OIG Issues 2024 Annual Report, MassHealth’s Applied Behavior Analysis Program – Service Providers

Boston, MA — The OIG’s Healthcare Division (HCD) reviewed MassHealth’s Applied Behavioral Analysis (ABA) Program in fulfillment of its legislative mandate to examine the Massachusetts Medicaid (MassHealth) and Health Safety Net programs. MassHealth’s ABA Program provides treatment to MassHealth-eligible children diagnosed with autism spectrum disorder. Specifically, the OIG’s HCD reviewed whether service providers deliver ABA treatment in a manner consistent with MassHealth’s performance specifications.

The HCD determined that MassHealth overpaid $17.3 million in claims to ABA providers that did not provide the required supervision of its paraprofessionals, “impossibly billed” more than 24 hours of service in one day and billed for ABA services on major holidays like Christmas and the Fourth of July.

Download a PDF version of the full report.

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