Association for Behavior Analysis International

Webinar Series: Legal and Clinical Essentials for Enforcing ABA Mandates, Ethical Billing, and Medical Necessity Documentation, February, 2022

In this presentation, Dan Unumb, Esq., and Dr. Tim Courtney, BCBA-D, will discuss the key reasons why BCBAs need to understand the laws governing third-party funding of ABA services. Dan and Tim have conducted numerous presentations throughout the country on issues related to accessing insurance funding for ABA services. This presentation highlights how not being aware of the law can reduce or delay service approvals and payments for services rendered. The presenters will also discuss potential blind spots for providers and how to avoid them. The presentation also discusses professional ethics considerations applying to medical necessity and documentation.

Instruction Level: Intermediate

Target Audience: BCBAs, ABA executives, administrative staff, billing staff, any staff involved in compliance, authorizations, denials, filing, or documentation processes.

Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) define mental health parity and describe how it is relevant to the medical necessity process; (2) identify two of the BACB ethics codes related to providing insurance funded ABA services; (3) identify at least two areas of risk for fraudulent or unethical service provision and billing practices.