Compliance programs were formally introduced into the healthcare space only 30 years ago. Historically, the focus of these programs has been mainly on hospitals, insurance providers, and nursing facilities; however, attention is rapidly turning to Applied Behavioral Analysis providers. As the incidence rate of Autism Spectrum Disorder rises, the cost of treatment by insurance companies, state programs, and federal funding sources increases exponentially. The government has several programs in place to monitor fraud, waste, and abuse, and maintains acute interest in those who are misusing funds. Applied Behavioral Analysis providers have recently come under scrutiny in matters of fraud, waste, and abuse; these allegations bring stigma for the industry and necessitate a call to action. Further, as funders become increasingly concerned with assessing value against costs, providers will need to develop increasingly robust systems in order to ensure proper documentation and outcomes-driven processes, in order to avoid devastating payment recoveries. This panel presents a full range perspective, bringing together both providers and funders to discuss healthcare compliance from multiple vantages, in order to provide participants with a path forward to ensuring quality care and upholding ethical standards.
|Learning Objectives: 1) Participants will gain general knowledge of what Fraud, Waste and Abuse looks like in the Applied Behavioral Analysis industry 2) Participants will define 5 steps that attendees can use to initiate/improve upon a compliance program designed to protect clients, drive quality outcomes, and meet funder regulations 3) Participants will identify relevant items of the Professional and Ethical Compliance Code for Behavior Analysts, as it pertains to personal responsibility for delivering care that is effective, efficient, and well-documented