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Providers urge stable Medicaid coverage and reimbursement for ABA treatment for autism
Summary
Autism service providers, parents and clinicians asked the subcommittee to implement fee-for-service ABA reimbursement, protect rates from MCO cuts, and expand workforce pathways to increase access for children on Medicaid.
Multiple autism providers and families told the Senate Medicaid subcommittee they are struggling to deliver applied behavior analysis (ABA) under Ohio's current Medicaid arrangements and asked the Senate to adopt amendments to stabilize access.
Marla Root, founder of the Ohio Autism Insurance Coalition, described long waits and low participation by Medicaid providers. She told the committee her group found that just 8 percent of Medicaid-eligible children with autism are receiving ABA, the evidence-based therapy most commonly prescribed for autism spectrum disorder.
Providers and clinicians asked for three specific changes: (1) implement fee‑for‑service ABA reimbursement effective July 1, (2) place a moratorium on managed-care organizations reducing ABA rates for two years, and (3) permit competent behavior technicians to deliver services while completing national certification, with a transition window. Jen Gondin, an ABA provider from Youngstown, said the combination of inconsistent MCO policies, backlogged authorizations and low rates is destabilizing the network.
Parents and clinicians described the stakes. Kim Wolf, a board‑certified behavior analyst, said a child referred to ABA at school age missed the early intervention window, creating more severe school and home problems that might have been prevented. Amy Jones, a parent and BCBA, described how interruptions in coverage send children back to the end of long wait lists and reduce treatment momentum.
Speakers said the Department of Medicaid has drafted rules but repeatedly pushed the effective date, delaying provider certainty. Witnesses asked the committee to pass budget amendments that would put fee schedules into effect on July 1, add rate protections, and allow a reasonable certification window for entry‑level staff.
No formal motions were adopted during the hearing; pro‑ABA witnesses asked legislators to adopt the proposed budget amendments to accelerate implementation and stabilize provider networks.
