BCBAs Face Scrutiny for Signing Off on Unobserved Sessions
Federal audits reveal widespread billing fraud in ABA therapy, compromising patient safety and regulatory compliance across multiple states.
Policy
The federal and state actions deciding what ABA can bill and who qualifies. Coverage of Medicaid rate cuts, federal HCBS reductions, OIG audits, the new CMS fraud initiative, and state lifetime-hour caps. For BCBAs and operators tracking compliance exposure. Run alongside business, private equity, clinical practice.
Dr. Mehmet Oz Targets ABA Fraud in Aggressive New Initiative
The CMS Administrator's crackdown on ABA therapy fraud signals a significant shift in federal oversight and enforcement within the industry.
Federal Medicaid Cuts Threaten ABA Services Nationwide
The One Big Beautiful Bill Act slashes $1 trillion from Medicaid, jeopardizing vital home and community-based services for autistic individuals.
TRICARE’s ABA Therapy System Fails Military Families
Despite covering ABA therapy, military families face severe access issues, provider shortages, and a broken system, according to a recent review.
The Venture Capital Wave in ABA Tech: Who Invested, Who Won, Who Folded
Between 2019 and 2023, venture capital poured into ABA technology startups at a pace the industry had never seen. A unicorn appeared. Celebrities invested. SoftBank showed up. Then the reimbursement environment shifted,…
Indiana’s 4,000-Hour Lifetime Cap: The Most Aggressive ABA Utilization Control in the Country
Effective April 1, 2026, Indiana imposed a lifetime allocation of 4,000 hours of ABA therapy for children on Medicaid — the most aggressive utilization control any state has enacted. After exhausting the…
Wisconsin’s $18.5 Million ABA Audit: 100 Out of 100 Sampled Claims Had Errors – and the State Only Partially Concurred
Wisconsin’s ABA Medicaid spending rose from $39.9 million in 2018 to $53.7 million in 2022. The HHS-OIG audit found that all 100 sampled enrollee-months contained at least one improper or potentially improper…
The Parity Enforcement Vacuum: Trump Administration Pauses the 2024 MHPAEA Final Rule, Leaving States as Sole Enforcers – With ABA Specifically in the Crosshairs
The Trump administration has paused enforcement of the 2024 final rule implementing the Mental Health Parity and Addiction Equity Act, eliminating the federal compliance requirements that the rule had imposed on commercial…
Minnesota’s EIDBI Fraud Ring: Kickbacks, Fabricated Diagnoses, and $14 Million Drained from an Autism Therapy Program
Federal prosecutors in Minnesota have charged multiple defendants in a coordinated fraud scheme targeting the state’s Early Intensive Developmental and Behavioral Intervention program, which funds ABA and related services for autistic individuals.…
Indiana’s Self-Reporting Ultimatum: FSSA Secretary Roob Gave ABA Providers Until April 3 to Confess
Indiana Family and Social Services Administration Secretary Mitch Roob held a tense meeting with ABA industry stakeholders in mid-March 2026, requiring providers to self-report any practices that could constitute fraud, waste, or…
New York’s ABA Crisis: Medicaid Rates, OPWDD, and Why the Empire State Is Losing Providers
New York was the 49th state to cover ABA under Medicaid, launching the benefit in August 2021 after years of advocacy. Less than four years later, the state is cutting the technician…
Georgia’s ABA Desert: Why One of America’s Most Populous States Is Underserved
Georgia ranks among the top five states in the nation for BCBA demand, yet its 159 counties include vast rural stretches with no behavior analysts at all. A combination of partial Medicaid…
Indiana Billed $340,000 Per Patient to an Autism Clinic. Now It’s Shutting That Clinic Out of Medicaid.
Indiana has moved to terminate Medicaid billing rights for one of the nation’s highest-billing autism therapy providers — acting two weeks after investigative reporting exposed a $340,000 per-patient billing average that immediately…
The HHS-OIG ABA Audit Wave: How Federal Investigators Found $133M in Improper Billing in Indiana Alone
The HHS Office of Inspector General’s December 2024 audit of Indiana Medicaid ABA is the first of a planned seven-state federal review series - and in every state completed so far, auditors…
The Autism Family Waitlist Crisis: How Families Are Actually Coping Right Now
The average ABA waitlist is measured in months - sometimes more than a year. In that time, children lose ground, parents improvise, and a multi-billion-dollar industry demonstrates that it has built capacity…
The Full M&A Map of ABA: Every Major Deal Since 2015, Annotated
From Great Point’s founding bet on Autism Learning Partners in 2010 to Blackstone’s $600 million wipeout and Roper’s $1. 65 billion software grab, a decade of private equity transformed - and at…
All 50 States Passed the Autism Insurance Mandate. Not All of Them Actually Meant It.
Tennessee completed the map in 2019. Every state now has some form of law requiring insurance coverage for autism therapy.
Medicaid MCO vs. Fee-for-Service: Why the Same Child Gets Different ABA Coverage in the Same State
Two children live in the same city. Both have autism. Both qualify for Medicaid. Both are entitled to medically necessary ABA therapy under the federal EPSDT mandate. But one is enrolled in…
The 2027 CPT Code Overhaul: What Six New Codes and the Death of T-Codes Mean for ABA Billing
In September 2025, the American Medical Association’s CPT Editorial Panel approved the most significant revision to ABA billing codes since the field received its first permanent CPT codes in 2019. Six new…
The Managed Care War: How Texas Became ABA’s Biggest Battlefield
Texas was the last state in America to cover ABA therapy through Medicaid. When it finally did, in February 2022, it routed every dollar through managed care organizations that set rates too…
The EPSDT Mandate: The Federal Law That States Keep Violating on ABA
The Early and Periodic Screening, Diagnostic, and Treatment mandate is the most powerful protection families of autistic children have under federal law. It requires Medicaid to cover all medically necessary services for…
The $14 Billion Line Item: How ABA Became Medicaid’s Fastest-Growing Budget Problem — and Why Every State Is Now Deciding What to Do About It
Medicaid spending on Applied Behavior Analysis therapy grew 279 percent from 2018 to 2024, reaching $14.49 billion across all states. Indiana's ABA spending increased 2,800 percent in six years. Nebraska's grew 1,700…
Nebraska Cut ABA Rates by Up to 79%. Here’s What Happened Next — and What It Means for the Rest of the Country
In August 2025, Nebraska slashed Medicaid reimbursements for ABA therapy — by 48% for behavior technicians, 51% for parent training, and as much as 79% for some services — setting off a…
Arizona’s Ghost Network Problem: How Mercy Care’s Rate Cuts Triggered the Collapse of Medicaid ABA Access for 1,000 Children — and the Two Lawsuits Trying to Stop It
When Arizona’s largest Medicaid insurer tried to cut reimbursement rates for ABA therapy by 40% in a single year, the two biggest providers in the state refused to accept the terms. Mercy…
Indiana’s $611 Million Problem: How the State Let ABA Costs Run Unchecked — and the Sweeping Reform It Built in Response
Indiana’s Medicaid ABA program grew from $17 million to $611 million in six years with almost no oversight, no accreditation requirements, and a billing model that rewarded providers for charging more. A…