Ten issues from the 20th Autism Law Summit, from school access and network adequacy to 2027 CPT codes, facility licensure, accreditation, and appeals.
Key Takeaways
- Coverage is settled; access is not. Every state has required insurance coverage of ABA since 2019, and most of this year’s agenda centered on where coverage still stops short: schools, networks, and denials.
- States are carrying much of the policy work. School access, facility licensure, and accreditation requirements all advanced at the state level in 2026, often with implementation deadlines still ahead.
- Federal rules are in motion. New adaptive behavior CPT codes take effect January 1, the federal parity rule is being rewritten, and federal labor law is being revisited.
- The work is shifting from passage to implementation. Much of what sat on the agenda concerns laws and rules already on the books, and how they will work in practice.
When the Autism Law Summit began, it was an informal gathering of a handful of national advocates trying to persuade state legislatures that applied behavior analysis belonged inside health insurance. The campaign it helped organize reached its final state in 2019. The Council of Autism Service Providers (CASP) credits the summit’s founder, Lorri Unumb, now CASP’s Chief Executive, with spearheading that legislation across all fifty.
The 20th edition convened October 27 and 28 at the Charleston Music Hall, hosted by the Autism Legal Resource Center, whose President is Dan Unumb. The summit says it draws more than 450 providers, lawyers, politicians, lobbyists, parents, and self-advocates, and unlike conferences that split attendees across parallel tracks, it runs one program in one room.
I arrived Monday afternoon for the welcome reception at the William Aiken House, a historic King Street venue whose balcony did much of the early networking. Afterward, a group that ranged from CASP board members to payers went out for oysters and local seafood, which is where I first heard about “Pickle.”
As it was explained to me over dinner, Pickle is the summit’s unofficial mascot, a plush Pickle Rick who goes home each year with a new winner. Winners often add something of their own, which is how he ended up with hands and a shirt. Dr. Gina Green won him last year, Kristin Hanson won him this year, and yes, he has his own Facebook group.
Monday night ended at a dueling piano bar. On Tuesday night, Dining with Strangers, which the summit uses to mix attendees who have not met, put me at a table of about a dozen at a celebrity chef’s restaurant, a few of whom I will be interviewing in the coming weeks.
Of the program itself, I sat in on five sessions: the opening overview, network adequacy, the CPT code update, the legal update, and appeals. The rest of my time went to interviews. Read as a whole, the agenda describes a field whose legal questions have moved. Whether ABA is covered is largely settled. Where it can be delivered, by whom, under which codes, and with what proof of quality are not.
The ten issues below follow the program in order. Speakers are named as the agenda listed them, and the notes on each issue are my own observations about the context it arrived in this year, not a record of what was said onstage.
1. Twenty Years of Autism Law, and an Overview of 2026
Lorri Unumb opened Tuesday with a welcome and an overview of the year’s developments. The summit has traveled widely, from Nashville in 2014 to Jackson Hole, Oklahoma City, and Milwaukee, but Charleston is home ground.
Unumb founded the nonprofit that became the Unumb Center for Neurodevelopment in Columbia in 2010, and South Carolina was among the states that changed autism law this year.
2. Private ABA Providers in Public Schools
The first session, on private ABA providers working inside public schools, listed Leslie Robinson, an attorney and autism parent, and Rebecca Urbano Powell, a Board Certified Behavior Analyst and Executive Director of Seven Dimensions Behavioral Health.
The theme arrived with fresh law behind it. South Carolina’s Act 186, signed in May, sets out a process for families to request that private providers deliver medically necessary ABA during the school day, and Tennessee enacted its own school-access law the same month. In both states, schools are still writing the policies that will put those laws into practice.
3. Network Adequacy and Mental Health Parity
Network adequacy, the question of whether health plans contract with enough providers for families to actually get care, followed. Dan Unumb was listed on the panel with Mariel Fernandez, CASP’s Vice President of Government Affairs, and Greg Williams, President of Third Horizon, whose firm helped build the Mental Health Parity Index comparing behavioral and physical health networks.
From the outside, networks have been one of the year’s more visible pressure points. In Arizona, families went to court in February after two Medicaid plans dropped large ABA providers. At the federal level, the 2024 parity rule is unenforced and being rewritten, with a proposed replacement promised by the end of this year.
4. The 2027 ABA CPT Code Changes
The ABA Coding Coalition’s update on the adaptive behavior CPT code set carried the longest speaker list on the agenda, eight names, among them Jenna Minton, Chief Executive of Proactive Strategies; Dr. Ivy Chong, Chief Clinical Officer of Autism Care Partners; and Julie Kornack, Chief Government and Payor Relations Officer at CARD.
The timing is close. The revised code set, with new codes added and temporary ones retired, takes effect January 1, and Acuity’s breakdown covers what changes. For providers, the practical work runs through electronic records, payer contracts, and authorizations written under the old codes.
5. Residential Programs and the HCBS Settings Rule
Tuesday afternoon turned to adults, with a session on building residential programs under the Medicaid home and community-based services settings rule. Lorri Unumb was listed alongside Lisa Belcastro, Director of Public Policy at Autism Speaks; Jessica Hudson, Executive Director of the Unumb Center; Sarah Pope, Chief Executive of SOS Care, and Kim Setliff, its Chief Operating and Finance Officer; and Dr. Debra Caudy, Founder and Chairman of the Board of 29 Acres.
The rule governs where Medicaid-funded community services may be delivered, and families of adults with profound autism have long pushed for more room for campus-style and intentional communities. The broader federal picture shifted this fall, when a court vacated the integration provisions of HHS’s Section 504 rules.
6. Facility Licensure for ABA Clinics
The day’s final session compared facility licensure in Arkansas, Colorado, and Texas, with Dan Unumb, Ellen Rhoads of Texana, Will Martin of Soar Autism Center, and Trevor Hawkins of Mitchell, Blackstock listed as speakers.
Licensing behavior analysts is now common; licensing the clinics they work in is not. Colorado joined that short list in June, when HB26-1425 created a state licensing board for practitioners and a separate licensing track for ABA clinics.
7. ABA Accreditation as a Medicaid Condition
Wednesday opened with the Autism Commission on Quality, the accreditor CASP launched in 2022. The session, titled “Look Behind the Seal,” listed Rachael Coburn, its Executive Director; Eileen Mendes, Director of Accreditation; and Thea Davis, Accreditation Review Manager.
Accreditation has started to carry consequences beyond reputation. Indiana Medicaid will require it of every enrolled ABA group by October 2027, and MassHealth’s requirement for center-based providers takes effect January 1.
8. Federal Labor Law and ABA Unionization
Jim Monica, President and Co-Founder of American Labor Group, and Hannah Wilson, an Associate at the firm, were scheduled for a half hour on federal labor law. The National Labor Relations Board regained its quorum this year, and its General Counsel has published a list of precedents she wants revisited.
The subject has a direct line to ABA. Technicians at eight ABA workplaces have organized since May 2025, and none has yet announced a first contract.
9. The 2026 Legal Update
The Legal Update, at ninety minutes the longest session on the program, surveyed the year in autism law. Dan Unumb was joined on the agenda by Veronica Glickman, Founder and Chief Executive of Autism Behavioral Educational Services, and Joy Pollard, PhD.
Outside the room, this has been a year in which state Medicaid decisions on rates and networks have found their way into court, in Arizona and North Carolina among other places.
10. Insurance Denials and the ABA Appeals Process
After the group photograph on Wednesday, the program turned to insurance denials in “From Denial to Approval: Building a High-Performing Appeals Process,” which listed T.J. Couey, Co-Owner of Bloom Behavior Therapy, and Mirella Petersen, Vice President of Payor Relations and Government Affairs at Autism Learning Partners.
The context varies by state; Acuity has found Medicaid hour limits that differ widely from one program to the next. Speed presentations closed the formal program, and the 20th Anniversary Gala followed that evening.
What Comes After Charleston
Much of what sat on this year’s agenda is already law or regulation. The codes are set, the accreditation deadlines are published, and the school-access statutes are signed. What remains is the slower work of model policies, payer contracts, survey visits, and appeal letters.
Twenty years ago, the summit’s business was getting laws passed. Much of the 2026 program concerned what happens after they are.
