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Payments Frozen For Some Autism Providers

The state has frozen payments to some providers who treat children with autism while it tries to ferret out fraudulent activity, but a high-ranking Medicaid official said the freeze should be lifted within two weeks.

Beth Kidder, a deputy secretary of the state Agency for Health Care Administration, told members of the Senate Health Policy Committee on Monday that the state has frozen payments to behavioral analysis providers until they can verify that they meet new certification requirements that went into effect Jan. 1.

The requirements are part of the state’s efforts to crack down on suspected Medicaid fraud in the behavioral analysis program.

In addition to the new requirements, the state implemented a six-month moratorium on the enrollment of new behavioral analysis providers in Miami-Dade and Broward counties.

Behavioral analysis services are provided in Florida’s Medicaid program mostly to children with autism spectrum disorder.

There are four different levels of behavioral analysis providers in Florida: billing group, lead analyst, associate analyst and registered technician.

Sen. Debbie Mayfield, a Rockledge Republican who serves on the Senate Health Policy Committee, told Kidder that her office is being “bombarded” by complaints by behavioral analysis providers who have been caught up in the agency’s attempts to snuff out fraud.

“Evidently, there was a certain area that was having problems with unlicensed registered behavioral technicians, so they just pulled all technicians licenses,” Mayfield said.

“So therefore, the ones that were doing it correctly, are no longer getting paid. But they are being told and asked to continue to perform the service,” Mayfield said to Kidder.

Kidder told Mayfield that the increased qualifications were for the “lowest level of people” who provide the service. “These people go into individuals’ homes and work with children with severely disabling conditions. They don’t have to have a whole lot of qualifications,” Kidder said, adding that the state wanted the technicians to have some sort of certification.

Kidder also said providers who meet the new requirements should have their payments returned to normal in the coming weeks.

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News Service of Florida
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