HI HR207

Med-QUEST reimbursement rates for applied behavior analysis (ABA) services have remained unchanged since 2015 despite wage increases of 30% statewide during that period.

Current Med-QUEST rates for ABA services, particularly for registered behavior technicians, fall below market rates and are significantly lower than rates paid by the Department of Education ($25/hour difference on neighbor islands) and Department of Health's Developmental Disabilities Division ($19.45/hour difference).

Low reimbursement rates have created provider shortages, resulting in years-long waitlists, service delays, and beneficiaries unable to access the full amount of clinically recommended services.

The Med-QUEST Division is requested to assess current ABA reimbursement rates and submit findings with recommendations for rate increases and proposed legislation to the Legislature no later than 20 days before the 2024 Regular Session convenes.

Early intensive ABA intervention for children under 21 with autism spectrum disorder diagnoses produces better long-term outcomes and reduced lifetime care costs, and federal Medicaid law requires covered services be provided with "reasonable promptness."