CalABA Response to Reports on Medicaid Payments for ABA Services

In recent months, critical reports about payments for applied behavior analysis (ABA) services for Medicaid beneficiaries with autism in several states have been issued by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services. Articles on that topic have also appeared in some media outlets, notably the Wall Street Journal (WSJ). CalABA understands that such scrutiny has been driven in part by large increases in the numbers of ABA Medicaid beneficiaries and providers and the concomitant costs.

We concur with calls for appropriate oversight of ABA services to Medicaid beneficiaries that have been prompted by the OIG and media reports. At the same time, we note that some reports omitted important facts about the contexts in which ABA health care services are delivered. To address those gaps as well as the concerns raised in the reports, CalABA offers the following comments and reminders for journalists, practitioners, consumers, OIG personnel, and the California Department of Health Care Services (DHCS), which administers Medi-Cal (our state’s Medicaid program).

CalABA also recognizes the potential for bias in how audits, reports, and media narratives are constructed and interpreted, particularly when examining services delivered within Medicaid systems that disproportionately serve historically marginalized communities. We encourage stakeholders to interpret findings with attention to contextual factors, including population needs, systemic constraints, and variation in service delivery environments.

Read the Full Statement HERE