Association for Behavior Analysis International

With the proliferation of insurance funding for applied behavior analysis (ABA), behavior analysts increasingly encounter insurer guidelines and limits that hinder their efforts to implement treatment plans that reflect best practices. This panel seeks to empower behavior analysts to recognize and reject payor practices that violate the federal Mental Health Parity and Addiction Equity Act (MHPAEA). Many common insurer guidelines, such as location exclusions, caregiver participation requirements, and age and hour limits, violate MHPAEA. More recently, payors have been using Medically Unlikely Edits (MUEs) to impose improper hour limits on medically necessary ABA in violation of MHPAEA. Although access to ABA is protected by MHPAEA, enforcement of MHPAEA has been limited and inconsistent since MHPAEA was first enacted in 2010. Now, federal agencies are focused on rooting out payor guidelines and practices that violate MHPAEA. With growing scrutiny on payors, behavior analysts have an opportunity to highlight improper guidelines and increase access to ABA that reflects best practices, rather than ABA that is shaped by payor guidelines.

Participants should have experience designing and implementing treatment plans for insurance-funded applied behavior analysis.