OIG Medicaid ABA Audits: What Every Provider Needs to Know About Federal Oversight, Documentation Standards, and the Coming Wave of Recoupments

by Ethan Webb | May 8, 2026 | Regulation

Key Takeaways The federal audit cascade is structural, not isolated: Every one of the 100 sampled enrollee-months across Indiana, Wisconsin, Maine, and Colorado contained at least one improper or potentially improper claim, signaling state-level oversight gaps rather...

Home-Based ABA Therapy vs. the Clinic Model. Two veteran behavior analysts say the science was never on the clinic’s side, and the field’s shift toward center-based delivery has cost children the intervention that actually works.

by Ethan Webb | May 7, 2026 | Blog

Key Takeaways Dr. Robert K. Ross and Dr. Fernando Armendariz argue that center-based ABA delivery is driven by structural convenience, not by evidence that clinics are where behavior change should occur. Caregivers respond to their child’s behavior hundreds of times a...

AI in ABA Is About to Go In-House: Mosaic’s Top Data Scientist Predicts Every Operator Will Build Its Own Software Within Five Years. He Just Stood Up a Resource Site to Help Them Do It Safely.

by Ethan Webb | May 7, 2026 | Technology

Key Takeaways The five-year forecast: Mosaic Pediatric Therapy’s Dr. David Cox predicts every ABA company will be using bespoke in-house software within five years, driven by agentic coding tools that let non-engineers ship working applications quickly. The working...

ABA Documentation Audit Findings, Code by Code: What the OIG Flagged on 97153, 97155, 97156, and the Session Notes Auditors Are Reading

by Ethan Webb | May 6, 2026 | Regulation

Key Takeaways The audits are documentation audits, not clinical audits: OIG findings turn on whether session notes, signatures, credentials, and treatment plans support what was billed. The clinical question of whether ABA was medically necessary was never reviewed....

RISE Rule Caps Federal Student Loans at $20,500 for Behavioral Health Graduate Programs. Master’s-Level BCBAs, Social Workers, and Counselors Fall Outside the New “Professional Degree” Definition.

by Ethan Webb | May 6, 2026 | Regulation

Key Takeaways A narrow professional-degree definition is now final. The Department of Education’s May 1 rule limits the $50,000 annual federal student loan cap to 11 fields, including medicine, dentistry, law, veterinary medicine, and clinical psychology, while...