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Bill

H 4353

Dr. Milburn Price lifetime contributions

2025-2026 Regular Session Introduced by Terry Alexander and 122 co-sponsors

Establishes biannual, data-driven reviews of ABA reimbursement rates to reflect costs, recruitment/retention, and regulatory changes, with annual public reports.

Introduced and adopted
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Bill Summary · H 4353

Summary of H 4353: An Act relative to applied behavioral analysis reimbursement rates

What the bill seeks to do

H 4353, introduced July 10, 2025 and with Senate concurrence in July 2025, would establish a formal, ongoing review process of reimbursement rates for applied behavior analysis (ABA) services provided to publicly aided individuals under Chapter 118E. The goal is to ensure rates reflect current costs, sustainable provider recruitment/retention, and evolving service demand.

Key provisions

  • Amendments to Chapter 118E: The bill adds a new section (Section 10H1/2) to require biannual reviews of ABA reimbursement rates by the Office of Medicaid, in consultation with the Center for Health Information and Analysis (CHIA).

  • Scope of the review:

    • Compare Massachusetts ABA payment rates with rates in jurisdictions that have similar cost-of-living indexes.
    • Assess the effect of current rates on recruitment and retention of qualified ABA providers over the previous five fiscal years.
    • Consider increased service delivery costs to comply with future accreditation or regulatory requirements.
    • Identify any services or eligible populations that were not mandated prior to the last rate review and may increase demand for ABA services.
  • Reporting requirements:

    • Each year, findings must be reported to (i) the clerks of the House and Senate; (ii) the chairs of the House and Senate committees on Ways and Means; and (iii) the chairs of the Joint Committee on Health Care Financing.
    • Reports are due no later than October 1 of the year prior to the release of updated rate regulations promulgated under this section.
  • Beneficiaries and implementers:

    • Affected: ABA providers serving publicly aided individuals under Chapter 118E; the Office of Medicaid; CHIA; and lawmakers who oversee health care financing.

Procedural and timeline notes

  • Legislative history:

    • Referred to the House Rules on July 10, 2025.
    • Reported/referred and rules suspended to the Committee on Health Care Financing on July 14, 2025.
    • Senate concurred on July 28, 2025.
  • Related measures:

    • HD 4876 is listed as a related House bill and is described as replacing the current version.
  • Effective date: Not specified in the text. The requirement centers on ongoing biannual reviews and corresponding rate updates.

Potential impact

  • Administrative: Establishes a formal, data-driven process to monitor and adjust ABA reimbursement rates.
  • Policy: Promotes transparency and alignment of payments with cost of living, provider stability, and evolving regulatory requirements.
  • Financial: May influence future rate setting by ensuring regular evaluation of costs and market conditions.

This bill does not itself change ABA payment amounts but sets up a mechanism to routinely review and report on those rates and their broader implications.

Compiled from official sources — confirm details with the bill’s official record.

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