Autism Care Providers Respond to CMS Guidance

Autism Spectrum Disorder (ASD) is one of the fastest-growing developmental disorders in the United States, with more than 2.3 million children affected. With the right support, children with ASD can learn and build new skills that transform their quality of life.

Applied behavior analysis (ABA) is evidence-based, standard therapy for children with autism, helping millions of children and families live better lives. ABA is a proven, scientific therapy that reduces potentially harmful behaviors and increases skills in people with autism. It has improved the lives of children with autism since the 1960s and continues to improve as evidence and best practices about its application evolve. It is by far the most recognized evidence-based treatment.

ABA has helped hundreds of thousands of children with autism, but it requires a highly individualized approach and the recommended frequency of treatment varies. Every child with autism is different. Treatment decisions are best determined between parents and providers, based on the individual circumstances of the child and family.

The reasons for recent increases in Medicaid reimbursement for ABA therapy are complex. While amount of care and growth of clinics contribute, there has also been a dramatic increase in diagnoses and people seeking ABA treatment in recent years.

The Council of Autism Service Providers (CASP) is the leading non-profit, national association of autism service provider organizations in the United States. CASP believes providers must be held accountable to the highest standards and has developed tools and recommendations for ensuring greater transparency, quality, and integrity in ABA care. CASP appreciates the efforts of CMS to provide additional support to states in their administration of this critical benefit. As CMS’ guidance recognizes, management of ABA coverage must ensure continued access to needed care. CASP can play a critical role in grounding the technical recommendations found in CMS’ guidance. We look forward to working with CMS and the states to refine, clarify, and build out this guidance so that children get the care they need and stakeholders are assured of accountability and compliance with the law. 

Parents, researchers, clinicians, and policymakers agree that ABA can make a positive difference in the lives of children with autism, and this evidence-based therapy is deserving of continued Medicaid coverage.

— Lorri Unumb, Chief Executive Officer, Council of Autism Service Providers; parent of child with autism