT in April, and federal law caps EPSDT at 21. The six-month transition for existing adult members runs out this fall — and the 4,000-hour lifetime cap it introduced counts everyone from zero. Read more → 🎧 Listen74% of New York's Medicaid ABA Providers Said They Would Leave if the Second Cut Landed. It Landed April 1.A NYSABA and CASP survey told New York that 74 percent of its Medicaid ABA providers would exit if the second cut landed. It landed April 1. The testimony is now a record of what a state was told before it acted. Read more → 🎧 Listen
💼 Industry News
A Commercial Payer Just Put an Expiry Date on Practicing Without Accreditation — in Five StatesA commercial plan covering five New England states now requires accreditation to stay contracted. Center-based Massachusetts and Rhode Island providers have until January 1, 2027, and accreditation takes most organizations two to three quarters. Read more → 🎧 ListenA Federal Warrant Names the Out-of-Network Strategy Itself as the Alleged FraudAn unsealed HHS-OIG affidavit alleges a company required its own therapists to stay non-credentialed so it could bill out-of-network rates — naming the payer strategy itself as the scheme. No charges have been filed. Read more → 🎧 Listen🔗 Also Worth Your Time → One State's Autism Benefit Went From $600,000 to $400 Million. Then the Indictments. → Your Blues Plan Says the Prior-Auth Phone Call Is Optional. Ask For Fax. → The Biggest ABA Market in the Country Is Deciding Whether to Cap How Many Months a Child Gets Treatment📤 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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