The dramatic growth in insurance claims for applied behavior analysis services over the past decade has brought both tremendous opportunity and significant scrutiny to the profession. As ABA has become a widely covered benefit for individuals with autism spectrum disorder and related conditions, the volume of claims, the number of providers, and the financial stakes involved have all increased substantially.
Provider: BehaviorLive — via BABAT
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Join Free →Insurance claims for ABA have risen dramatically over the last decade, raising concerns about fraud, waste, and abuse. This has resulted in increased scrutiny from payors and regulators, new clinical guidelines, compliance standards, and accreditation requirements. This workshop will present an overview of the industry challenges and its impact on providers. It will provide an overview of resources providers need in order to document service and ensure compliance, as well as where to report concerns about potential fraud. This presentation will address the following questions: • What do robust provider documentation systems look like and how should compliance be monitored? • How should small(er) providers monitor compliance? • What are some ways that insurance plans monitor for fraud? • What resources are available that document industry standards and best practice. • What actions should BCBA's/RBT's who observe fraud and/or have concerns be taking?
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 1.5 | Ethics |
| COA | 1.5 | — |
Amy Weinstock is the Director of the Insurance Resource Center for Autism and Behavioral Health at the UMass Chan Medical School’s Eunice Kennedy Shriver Center, and an instructor in the medical school’s Department of Psychiatry. She has an extensive background on insurance issues related to autism and has played a key role in passing several significant pieces of autism insurance legislation in Massachusetts, including the groundbreaking 2010 law requiring health insurance to cover medically necessary treatment for autism. Amy also serves as a trustee of the Riverview School, Living Independently Forever (LIFE), and as a Commissioner on the State’s Autism Commission.Following a successful career in real estate and banking, Amy, the parent of a child on the autism spectrum, decided to merge her personal passions and professional experience. She completed a Leadership Education in Neurodevelopmental and Related Disabilities (LEND fellowship at the Eunice Kennedy Shriver Center in 2005. Following this, she served as President of the outreach organization of the Lurie Center for Autism at Massachusetts General Hospital for two years prior to her appointment as Chair of the Insurance Committee for Advocates for Autism of Massachusetts (AFAM)Amy's work has been recognized through numerous awards including the Federation for Children with Special Needs Martha H. Ziegler Founders Award, the Margaret L. Bauman Award for Excellence, the Massachusetts ARC’s Distinguished Citizens Award, the Autism Speaks Advocacy Award, the Doug Flutie Jr. Foundation’s Shining Star and Essential piece awards, and the Northeast ARC’s Edward C. O’Keefe Memorial Award. She is a graduate of Wellesley College and received a Master of Architecture from Harvard University.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
161 research articles with practitioner takeaways
159 research articles with practitioner takeaways
133 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.