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Sunday, July 29, 2018

Florida Medicaid Mess

The Politics of Autism includes an extensive discussion of insurance and Medicaid services for people with intellectual and developmental disabilities

Florida's Agency for Health Care Administration has sanctioned four behavior therapy firms for not paying fines, employing unqualified therapists and withholding required information. AHCA is slow-walking therapy authorizations and approvals of new therapists,

Daniel Chang reports at The Miami Herald:
The Florida Association for Behavior Analysis, a statewide nonprofit that promotes the therapy — which is designed to correct behavioral issues in children with developmental disabilities — said the delays are hurting kids.
“These delays are inexcusable and are causing heartache for so many children and families who desperately need the services provided by qualified behavior analysts,” Nikki Dickens, president of FABA, said in a written statement. “Our state government simply cannot sit back while these vulnerable children suffer as a result of an ineffective and inefficient bureaucratic system.”
In May, AHCA imposed a moratorium on enrollment of new behavior analysis providers in Miami-Dade and Broward, alleging rampant fraud that included therapists falsifying credentials and billing for more hours than there are in a day. The sanctions announced last week are part of that investigation.
But some Miami-Dade providers say AHCA used wrong or outdated information as a reason to suspend their therapists from Medicaid and then forced the provider to repay thousands of dollars.