Provider Favors Licensing

 The Politics of Autism includes an extensive discussion of autism service providers.  Private equity firms now own many of them.   Insurance mandates and Medicaid spending have contributed to the growth trend.

In 1971, George Stigler wrote that "regulation is acquired by the industry and is designed and operated primarily for its benefit."  By seeking requirements such as occupational licensing, incumbents seek to limit competition.

Breaking News ABA:

Centria Autism told Florida’s applied behavior analysis (ABA) task force on October 5 that the state should license every provider location, charge each one $1,000 a year for inspections, and reduce Medicaid payments at locations that fail. The company operates in 11 states but does not provide ABA in Florida, according to the Florida Phoenix.

Shevaun Harris, secretary of the Agency for Health Care Administration (AHCA), which runs Florida Medicaid, chairs the task force but does not vote. She said she found it “interesting” that a provider would advocate licensing ABA facilities. “I just want to note our agency has been very intrigued by that concept,” she said, according to the Florida Phoenix. “We’ve had the same conversation here at the agency,” she added, citing “individuals going into people’s homes of very vulnerable kids.”

Florida recorded $6.57 billion in Medicaid and Children’s Health Insurance Program (CHIP) payments for ABA from 2023 through 2025, the highest state total in federal data AHCA presented in August. Lawmakers created the panel in 2026 to recommend changes to the program, from authorization limits to provider billing standards.

Private equity firm Thomas H. Lee Partners acquired Centria in 2019 in a deal reported at $415 million. The 74’s September analysis of federal Medicaid payment data ranked Centria first among the ABA providers it identified, with more than $440 million in payments recorded from 2019 through 2024. CEO David Harbour, who made the licensing pitch, said it could help “create standardization around the services,” according to the Phoenix.

AHCA separately asked whether required technician supervision should rise from at least 5% of service hours to 10% to 20%. Minutes approved at the meeting also document discussion of limits on approved hours. These remain proposals, rather than final task force recommendations.