Bill
S 1414
Expands ABA access by allowing assistant-level providers licensed to deliver ABA to bill payers; the division must set rates and codes for all licensed ABA providers.
Status and sponsors
- Filed in the Massachusetts Senate (Senate Docket No. 1558) — presented by Sen. Michael O. Moore with co-petitioners John J. Cronin, James B. Eldridge, Paul R. Feeney, John F. Keenan, Joan B. Lovely, Paul W. Mark, and Lydia Edwards.
- Introduced/Filed: January 16, 2025 (docket); recorded as introduced in the Senate April 10, 2025.
- Current procedural activity (per docket): referred to relevant committees and hearings scheduled (hearing dates listed for 09/29/2025). (Docket entries show multiple committee referrals; see official legislative record for latest status.)
Purpose and intent
- The bill seeks to increase access to Applied Behavior Analysis (ABA) services — commonly used for treatment of autism spectrum disorder and other behavioral needs — by ensuring that all providers licensed to deliver ABA (including assistant-level providers as licensed by the state board) are eligible for reimbursement from state and contracted payers.
Key provisions
- Amends Section 10H of Chapter 118E of the Massachusetts General Laws by adding paragraphs that require:
- The division (the agency charged under Chapter 118E) to establish a reimbursement rate for ABA services for all providers licensed by the Board of Registration of Allied Mental Health and Human Services Professions (Department of Public Health).
- The division to adopt reimbursement codes and modifiers as necessary so that all licensed ABA providers may submit claims for reimbursement to the division and its contracted health insurers, health plans, HMOs, behavioral health management firms, and third‑party administrators.
Who is affected
- Consumers: Individuals (often children with autism) who receive ABA services — potentially improved access and reduced wait times if more assistant-level providers can be reimbursed.
- Providers: All providers licensed to deliver ABA by the referenced Board, including assistant-level practitioners who may currently be excluded from reimbursement pathways.
- Payers/Administrators: The Division (responsible for implementing rates and codes), MassHealth/other public payers, private insurers, HMOs, behavioral health management firms, and third‑party administrators who will process claims under the newly required codes/modifiers.
Administrative and fiscal notes
- The bill does not set specific dollar amounts, percentage rates, or an explicit implementation deadline; it directs the division to establish rates and adopt billing codes/modifiers.
- Potential fiscal impacts include increased claims expenditures for public and private payers if newly eligible providers submit reimbursable claims; administrative work for the division to create codes and update systems.
- The Board of Registration of Allied Mental Health and Human Services Professions remains the licensing authority determining who qualifies as a licensed ABA provider.
Limitations / next steps
- The text creates eligibility and coding obligations but leaves rate-setting details to the division; stakeholders will need to monitor rulemaking, rate methodology, and effective dates once the bill advances.
- Consult the official legislative docket for the most current committee actions and final status.
Compiled from official sources — confirm details with the bill’s official record.
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