Target:  To increase the number of enrolled clinicians who provide ABA services to VT Medicaid members.

This measure is important because it allows the Department of Vermont Health Access (DVHA) to monitor the number ABA clinicians who are enrolled in VT Medicaid and are authorized to provide ABA services to Medicaid members.

DVHA submitted a State Plan Amendment (SPA) to CMS in the Spring of 2015 requesting the authority to enroll ABA clinicians as Medicaid providers and to use VT Medicaid dollars to reimburse them for ABA services for SFY 2016 forward.  DVHA made changes to the ABA benefit over the years, including an increase in ABA reimbursement rates in 2016, implementation of a prospective tiered case rate methodology in SFY20, and implementation of a post service payment delivery system in SFY22.  These changes were made to expand the network of providers and increase the availability of ABA services for VT Medicaid members.

The data in the above graph demonstrates a steady increase in ABA clinicians enrolled in VT Medicaid through SFY24.  Feedback from providers indicated the slight dip in enrolled clinicians in SFY22 was due to workforce shortages.  ABA providers shared they are able to hire Board Certified Behavioral Analysts (BCBAs) but are struggling to hire Behavioral Technicians (BTs).  Therefore, this continues to directly impact the workload available for BCBAs impacting long-term employment retention. The increase in enrolled clinicians who provide ABA services to VT Medicaid members is encouraging.  The increase in available staff should have a direct positive impact on the number of VT Medicaid members served statewide.

Last updated:  08/01/24

• DVHA Policy Unit
• DVHA Provider Member Relations Unit
• DVHA Payment Reform Unit