It’s time to weed our fraudulent analysts who harm kids and rip off the public

Florida is in a bit of a tricky situation for providing quality treatment for kids with developmental disorders like autism.

On the one hand, no one benefits when fraudsters who set themselves up as behavior analysts use shady billing practices to take advantage of the health care system and steal from taxpayers. That definitely needs to be stopped, and South Florida is ground zero for Medicaid fraud in Florida. But on the other hand, we need to recognize that Florida has thousands of quality providers who give professional care to autistic children –  care that needs to continue uninterrupted.

To stop  abuse of the system, the state Agency for Health Care Administration hit the pause button and issued a temporary moratorium on new behavior analysts here in Broward and Miami-Dade counties.

I get it. From the state agency’s perspective, it’s a lot easier to keep new fraudulent behavior analysts from being added to the provider network than it is to weed out the bad apples already in the system. And while the moratorium is probably a good idea, the bureaucracy surrounding Florida’s authorization process are causing delays in treatment that are affecting kids in a bad way.

The state’s trade association for behavior analyst professionals, the Florida Association for Behavior Analysis, has come out in support of AHCA’s efforts to prosecute fraudulent providers. I agree with the association and its members that more needs to be done to stop the abuses without delaying treatment or creating unnecessary obstacles to providing quality care.

According to a recent op-ed in the Sun-Sentinel by one of the association’s board members, more than half of all states require some type of licensure for behavior analysts – but not Florida. Talking about treating children, Jon Bailey wrote: “The health, safety, and well-being of a future generation is quite literally in the hands of one of these individuals, so they had better know how to properly handle this awesome responsibility.”

The Miami Herald also recently reported that some behavior analysts have even been forced to pay their staff out of their own pocket because the state is delaying approvals. Because of these delays providers are having to deliver services without knowing for sure whether they’ll actually get reimbursed.

One solution being proposed involves a more streamlined process for quality providers who are board certified or are registered as a behavior technician. It would basically boil down to a system where any provider who voluntarily chooses to meet the educational and experience requirements necessary for these distinctions would get the benefit of not having to jump through the same AHCA hoops each and every time.

While this might not be the only solution, it is certainly one worth considering. Because the fact remains that there are thousands of children in Florida right now who need to services provided by behavior analysts and slowing down or stopping the services they receive doesn’t make sense – even if it’s in the name of fighting fraud.