Florida Judge Allows Pediatric Associates Challenge to Medicaid ABA Rates
An administrative law judge ruled that Pediatric Associates has standing to challenge Florida's Medicaid reimbursement rates for applied behavioral analysis (ABA) services for children with autism. Division of Administrative Hearings Judge W. David Watkins denied the state's motion to dismiss the case on Wednesday. The provider alleges the DeSantis administration miscalculated rates that fail to cover ABA service costs. The ruling allows the rate challenge to proceed to a full hearing on the merits.
A successful rate challenge could force Florida to increase Medicaid ABA reimbursement, affecting provider participation, managed care plan actuarial soundness, and children's access to autism services statewide.
Behavioral Health · Managed Care
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