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Audit of Medicaid Applied Behavior Analysis for Children Diagnosed With Autism

Autism spectrum disorder (autism) is a developmental disability that can cause significant social, communication, and behavioral challenges for children. According to the Centers for Disease Control and Prevention, there is currently no cure for autism; however, research has shown that early intervention and treatment can improve a child's development. A common treatment for autism is Applied Behavior Analysis (ABA). ABA can help an autistic child improve social interaction, learn new skills, maintain positive behaviors, and minimize negative behaviors. In the past few years, some Federal and State agencies have identified questionable billing patterns by some ABA providers as well as Federal and State payments to providers for unallowable services. We will audit Medicaid claims for ABA services provided to children diagnosed with autism to determine whether a State Medicaid agency's ABA payments complied with Federal and State requirements.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
June 2021 Centers for Medicare and Medicaid Services Audit of Medicaid Applied Behavior Analysis for Children Diagnosed With Autism Office of Audit Services W-00-21-31555 2022