ABA Flexibilities Ending May 11, 2023, Per AHCA

Date: 05/22/23

Fort Lauderdale, Florida

In March through May 2020, Florida Medicaid provided guidance on telemedicine and Continuation of Authorization flexibilities offered to behavior analysis providers and Florida Medicaid recipients to ensure service continuity during that time.

The Agency for Health Care Administration (AHCA) sent policy guidance notifying providers that the following flexibilities will end effective May 11, 2023:

Behavior Analysis: Beginning with May 11, 2023 dates of service, Florida Medicaid will no longer reimburse Assistant Behavior Analysts delivering caregiver training via telemedicine. Lead analysts will continue to be eligible to receive reimbursement for caregiver training delivered via telemedicine in accordance with the behavior analysis fee schedule.

Direct Observation and Supervision of the Behavior Plan Implementation. In April 2020, Florida Medicaid allowed providers the option to use currently approved Lead Analyst or Assistant Behavior Analyst hours to render services using telemedicine to promote in-home training and direct observation of the registered behavior technician on the implementation of the behavior plan and intervention strategies. Beginning May 11, 2023, this flexibility will no longer be available.

Behavior Analysis Continuation of Authorization During the Public Health Emergency. In May 2020, Florida Medicaid allowed providers the option of obtaining administrative approval to extend current authorizations to reduce the need for providers having to conduct reassessments for recipients currently receiving services. Beginning May 11, 2023, all service continuation requests will require a completed reassessment, updated treatment plan and medical necessity review in accordance with the Florida Medicaid Behavior Analysis Coverage Policy.

For questions or further information, providers can call the Florida Medicaid Helpline at 1-877-254-1055. If you have questions about this notice, please contact your Provider Engagement Administrator or call Sunshine Health Provider Services at 1-844-477-8313. Stay up to date on Sunshine Health provider notices by reviewing and bookmarking Provider News.

^SH_6036