The recognition of applied behavior analysis as a medically necessary mental health benefit represents one of the most significant advances in autism service access. However, this recognition has introduced a fundamental tension: behavior analysts are now healthcare providers operating within a system whose guidelines may not always align with evidence-based practice standards.
Provider: BehaviorLive — via Missouri Association for Behavior Analysis
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Join Free →The recognition of applied behavior analysis (ABA) as a medically necessary mental health benefit has turned behavior analysts into health care providers, and the race is on to see whether best-practice ABA will be defined by the insurance industry or behavior analysts. Behavior analysts who work with Medicaid and/or commercial insurance have increasingly encountered insurer guidelines that interfere with their efforts to implement evidence-based treatment plans. Many common insurer guidelines, such as location exclusions, caregiver participation requirements, and age and hour limits, violate the federal Mental Health Parity and Addiction Equity Act (MHPAEA). More recently, insurers have been using Medically Unlikely Edits (MUEs) to limit treatment hours in violation of MHPAEA. For the first time since MHPAEA became law, federal agencies are scrutinizing insurer guidelines and practices through the lens of MHPAEA compliance. In this new climate of MHPAEA enforcement, behavior analysts are uniquely positioned to reject improper guidelines that constrain their ABA practices. This workshop will equip behavior analysts to recognize and reject payor practices that violate the federal Mental Health Parity and Addiction Equity Act (MHPAEA). Participants will acquire the knowledge and resources to identify, eliminate, and effectively report improper guidelines.
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 2 | Ethics |
Julie Kornack has spent more than a decade increasing access to mental health services by shaping legislation, regulation, and policy at the federal, state, and local levels. Her work includes identifying, developing, and supporting federal and state initiatives that safeguard and increase access to autism services and supports, as well as analyzing the impact of federal and state legislative and regulatory developments on access to mental health services. She is co-author of The Diversity Is in the Details: Unintentional Language Discrimination in the Practice of Applied Behavior Analysis and A Response to Papatola and Lustig’s Paper on Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis in the Treatment of Individuals on the Autism Spectrum, published in Behavior Analysis in Practice, and is the author of The History, Pitfalls, and Promise of Licensure in the Field of Behavior Analysis, published in Handbook of Treatments for Autism Spectrum Disorder. Her analysis of the economics of autism treatment was published in the Handbook of Early Intervention for Autism Spectrum Disorders: Research, Policy, and Practice, and she was an editor of Evidence-Based Treatment for Children with Autism: The CARD Model. She is the ABAI representative on the ABA Billing Codes Commission. She co-founded and serves on the board of directors of the National Coalition for Access to Autism Services and serves on multiple state and national advisory councils, committees, and task forces. She has helped develop disability health policy for state and federal political campaigns, and she is a co-author of the Democratic National Committee’s Disability Primer for Democratic Candidates.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
279 research articles with practitioner takeaways
252 research articles with practitioner takeaways
244 research articles with practitioner takeaways
Side-by-side comparison with a clinical decision framework
Research-backed educational guide for behavior analysts
Research-backed answers to common clinical questions
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.