EPSDT: Applied Behavior Analysis (ABA)

eQ Health Solutions, the QIO-like organization for the Arkansas Department of Human Services (DHS), provides utilization and quality control over per review for both Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefits of Applied Behavior Analysis (ABA) and Day Habilitation to qualifying Arkansas Medicaid beneficiaries.  These are services require a physician’s recommendation of medical necessity.  Kids on ARKids First B are not entitled to all the extended EPSDT benefits.

 

Request for ABA services

  1. All reviews require preapproval of the diagnosis of autism spectrum disorder by Division of Developmental Disabilities.
  2. All reviews are conducted by a Board-Certified Behavior analyst
  3. All requests are for 6 months duration
  4. If the PA request does not contain documentation clearly establishing that the requested services are medically necessary, the request will be reviewed either BCBA-D or a physician reviewer who will determine whether to enter a determination that some or all of the requested care is not medically necessary (adverse decision)