Texas Medicaid represents one of the most significant funding pathways for applied behavior analysis services in the state, providing access to ABA treatment for thousands of children and adults with autism spectrum disorder who would otherwise be unable to afford care. For BCBAs and ABA organizations seeking to serve Medicaid-enrolled clients, understanding the enrollment, authorization, and compliance requirements is not optional — it is a prerequisite for ethical and sustainable service delivery.
Provider: BehaviorLive
Take This Course →Including ethics, supervision, and topics like this one. New live CEU every Wednesday.
Join Free →Course Description This workshop will provide training on how to navigate the Autism Services benefit through Texas Medicaid, including the ethical considerations and responsibilities involved in providing Medicaid-funded services. Attendees will receive step-by-step guidance on the application and enrollment process, authorization process, and other program requirements as well as practice tools and strategies for overcoming common challenges and obstacles. Learning Objectives: 1) Attendees will analyze the applicable Core Principles and Ethics Standards of the Ethics Code for Behavior Analysts in the context of Medicaid provision.2) Attendees will describe how to submit their application through the Provider Enrollment and Management System (PEMS) for Texas Medicaid & Healthcare Partnership (TMHP) enrollment in order to adhere to regulatory compliance and professional conduct standards.3) Attendees will identify the Managed Care Organization(MCO) in their service area, verify benefit information, and ensure that referring providers are Texas Medicaid enrolled in order to adhere to regulatory compliance and professional conduct standards4) Attendees will advocate for appropriate services for clients by identifying key contacts and processes for resolving approval, contracting, credentialing, and authorization barriers.5) Attendees will define medical necessity criteria and prior authorization requirements to obtain authorizations and maintain ongoing services in order to document professional activity and advocate for appropriate services for clients.6) Attendees will explain the process to file complaints and appeals related to the Autism Services benefit as a way to advocate for appropriate services for clients.
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 3 | Ethics |
The mission of the TxABA Public Policy Group (PPG) is to review and act on legislative activity and other issues impacting behavior analysts and consumers in Texas.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
280 research articles with practitioner takeaways
239 research articles with practitioner takeaways
236 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.