Florida Behavior Analysis Authorizations Status

As a small, local ABA company providing services in an area where services are severely limited in Hernando and Pasco Counties, we have asked for assistance from Senator Wilton Simpson and AHCA to support authorization processing (honoring Beacon authorizations) and processing staff applications for enrollment since February, 2018. We spoke to several individuals at AHCA and we have asked for assistance so that we can continue to provide services in a area where the majority of our patients are on Medicaid. We hope to know something more soon and will let you know as we have updates. ***Here’s what we do know: Beginning May 1, 2018, eQHealth began processing clinical reviews to determine whether ABA services meet the requirements for “medical necessity”. eQHealth provided a brief live webinar training and indicated they will have a two (2) to five (5) day turnaround time to obtain approvals, denials, and partial approvals. For denials and partial approvals, the clock starts over, if appealed. How long it will take to provide services is unclear. Approvals through Beacon Health Options (prior authorizing contractor) have not been honored by eQHealth to date. Provider enrollment, even outside of Miami-Dade and Broward Counties, is still taking much longer than had previously (1-2 weeks versus months) - we cannot get anyone enrolled. AHCA published a Press Release http://ahca.myflorida.com/Executive/Communications/Press_Releases/pdf/BA_provider_release5142018.pdf and shared the Provider Enrollment Moratorium Request granted for South Florida http://ahca.myflorida.com/docs/RedactedVersion.pdf and the Miami Herald published an article http://www.miamiherald.com/news/health-care/article211158814.html. And another change.org petition for Behavior Analysis services in South Florida started by families in South Florida. I’m told that providers across the state are not getting enrolled anywhere. We’ll see how quickly authorizations are processed and whether providers will be enrolled outside of South Florida. We need this resolved soon! Otherwise, it severely limits our ability to provide services.