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1.5 BACB General CEUs $30 1 hr 16 min On-Demand

General CEU: Fraud in the South: Examining the Contingencies Driving Fraudulent Behavior

Fraud in the South: Examining the Contingencies Driving Fraudulent Behavior matters because it changes what a BCBA notices when decisions have to hold up in clinical documentation, payer communication, supervision records, and leadership review. In Examining the Contingencies Driving Fraudulent Behavior, for this course, the practical stakes show up in service continuity, accurate reporting, and defensible clinical decisions, not in abstract discussion alone.

Provider: BehaviorLive — via Florida Association of Behavior Analysis

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Course Description

South Florida has long been plagued by issues of ABA fraud, with reports of fraudulent services, exam cheating, and misappropriation of funds pervading the state. Despite efforts by various organizations and governmental agencies to combat the problem, evidence suggests that little progress has been made in curbing fraudulent behavior. This ongoing misconduct has had detrimental effects on both the ABA field and its clients. In 2023, the "Fraud in the South" presentation delved into the historical, cultural, and environmental factors perpetuating fraudulent behavior in South Florida, alongside the concerning disparity in provider numbers compared to the rest of the state. Building on this foundation, our current presentation serves as a follow-up to last year's session. Our goal is to compare last year's data with this year's findings and assess any progress or regression in addressing the problem. Moreover, we want to assess the underlying motivations fueling the fraud. Are these actions inadvertently driven by a lack of understanding about billing codes and policies, or are they deliberate and knowingly illegal? To answer these pivotal questions, we conducted surveys among providers in South Florida, seeking insights into their understanding of billing codes, insurance policies, and perceptions regarding the consequences of overbilling or fraud. Our presentation will unveil the outcomes of these surveys, offering valuable insights into the possible causes of ABA fraud in the region and charting a course toward effective mitigation strategies.

What You'll Learn

  1. Comprehend the historical and environmental factors contributing to fraudulent behavior within the ABA field, particularly prevalent in South Florida.
  2. Analyze efforts by organizations and agencies to combat ABA fraud in South Florida, evaluate the effectiveness of these measures, and compare previous data to assess whether there has been progression or reduction of the issue over time.
  3. Uncover potential causes of fraud by evaluating providers' understanding of billing codes, insurance policies, and their perceptions of the immediate and long-term consequences of overbilling or fraud.

CEU Credits Earned

Certification BodyCreditsType
BACB® 1.5 General
COA 1.5
FL MH/PSY 1.5

About the Instructor

MC
Michelle Castanos
M.Ed., BCBA

Michelle Castanos is a Board Certified Behavior Analyst with over 19 years of experience in Applied Behavior Analysis. She earned her bachelor's degree in psychology and a master's degree in special education from the University of North Florida. Her journey into ABA was inspired by her cousin, Miguel, who was diagnosed with Autism Spectrum Disorder in 1997. Michelle began her career as a technician in 2004, starting at the age of 18. By 2007, she founded a company offering behavioral-based babysitting services for children with Autism. Over time, this venture has grown into what is today South Florida Behavior, a comprehensive pediatric ABA center with locations in Miami, FL, and Weston, FL. In addition to her entrepreneurial endeavors, Michelle is one of the founders of THRIVE, the first post-secondary college support program for degree-seeking students with ASD in Florida, situated at the University of North Florida. She has also worked on mobile crisis teams and in institutional settings for adults with Intellectual and Developmental Disabilities and dual diagnoses. Presently, Michelle serves as the President of SOFABA, the South Florida Chapter of FABA. She is also the founder and moderator for the Florida Medicaid ABA Facebook forum and is an elected Member-at-Large on the FABA board, completing her final year of her three-year term.

General Paper
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Clinical Disclaimer

All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.

60+ Free CEUs — ethics, supervision & clinical topics