Florida Medicaid Coverage Stalled for ABA Services for our Most Vulnerable People

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Dear Inspector General Mary Beth Kidder, Governor Scott & Brad Piepenbrink:

Please intervene and allow Behavior Analysis Services authorizations to be released to ABA providers with no further delay. Services cannot effectively be maintained without a continuity of care. The inability to obtain authorizations creates harm for our most vulnerable population - our children with special needs, developmental disabilities, ASD, ADHD, Depression, Anxiety, Bipolar, and others. 

We work with children with significant behavior issues ... which in lite of the recent incident in South Florida is a top priority for our State, at this time, as this population possibly ends up endangering themselves or others... If they do not receive intensive behavior analysis services.

On 3/1/18 Florida Medicaid stopped authorizing behavior analysis services stating: “technical difficulties”. We waited patiently. 

On 3/15/18 We received a statewide notice indicating Medicaid is changing how ABA services are authorized. For the last year we have been working with Beacon and now it has been indicated we are to work with eQHealth to obtain ABA authorizations. Although there is literally no information on what this measn. eQHealth here: http://fl.eqhs.org/

Note: on May 1, 2018 eQHealth did provide additional information and documentation on their website.

The message we received from Medicaid, EQHealth, Beacon, and ACHA was to simply wait until 3/21/18 for a webinar and 3/26/18 processing authorizations.

We have authorizations in limbo, clients’ services on-hold, staff on hold. And no clear understanding about services that were already reviewed by Beacon and whether eQHealth / Medicaid will honor approvals already received.

We implore you, ACHA’s Beth Kidder and Governor Scott, to facilitate a cohesive transition for behavior services and to assure your constituents that you will not leave them without the care they need.

Shelly Lynn Henry, MS, BCBA
Trinity ABA, LLC | trinityaba@trinity-aba.com | www.trinity-ABA.com | 727-809-1328

---------- Forwarded message ----------
From: State of Florida Agency for Health Care Administration <Medicaid_Alert@ahca.myflorida.com>
Date: Fri, Mar 16, 2018 at 9:27 AM
Subject: This Replaces Alert Titled: Immediate Changes to Prior Authorization of Behavior Analysis Services (3/15/2018)
To: SHELLYLYNNHENRY@trinity-aba.com


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A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
March 16, 2018
Provider Type(s): 39

This Replaces Alert Titled: Immediate Changes to Prior Authorization of Behavior Analysis Services (3/15/2018)

The Agency for Health Care Administration (Agency) will contract with eQHealth Solutions to administer an authorization review program for Behavior Analysis (BA) services and anticipates that this will be implemented by March 26, 2018.  Effective immediately, providers should no longer submit prior authorization requests to Beacon Health Solutions.

Providers can continue to provide medically necessary BA services under authorizations approved by Beacon.

For questions, contact eQHealth at 1-855-444-3747 and via the web at http://fl.eqhs.org/

During this transition period, the Agency will continue to update providers on impending changes through mailed letters and Provider Alerts.

QUESTIONS? FLMedicaidManagedCare@ahca. myflorida.com

COMPLAINTS OR ISSUES? ON LINE https://apps.ahca myflorida.com/smmc_cirts/  |  CALL 1-877-254-1055

The Agency for Health Care Administration is committed to its mission of providing "Better Health Care for All Floridians." The Agency administers Florida’s Medicaid program, licenses and regulates more than 45,000 health care facilities and 37 health maintenance organizations, and publishes health care data and statistics at www.FloridaHealthFinder.gov  Additional information about Agency initiatives is available via Facebook (AHCAFlorida), Twitter (@AHCA_FL) and YouTube (/AHCAFlorida).

Agency for Health Care Administration  |  2727 Mahan Drive, Tallahassee, FL 32308  |  http://ahca.myflorida.com



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