Inside Behavior Analysis
Volume 2 | 2010 | Number 2
Practice Board Report
By Michael Dorsey, Michael Douger, Doreen Granpeesheh, R. Douglas Greer, John Guercio, Travis Thompson, Michael Weinberg, and Jennifer Zarcone
The ABAI Practice Board kept an active agenda in 2009 and early 2010. Most notable during this period was progress developing an application to recognize Current Procedural Terminology (CPT) codes for third party insurance billing for applied behavior analysis (ABA) services for children diagnosed with autism—see Travis Thompson’s article for details on the efforts of the Insurance Billing Code Committee. Members of the Practice Board organized several events for the annual conventional that were very well received, including symposia on medical insurance funding and reimbursement for parents and professionals and an Invited Presentation by Massachusetts State Representative John Scibak, whose made a presentation titled, "Utilizing Behavior Change to Achieve Political Change." Practice Board sponsored events have been codified into a formal Practice track beginning in 2011. The Practice track is designed for presentations that pertain to professional issues of practicing behavior analysts related to credentialing (i.e., certification and licensing), insurance coverage, program evaluation, systems level analysis, and ethical issues. Of particular interest are presentations that address the gap between research and practice. The track will be open for submissions and will be organized by the ABAI Practice Board and under the leadership of Drs. Jennifer Zarcone and Ronnie Detrich.
Additionally, The ABAI Hotline continues to be a popular destination for members and other interested parties to submit questions related to various topics concerning ABA, particularly ethical issues in practice.
Behavior analyst licensing laws that passed in 2009 go into effect on various dates during 2010 in Arizona, Nevada, Oklahoma, and Pennsylvania. Also, a bill in Kentucky was passed in April, 2010. Furthermore, in five states, licensure will be required for practitioners to bill insurance companies for behavior analysis services. These licensing bills have been combined with autism insurance funding legislation that has been developed by Autism Speaks. One exception is in Nevada, where the insurance bill—submitted by Autism Speaks and requiring BCBA or BCaBA certification to be qualified to provide behavior analytic services for children or adolescents with autism and bill insurance companies—was amended prior to passage. The Nevada legislature believed that practitioners, as well as front line workers, must be licensed to be considered a provider by health care insurance providers and to bill for services.
The ABAI Executive Council and Practice Board have been engaged in ongoing deliberations with the BACB Board of Directors to come to a unified position for a Model Licensure Act. The BACB has increased its course requirements and our two associations are very close to a resolution and looking forward to years of future collaboration.
Members of the Practice Board also hosted ABAI booths around the country and presented at ABAI chapter and other conferences to increase awareness among chapter members of the activities of the Board, including at Autism New Jersey, Behavior Analysis Association of Michigan, The Berkshire Association for Behavior Analysis, California ABA, Florida ABA, Four Corners ABA, Kentucky ABA, Massachusetts ABA, Minnesota Northland ABA, Missouri ABA, Nebraska (chapter pending), New Jersey ABA, Oklahoma (chapter pending), Pennsylvania ABA, Tennessee ABA, Texas ABA, and Vermont ABA. Practice Board members have also been central to the new ABAI Affiliated Chapter and SIG Leadership Training sessions. Board members have made presentations and provided information about licensure, legislative advocacy, and state efforts to pursue legislation that protects the field and its stakeholders. Leadership presentations have been well received by state chapter and SIG representatives.
This trend is being seen in other states where insurance companies are leading licensure efforts, including Blue Cross/Blue Shield (BC/BS) in Missouri and Connecticut. This is particularly relevant in Connecticut, which already has an autism insurance funding bill in place as of January 1, 2010. However, BC/BS Anthem has stated it will not accept non-licensed BCBAs or BCaBAs on its provider panels nor pay this group for services billed at the same rate as licensed applied behavior analysts. There is also a trend of insurance companies refusing to include BACB certificants on their provider panels as "in-network" providers; healthcare provider companies such as AETNA and SIGNA are identifying BACB certificants as out-of-network providers and pay at a rate that is approximately half or lower than the rate paid to licensed and in-network providers. The Practice Board will continue to advocate with insurance companies that BACB certificants be reimbursed at the same level as licensed professionals and "in-network" providers.
The Practice Board will continue its efforts to communicate first with chapters where they exist, to understand chapter positions on pending legislation, and to work with chapters and other ABAI constituents within specific states. The Board will also continue to seek the support of stakeholders in their respective states.