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Advocates tell committee HB4623 would expand MassHealth ABA workforce by recognizing assistant analysts
Summary
Supporters told the Joint Committee on Health Care Financing that HB4623 would let board-certified assistant behavior analysts (BCABAs) bill MassHealth, easing long wait lists for autism services and potentially lowering per-member costs, according to an actuarial model submitted to the committee.
Representative Lisa Field, speaking out of order at a Jan. hearing of the Joint Committee on Health Care Financing, urged lawmakers to give HB4623 a favorable report so MassHealth will recognize board-certified assistant behavior analysts (BCABAs) for reimbursement.
"Families seeking ASD services are facing unprecedented delays," Representative Lisa Field said, arguing that excluding BCABAs "significantly reduces the pool of qualified professionals able to serve children with autism through MassHealth." She told the panel that 70 to 80 percent of ABA services in the state are funded by MassHealth.
The bill would add a mid-level supervisory role within MassHealth’s reimbursement framework, allowing BCABAs to oversee direct staff and expand service capacity. Dr. Sandra Beaton, senior clinical manager at Community Autism Services in Brockton, said her office’s wait list rose from 47 to 57 families and that two clinicians on her staff could immediately serve "another 8 to 16 families" if the change were implemented.
An actuarial analysis submitted by Wakely and presented by Annie Tessman Ewing argued the model could lower MassHealth costs per user. "Our actuarial analysis found that this transition could reduce MassHealth costs by up to 6% annually," Tessman Ewing testified, noting the estimate depends on assumptions about shifting BCBA-led hours to mid-tier providers and the pay differential used in the model.
Supporters said expanding recognized provider categories would both increase timely access to care and create a clearer career pathway for ABA professionals. They asked the committee to consider the bill alongside operational and reimbursement changes coming in the 2026 MassHealth ABA policy.
The committee took testimony but did not act on HB4623 at the hearing. The chairs encouraged submission of additional written testimony and data to the committee record.
