Celebrating Mothers (and Everyone Else Who Deserves a Break): 50% Off the ABA Business Leaders Platform This Weekend Only!
Experts, X-Rays, and Indiana Drama: Live discussion today at 9:00 AM Eastern
Who Gets to Speak in ABA—and What Does That Say About Us?
Indiana Is Back in the News: What ABA Providers Need to Know About the State’s Latest Push for Cost Controls
How Applied Behavior Analysis Can Improve Healthcare Systems
Dealing with workplace drama!
🧩 Trends, Truths & Turning Points: What’s Shaping Autism and Behavioral Health in 2025
Arkansas Mom Releases Powerful Children’s Book on Autism and Mealtime Struggles
“What are we really doing here?”: The Push to Standardize Quality in Autism Therapy
Behavioral Health Deal Volume Up 53% in Early 2025: What This Means for ABA Practices
The Growing Gap in Autism and IDD Care: Why the Industry Must Scale Ethically and Strategically
Should a BCBA Always Own the Clinic? Maybe Not.
Staff, Tariffs, and RFK Jr.: What ABA Companies Need to Know Right Now - Live today at 8 AM Eastern!
ABA Staff Turnover Is Still Out of Control — Here’s What the Data Says
How the New Tariffs Could Impact ABA Businesses (And What You Can Do About It)
RFK Jr.’s Autism Registry Proposal: Understanding the Implications for ABA Companies
How Margin Keepers Can Help You Master Payroll & Financial Planning
Quality over Quantity- Is more supervision always better?
Denials, Audits & Billing Headaches: ABA News Roundup – April 14, 2025
Nebraska Issues New ABA Medicaid Service Definitions Amid Federal Audit Scrutiny
Concerns Grow Over Insurance Misuse of Medically Unlikely Edits (MUEs) in ABA Therapy Denials
Federal Audit Finds $56 Million in Improper Medicaid Payments for ABA Therapy in Indiana
It’s Time to Get Real: ABA Business Owner Burnout
From Policy Shifts to Legal Hits: ABA News Roundup – April 7, 2025 - Live event today at 11AM Eastern!
Texas Recognizes QABA® for Behavior Analyst Licensure
Maryland Clinic Settles HIPAA Violations After Ransomware Attack
New York’s Proposed Medicaid Cuts Raise Concerns for Autism Services
Massachusetts Expands ABA Therapy Coverage to Children with Down Syndrome
Indiana’s Updated Medicaid Policy for ABA Therapy: What You Need to Know
Expanding to a Clinic? Do this first!
From Big Deals to Big Trouble: ABA Business News - March 31, 2025
The truth behind the client and staff cancellations
Top ABA Headlines
Local Owner Highlight- When to scale your ABA Business
Understanding the journey- Improving caregiver relationships with Melanie Thurston
How Effective Bookkeeping Ensures Payroll Stability and Helps You Retain ABA Staff
The Importance of Bookkeeping Services for ABA Business Owners
Mastering Marketing – Local Outreach Done Right
How to Scale Your ABA Business
You Just Closed Your ABA Company... Now What?
Building the Future of Small ABA Businesses – Join Us in This Mission
Red Flags in ABA Service Providers
Coaching Session- Discussing Onboarding with a New Owner
Would You Rather: Hiring in ABA
Grow your own BCBAs vs. hiring- What you need to know
Aligning Leadership with Values: Behavioral Intelligence in ABA with Dr. Paul Gavoni
ABA Accreditation: Compliance or Commitment to Quality?
AI meets clinical decision making- Using AI to improve patient outcomes- with Amanda Ralston
Comprehensive Updates to ABA Practice Handbooks: Enhanced Policies, Compliance, and ACQ Standards Integration
Leadership in ABA: Building Values, Managing Relationships, and Driving Progress with Martin Myers
Leadership, transparency, and collaboration in ABA organizations, with Jennifer Heidt
Building Better Care; Public Policy and Staff Empowerment
Free RBT Training for Your ABA Team This Holiday Season!
Innovating ABA Practice with AI Solutions
How can we help? Using ACT with Meg Solomon.
Building Resilience in ABA Practices: Lessons in Staffing, Billing, and Growth
Flash Sale: 6 Months Free Access to Our ABA Business Leaders Training Platform for 25 Companies!
I Hate My Job: Exploring Real Solutions
I Hate My Job: Reaction to Posts
I Hate My Job: Real Stories of Ethical Dilemmas in ABA
Introducing the New ABA Business Leaders Training Platform
I Hate My Job: Voicing the Frustrations of ABA Professionals
Introducing Our New Self-Paced Courses: Revenue Cycle Management & Effective Hiring with Indeed
CPABA Conference: A Path Forward for the Field - Get a 10% Discount!
Empower & Thrive: Registration Extended Until October 7 - 50% off!
Exciting New Coaching Opportunity for 3 Pie Squared ABA Business Leaders!
Free Download! Discover Essential Tax Compliance Tips with MarginKeepers
Why Stephen is Excited About the CPABA Conference 2024 - Discount just for you! -
3 Pie Squared Partners with Happy Medium RBT to Offer a Revolutionary 40-Hour RBT Training
Maximizing Recruitment with Indeed: How to Find the Right Candidates Without Breaking the Bank
Empathetic Leadership in ABA: Supporting Our Techs
Five Weeks of Wisdom: Bite-Sized Insights from 3 Pie Squared
Introducing the ABA Business Leaders Training Platform
Free Download! Boost Your Established ABA Practice with MarginKeepers' Essential Accounting Tips
Inside the World of ABA Audits and Legal Guidance with Kim Mack Rosenberg, Esq.
Ethical Practices for ABA Testimonials and Reviews with Dr. Jon Bailey
Navigating Growth and Challenges in ABA Business with Alecia Barrett
For a limited time, buy any of our handbooks and get our Business Leaders Membership for 75% off!
Collaboration in ABA: Strengthening Connections Among ABA Business Owners
"I Hate My Job" Series Kickoff: Discussing Burnout and Unethical Practices in the ABA Field
Top Five Essentials for Your Company Policies
Discount Ends Tomorrow – Last Chance to Get 20% Off Our Comprehensive ABA Billing Training Series!
Mastering Digital Marketing for ABA Practices with Reece from Reputation Elevation
Navigating ABA Business Growth: Consultation with Alecia Barrett
Unlock Your Billing Potential: Our New ABA Billing Course and Free ABA Billing Tips!
Navigating Company Policies: A Blueprint for ABA Practices
Free Chart of Accounts: Optimize Your Bookkeeping with MarginKeepers
Safeguarding Integrity: Proactive Strategies to Mitigate Billing Fraud in ABA Therapy
Steering Clear of Fraud: Mastering Insurance Billing in ABA Practice
From Overwhelm to Strategy: The Journey of an ABA Business Leader
Beyond the Startup: Common Mistakes by Seasoned ABA Business Owners
Essential Elements of an Employee Handbook for ABA Practices
Don’t Do That!: Avoiding Common Missteps in Your ABA Practice
Pre-Hire Power: The Critical Importance of an Employee Handbook for ABA Practices
Integrating Art into ABA Therapy: A Conversation with Natasha Bouchillon
Why a Client Handbook is Crucial Before Starting ABA Services
🥧 Grab a Slice of Success: Pi Day Flash Sale! 🎉
Why Should I Get a Client Handbook Before I Start Seeing Clients?
Financial Insights for ABA Practices: Free Chart of Accounts from MarginKeepers!
Navigating Authentic Copywriting in ABA Services: Insights and Innovations
Big Changes to the Podcast!
Get Free Expert Consulting for Your ABA Business on Our Podcast – Apply Now!
Navigating the Credentialing Conundrum: Insights from ABA Leaders
Navigating ADA Compliance: Essential Insights for ABA Business Owners
Nurturing Success: The Interplay Between Company and Team Dynamics
🌟 Dive Into the World of Sleep with Dr. Emily Ice: A Podcast Episode Not to Miss 🌜
A little late but our update is here!
Maximizing Your ABA Practice’s Potential: The Power of Bookkeeping with MarginKeepers
33% Off ABA Business Leaders for the Next 25 People!
Client Hours Discussion with April, Mallory Stinger, and Jennifer Helton
Improving Quality Through Accreditation: A Discussion with Erick Dubuque, Director of ACQ
Optimize Your ABA Practice with the Case Load Utilization Tool - 50% until Friday!
Black Friday Special - Rate Negotiations 2.0 - Elevating Your Practice with Provider Rate Resources
Navigating Medical Necessity with Dan and Mike from ABA on Tap
Upcoming Podcast with Erick Dubuque, Director of ACQ & Exciting News on How We Can Help Companies Navigate This New Standard! 🌟🎙️
Partnering with MarginKeepers, Co.: A Game Changer for Your ABA Practice
Celebrate Canadian Thanksgiving with a Bang: 50% Off ABA Business Leaders Membership and Earn 33.5 CEUs!
Empowering Change: Insights from New BCBA Business Owners
Founding a Nonprofit Practice with Susan Habchy
ABA Business Amazon List
De-Stress & Avoid ABA Burnout with a Relaxing Post-Work Routine
Three Common Struggles of a New ABA Practice
Benefits of Outsourcing with 3 Pie Squared
Why 3 Pie Squared
The Essential List for a Successful Business
2019 Satisfaction Survey results
The Cost of RBT Turnover
What You Need to Know About HIPAA
Podcast with Dr. Becca Tagg
Run Your Therapy Business Like a Well-Oiled Machine!
How to Grow Your Practice
UnitedHealthcare’s Strategy to Limit ABA Therapy Raises Alarm in the Autism Community
A recent investigation by ProPublica has shed light on troubling internal strategies used by UnitedHealthcare — specifically through its subsidiary, Optum — to reduce access to Applied Behavior Analysis (ABA) therapy for children with autism. The internal documents uncovered paint a concerning picture of how one of the largest insurers in the United States is working to limit services many families rely on.
For ABA providers and practice owners, this story isn’t just about one insurance company. It highlights the broader challenges that come when large payors treat healthcare decisions primarily as cost management problems, rather than client care responsibilities.
The “Gold Standard” – Until It Costs Too Much
According to the ProPublica report, Optum acknowledges within its own documents that ABA is the “evidence-based gold standard” for treating children with autism. Despite this, their internal strategy focuses on cutting costs — and that cost-cutting seems to directly target access to ABA services.
The primary methods laid out by Optum include:
- Limiting the number of in-network ABA providers
- Removing providers deemed “too expensive”
- Reducing authorized hours for children, even when medically necessary
- Tightening clinical review processes to justify denials or service reductions
This is a pattern that many ABA providers have long suspected, but the ProPublica report provides rare internal confirmation.
Medicaid Families Hit the Hardest
Perhaps most troubling is the disproportionate impact these strategies have on Medicaid recipients. The internal documents describe a deliberate effort to shrink provider networks within Medicaid plans operated by UnitedHealthcare.
In some states, UnitedHealthcare planned to cut more than 40% of in-network ABA provider groups. The documents also noted that as many as 19% of current ABA clients could see their authorized hours reduced or eliminated entirely.
For many families using Medicaid, switching to another insurance provider isn’t an option. If UnitedHealthcare is their assigned plan — and local ABA providers are being pushed out of network — access to care can dry up almost overnight.
Potential Violations of Parity Laws
The strategies outlined by UnitedHealthcare raise serious questions about compliance with federal mental health parity laws.
The Mental Health Parity and Addiction Equity Act requires insurance plans to treat mental health services equally to medical and surgical services. If ABA — an evidence-based, medically necessary treatment for autism — is being treated differently simply because of cost, that could be a significant violation.
Additionally, Medicaid managed care plans are legally required to maintain adequate provider networks to meet the needs of their members. Purposely cutting large numbers of providers or reducing hours authorized without clear medical justification may run afoul of those requirements.
Not Just an Isolated Incident
While this report focuses on UnitedHealthcare, many in the ABA field recognize the pattern.
ABA providers across the country have reported:
- Increasing denials for initial treatment authorizations
- Pressure to reduce authorized hours regardless of client progress
- Unexplained network terminations
- Shifting standards for documentation without clear communication
This environment creates instability for providers and families alike. For ABA companies, maintaining a sustainable practice becomes harder when authorized hours are unpredictable or arbitrary. For families, losing access to trusted providers or seeing therapy hours slashed can have a real, damaging impact on their children.
What This Means for ABA Providers and Families
The ProPublica story is a stark reminder that ABA providers cannot rely on the assumption that payors are acting solely in the best interest of client care. The reality is that cost containment drives many insurance policies — even when it conflicts with clinical recommendations or evidence-based care.
For ABA providers, this may mean:
- Documenting medical necessity thoroughly and consistently
- Preparing families for potential insurance challenges early in treatment
- Staying informed on parity laws and their rights under Medicaid contracts
- Considering diversification of payor mix to avoid over-reliance on a single insurance company
For families, advocacy becomes more important than ever. Knowing how to appeal denials, understanding state Medicaid rules, and being connected to autism advocacy groups can make a critical difference.
The Bigger Question: Who Decides What’s Medically Necessary?
Perhaps the most concerning aspect of this report is the underlying question: Who gets to decide what is medically necessary for a child with autism?
When insurers create internal policies designed to reduce hours or eliminate providers, it shifts decision-making away from clinical teams and into the hands of financial analysts. That should concern everyone in healthcare — especially in fields like ABA, where consistency and trusted provider relationships are key to success.
Sources:
- ProPublica – How UnitedHealthcare is Denying ABA Therapy for Autism
- MPR News Coverage of ProPublica’s Investigation
- Minnesota Reformer – UnitedHealth Limiting ABA Therapy
- Gizmodo – UnitedHealth’s Internal Strategy Revealed
- KALW – ProPublica Reporter Interview
- Bioethics.com – Ethical Concerns About UnitedHealthcare Practices
