Homeostasis: Ethical Guidance for Navigating Payer Policy Adjustments   

Original Webinar Date: December 2018

CEU offered: 2.0 Ethics CEU

Short Title:  Homeostasis: Navigating Payer Policy Adjustments

Webinar Duration: 1 hour 52 minutes 

CE Instructors:

  • Rebecca Womack, BCBA
  • Michele Silcox


This recorded webinar was originally presented by the Behavior Analysis Advocacy Network (BAAN).  Upon BAAN's dissolution in June 2020, its CEU course library was transferred to CASP.    

Abstract: 

The Defense Health Agency, providing oversight of the TRICARE military benefit, released information on changes to the Autism Care Demonstration program. The modifications will require providers to make significant adjustments across the landscape of service delivery with clinical integrity. The Behavior Analysis Advocacy Network (BAAN) will share ways to ethically address concerns with funding sources, and effective processes to support this transition. Guidance will be given on methods for implementing practices associated with Category I CPT codes pertaining to applied behavior analysis (ABA) therapy. Recommendations will be aligned with the Behavior Analyst Certification Board (BACB) Compliance Code standards. Attendees will be equipped with ways to address concerns with this funding source, strategies for aligning business practices with the new requirements, and suggestions for maintaining the necessary supervision associated with the Registered Behavior Technician (RBT) certification.

Participants will receive:

  • A review of challenges being posed by the implementation of policy changes
  • Ethical guidance for conflict resolution with funding sources
  • Attendees will learn ways to apply TRICARE Operation Manual requirements to their session content and subsequent documentation
  • Examples and discussion about how to implement the recommendations

Instructor(s)

Rebecca Womack, MS, BCBA, LBA

Rebecca has been privileged to serve adults and children using applied behavior analysis (ABA) in settings such as facility-based care, group homes, day centers, clinics, and family homes both across the United States and overseas. In addition to her clinical experience, Rebecca is passionate about ABA service delivery aligning with generally accepted standards of care. With an expertise in applying health care documentation requirements and systems of compliance, she recently was the author of a chapter on documentation guidelines for ABA services. Rebecca is co-chair of the Documentation Special Interest Group (SIG) for the Council of Autism Service Providers (CASP), a co-leader for the AI/ML Workgroup, an appointed Subject Matter Expert for the Association of Professional Behavior Analysts, and a Member of the Board of Directors for the Behavior Analyst Certification Board (BACB). Rebecca also has extensive experience with public policy work. Not only is she an experienced presenter at national conferences, she has also won national awards for her role as an advocate and work to support ABA organizations in delivering quality services. Rebecca formed RAW Consulting Solutions as a way to provide education and consultation services to ABA organizations, professionals, and providers of ABA services. Whatever the role, her ultimate goal is to make a significant impact through effective and efficient services utilizing the science of behavior analysis.

CMRS Michele Silcox

Michele Silcox, has a 25-year career in Accounting. For the last nine years, Michele has focused her career in ABA Therapy billing and insurance funding sources, founding ABA Therapy Billing and Insurance Services, a nationally recognized Autism Services billing, consulting, and credentialing company, supporting the provider just starting out through the large ABA agency flourishing with multiple providers, clients, and funding sources. Additionally, her software background puts her in a position to help providers maximize the use of the practice management software they have chosen. As a Certified Medical Reimbursement Specialist (CMRS) and her studies in auditing, she can provide an in-depth risk assessment for providers to support compliance and profitability of their practice. Michele is coauthor of Revenue Cycle Management for ABA Therapy.