Task Force on Autism
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- October 2, 2026
Representative Denise Jones Ennett
Unverified
3:00
good morning alright call to order how you doing senator boyd well right let's see Consideration of
motion to approve the minutes from June4th can I get a can get a motion? Can I get a second? second all in favor sayy yaayya yeah
it's all opposed say no OK approved minister approved sorry next on the agenda we have Justin Brasher from the attorney general's office. he's going to update us about the medical fraud investigations dealing with ABA services. come on up and can you introduce yourself? thank you.
Justin Brasher
Unverified
4:03
Yes thank you so much for having me everyone. my name is Justin Brasher. I'm a senior assistant attorney general with theagG's office and really thankful that y'all give us an opportunity to come here and talk about what we do with Medicaid fraud and we're very appreciative of the the work that y'all are doing and you also give me an opportunity to brag on some of the the stuff that we do regarding Medicaid fraud so and then at any point if you all have questions I'm more than happy to do the best I can to answer them. I might not have the answers to everything in which case I'm more than
happy to go back and talk to our people and then get you an answer afterwards so the first thing I'm gonna just give a sort of a general overview of how our office handles medicaid fraud and then if there's specifics that that y'all want answers on I'll do the best to answer that it's obviously something that our office takes very seriously our attorney general was actually down in Washington DC in May at a roundtable that was convened by the White House task
force on fraud and so we've taken a really forward approach on that and he is in in a communication with the individual Scott Brady who runs that task force on a on a regular basis so we're doing the best we can to leverage federal partnerships as much as possible we work with federal partner s in Hs which is Homeland Security where we work with DHS we work with the or with HSs I'm sorry we work with the US attorney's office on a lot of these things.
what we can do as a state medicaid fraud control unit where we get some of our money from from the federal government and then some of our money is state government to fund our investigations and our prosecutions we can go after the providers we can't go after the beneficiaries and that's important that's the way the law is structured. there is currently a federal legislation that would allow state medicaid fraud control units to also go after beneficiary
fraud we have signed on to a letter supporting that bill but currently the way the law is structured we are allowed to go after providers so that's what we do well we look for is the term is a credible allegation of fraud that's the terminology we need a credible allegation of fraud in order to open an investigation. We get those through numerous ways we have a a fraud hotline that people call I like to say we like
snitches go ahead call us and we will we'll take it from there we love that sort of information we're more than happy to to investigate it. We also while we need that credible allegation of fraud we need some sort of complaint in order to start looking into things unless we have a waiver from the federal government that allows us if it's through data mining in our collaboration with the state DHs with with human services we get claim data from them and so we can take a look at things
that stand out that we know couldn't possibly be true. for example you know in extreme case but we've seen things like this is someone's build eight hour days for30 days in a row right and we've we've had cases like this and we're like that can't be right and that is the sort of thing ok we're going to take a larger look at this and then when we do that that involves things like subpoenas for things like bank records, right? Are you making money other ways you're you say you're billing 18 hours a day.
Are you also do you also work at the7-Eleven like if both of those things are happening something's fishy right? so things like that we will subpoena workforce services and get records from them again are they employed somewhere else we also we we have a team of investigators to do a wonderful job and their boots on the ground they'll you know they'll get a warrant to do it but they'll they'll observe the house and they'll be like hey you know is the person actually here they'll go on people's social media they'll see what they're posting you know they
posted that they were at a park at 2 o'clock yesterday and then the billing says that they were also doing this so it really is it can be as elementary as that we've even used some GPS technology again to kind of figure out where people are again using the proper warrant process and all of that and subpoenas and all of those things but those are all techniques that we use once we have that credible allegation of fraud. We also again working with the federal entities is really important so we get things referred to us for
example from the VA the VA will say hey we're seeing VA benefits fraud and where where there's one kind of fraud there's often other kinds of fraud too. we'll get that from medicare right the federal Medicare will get in touch with us and they'll be like hey we found Medicare fraud there's probably Medicaid fraud too. so those are those are again those sorts of connections are important and we've been able to work with the US attorney's office on prosecutions because what will happen and I'll talk about it
in a minute one of our higher profile cases involving Drctor Bryanyatt which I'm sure y'all are at least somewhat familiar with we've been we've been able to work with the feds and we have a state levelvel prosecution but they've also deputized made it as a special assistant US attorney one of our attorneys so that they're she's working with them on that federal case as well and that collaboration a lot of the evidence that we gathered the feds have been able to use and vice versa that sort of collaboration is really
important and so we thank our partners there at the at the US attorney's office. once we have gathered evidence, right then we have a choice to make you can bring a case civilly you can bring a case criminally right? and we like to start our cases criminally because there's there's legal for lack of a better word legal procedure involved but a criminal subpoena can be used in a criminal or a civil case, a civil information gathered from a civil subpoena can't always be
used in a criminal case so you start criminal and if you don't have the evidence then you bring it civilly. There are considerations involved when determining whether to bring a case civilly or criminally things like statute of limitations are involved because the statute of limitations differ for a civil or criminal case and they also differ based on the amount involved, right because that determines whether it's a missed so for example criminally if it's under $2500 then it's a misdemeanor if it's 25 to5,000 dollars it's a sea
felony if it's5 to25 it's a B and then over 25 is an A and I apologize if I got my numbers slightly wrong but I believe that that's it so that again in the statute of limitations varies depending on if it's a misdemeanor or if it's a felony and those sorts of things so those are all considerations that go into whether bringing a case civilly or criminally you also there's certain penalties that you can put on a civil case certain restitution you can ask for you can't necessarily ask for in a criminal cases again there's
just procedure involved so those always those are part of the considerations that we have to make the flip side of that is that when an individual gets a criminal conviction for medicaid fraud they are immediately they are put on a federal list that they are not allowed to be a provider anymore and that's important there's also statewide it's DHS policy 1088. there's also statewide and not necessarily a list but you are kicked off as a provider for violating certain things
criminally and that that list that thenn diagram is not a complete overlap with the federal one. there's certain things like if you get convicted of a rape in Arkansas you're also not allowed statewide to be a medicaid provider, right something like that so that in getting that sort of exclusion criminally is important but criminal is also higher bar, right? you got to prove beyond a reasonable doubt civilly you only have to prove by a preponderance of evidence of the evidence we colloquially refer to that as51%.
right so you have to evaluate the evidence that you've got and then make a determination about what the best way to go forward is based on that so those that's just kind of walking through sort of our process some of the things that we see and one of the things that the attorney general wanted to emphasize is there's the big name stuff that gets all the headlines and stuff. Drctoryatt I'm also going to talk about Doctor Schwartz a little bit. That stuff gets in the news or the things we see in Minnesota or Ohio or whatever those get the really the big name stuff but
it's important to also focus on the the everyday stuff because that also that's still a drain on our system it's still illegal behavior that affects people in their day to day lives and it's people who are supposed to be getting real treatment from people that aren't because people are taking advantage of the system and so we take things we call them impossible hours cases that's the kind of case we see and it really is you know someone billing 18 hours for30 days straight things like that we also see situations
where people will sign up someone else because they can't be the caregiver so we had a situation where a father couldn't be the caregiver for his disabled son so he convinced another one of his sons to sign up to be the caregiver and then that son wasn't actually providing services at all and so that ended up with a conviction for both the son and the father because both of them were lying about what they were doing right so those are situations like that we also have had instances where it's been a company that's been trying to defraud. so one example of that is is it come
we call it DME fraud so medical equipment, right? a big case that we had a couple of years back was a company that basically there you have ostomy wipes which are char go about not for 9bucks or so a container and you have baby wipes that go for about $1 a container, right? The ostomy wipes are a specific sort of thing that you got to use you know for a specific sort of care you had a company that was buying baby wipes for the dollar and then billing medicaid for the $9 for the ostomy wipes and that's a that's a heck of a
margin. I would love any business that could get that sort of margin and so that that was a big deal and we we went after those people and there were certain people that had to pay some money back and are doing you know have criminal convictions now because of that so those are those are sort of those are just two examples of the kinds of cases that we see and go after and that can provide a couple more examples if you want but that's sort of you get the
you get the idea a couple of the big name cases so for example a quick update on what's going on with Doctor Bryanyatt which is he was the you know former chair of the Arkansasedical Board and then we obtained a large amount of evidence and this is really credit to our investigators in our office who did a wonderful job of this who who found that he was both basically entrapping his patients and not not allowing them to leave as well as you know was on billing medicaid for services that again
weren't be provided and we had a good video evidence of this so yeah so we he's currently what's going on is he has a state court case and a federal court case running concurrently the federal cases for kidnapping the state court case is for medicaid fraud. he is currently being evaluated whether he is fit to stand trial, right sort of a colloquially refer that to as refer to that as like an insanity to sort of thing the
more legal term is whether he's fit to stand trial or not and so that is currently in limbo at the moment he's changed attorneys a couple of times which is kind of kicked the case out as well but we're currently working on that we're working really hard and we're working with our federal partners who again have been fantastic and so we're sharing evidence back and forth as much as we can on that so that's kind of where that is we have a hearing coming up where we're going to be addressing more directly the is he fit to stand trial issue joseph Schwartz is an
individual who back in 25 pled guilty to medicaid fraud and attempt to evade or defeat tax that was back in april 25. what happened was he was also sentenced federally so the state sentence which was 1el months that he was supposed to serve was set to run concurrent to his federal sentence then he got pardoned by the federal government the way a federal pardon works your pardoned for your federal charges you're not pardoned for the state charges so he was pardoned from the federal
charges. Our office took it upon ourselves to go back in front of the court and say ok he's been pardoned by these federal charges he still needs to serve his state charges and we were able to win that he had to go back and serve another month then then he met his parole requirements he is currently making restitution payments however of about $200,000 a quarter and he has been making those payments so that's money that we're recouping back for the state of Arkansas based on his malfeasance. so again I just kind of give that as an overview
that's kind of the uh30,000 foot view of what our office does and some examples and I wanted to close with we have a fraud hotline with that anyone can call anonymously if they want and again and give us some information that we can take and run with and that hotline is 1-866-8100016 and anyone's free to call that and believe me we we get plenty of good tips off of that hotline so
with that free to I'll take anyone's questions like I said I ' ll do my best to answer them and if not I'll go back and see what the information is and then get back in touch with you thank you so much for having
Senator Justin Boyd
Unverified
18:18
me thank you thank you madam chairir. I just thank you for your presentation. This is good. this is helpful. I'm glad to know that we're putting an emphasis on the the fraud aspect of of care we've all been watching it in the news just wanted to make sure you know you know this might be more
important for medicaid or you know, DhS but in August 2026, the federal government did release a tool kit on ABA fraud and how to catch and identify and so on and so forth. So
Speaker 30
18:44
I just want to make sure you you're aware of that. yes and thank you senator and
Justin Brasher
Unverified
18:51
yes we are there have been meetings occurring in our office regarding that tool kit and exactly how to implement that going forward. ABA is something that we are we are very much aware of what's going on around
there we as I'm sure you've heard before I I'm not going to speak to any open investigations that we have but it is certainly a sort of fraud and I don't want to besmirch the practice of ABA which I think is great but we're certainly aware of of the potential for fraud around there it's been brought to our attention and we are aware of the toolkit we've had some meetings about it about how we're going to go forward implementing some of those things.
Representative Denise Jones Ennett
Unverified
19:35
I have some questions yes absolutely so the piggyback off with senator Boyd mentioned about
the tool kit when you get those when you go with the attorney general and figure out how you're going to implement this? can you
Justin Brasher
Unverified
19:52
keep us updated on that? not a problem to sorry to the extent that
Representative Denise Jones Ennett
Unverified
19:56
I can of course yes OK so here's my question what safeguards is the office recommending to distinguish fraud and enforcement from
access restriction so that tightening oversight does not create service gaps for families who really need the services that's a that's
Justin Brasher
Unverified
20:14
a great question and very important and I think one of the the big things we do is becau that threshold before we are opening an investigation you need the the allegation of fraud needs to be credible, right? And I think that's really important in our people take that very seriously. so we don't just we're not just roving around
going I think there's something here let's throw the book at him and see what we can do. there needs to be something that's a trigger and so even you know I mentioned the fraud hotline we're not gonna just again go and and throw everything at something just because one person called and said I think my neigh I don't like my neighbor and they're committing medicaid fraud. We need to see something like what we talked about where there's there's claims that are you know impossible or we we've had plenty of situations we subpoena records from hospitals right and
we look and you build for these5 days and that person was in the hospital those5 days that you know again that doesn't line up. We need something like that before we're going in so we are not again we we don't the last thing we want to do is the people who are most vulnerable and are most hurt by this fraud are the last people that we're trying to take away their ability to get these services that they need so I think that threshold needing that credible allegation of fraud is really important. I hope that that answers your question.
Representative Denise Jones Ennett
Unverified
21:39
all right do the task forcece y'all have any questions for him? I like to recognize uhpresentative Cclowney. she is visiting us from Fayetteville and she has a question for you.
Representative Nicole Clowney
Unverified
21:52
I'm sorry thank you madam chairir. just real quick question are the cases that you just mentioned medicaid fraud in general or were those ABA cases specifically those are all Medicaid fraud in general. OK just wanted to clarify that you
Representative Denise Jones Ennett
Unverified
22:11
any other questions from the task force? all right all right thank you for your testimony it all right next on the agenda we have let's see Miss dotson
Rachel Dodson
Unverified
22:54
If he could state your name yes ma'am my name is Rachel Dodson. and I have brought with me today Jessica Lenahan who is a clinical director at every littlettle Step AA where my daughter receives services. all right thank you to begin, I would like
Speaker 51
23:16
to tell you all the reason that I'm here. and it is for my daughter Ella Grace. Ella Grace is 9 years old
let me go there we go My daughter is 9 years old. she has level3 autism and was diagnosed nonverbal in 2022. She also has juvenile idiopathic arthritis eocephilic esophagitis which is a chronic and allergic inflammation of the esophagus caused by a buildup of white blood cells and she suffers from very severe eczema. These medical conditions severely impact her daily quality of life. Ella takes
18 pills or doses of liquid medication a day to remain in medical remission from her JIA her EOE, her severe iron deficiency and eczema. I'm disclosing these things publicly because I want to let you know what Ella needs from us to take care of her but also Ella is so much more than just her diagnosis of singing and swimming and everything Disney. she laughs at her siblings and everybody she is around we'll
tell you she's friendly she's loving and she's silly but she's also impulsive and we'll follow through with actions before thinking it through. because of her behaviors, Ella needs someone to attend to her one on one every minute of every day. it's not uncommon for Ella to decide she needs something from the outside refrigerator in our garage and she'll walk out quietly while may be changing her baby sister's diaper or she may put herself in the shower because she's decided she's
ready to be clean and I'm in the laundry room flipping laundry it's I have to be able to hear and see her at all times to keep her safe. we rely on our insurance providers to be able to care for Ella need insurance to afford all of her medications and provide her with ABA therapy I'm advocating for change for for her on her behalf for how insurance providers communicate with families and how they allow families to participate in their
own care and how they determine any child's needs. When Ella was diagnosed with autism in 2022, we were referred to try ABA therapy to help her. She was in preschool and her teacher told me that she could not get Ella to participate with the rest of the class and they allowed her to sit in the window and stare out the window while the other students were being challenged to participate. They simply told me they could not get Ella to join in with her peers
after talking with our ABA provider, they were confident that they could get Ella to join in and be a part of the class instead of just being a bystander. they did help Ella succeed and I got the amazing opportunity to see her thriving and even walk as a pre-K graduate, which would have been impossible for her the year before then she went to kindergarten and ABA was not allowed to attend her school at first in her classroom. Hergen teacher and her sped teacher tried to
evaluate Ellah and knew that they could not get her to show them that she knew the alphabet. I asked if her BCBA and her RBT could come to the classroom and assess her positive reinforcements or use positive reinforcements to assess her and that because they had worked really well in pre-K. They were allowed to come in and do the assessment and as a result Ella was able to show she knew the entire alphabet as well as numbers 1 to 20. The school had to completely write her IP because she had met all of her
goals in one assessment that was facilitated by ABA. Her team was there and is there asellla's translators until Ella can communicate for herself by herself I'm a teacher. this is my 11th year
Speaker 56
27:15
teaching in the public school system. I've experienced autism outside the realm of being a parent. What
Speaker 51
27:22
I always struggled with as an educator is that I was not always able to communicate with nonverbal students effectively. I wasn't able to determine what they
wanted or what they needed or why they were upset. and why they were showing discomfort. Why I've learned what I have learned through parent trainings with my own child is that the ABA team is able to translate her needs and by showing Ella that she's understood then in turn the ABA team can show her how to effectively communicate and advocate her needs for herself I fought tirelessly for Ella Grace to have aBA because her AB her BCBA and her RBts are her translators
I do they do not do the work for Ella, but they give her the ability to communicate with others and help her understand what it is exactly that is she is supposed to do in the classroom setting. She is now in a private school because my husband and I felt this was the most appropriate setting for her to receive ABA OTN speech. With ABA Ella has made let me switch with ABA Ellah has made improvements in several areas of her life. When Ella started school she was struggling to sit and attend for
two minutes. Now she participates in class for up to 35 minutes. This took from kindergarten to2nd grade. Ella's ABA goals sometimes take months to years took fully accomplished it's hard as a parent to accept how long it takes sometimes for your child to successful ly achieve a goal but the joy of seeing them do that is unmatched by anything else. Ella can now also tolerate different tasks at the table, something that she struggled with at first we'll listen to multiple instructors
and follow one step directions. at home, Ella used to require someone next to her at all times to stay seated at the table and for someone to physically help her hold utensils to eat. Now she'll sit with us as a family and eat meals using hairy utensils and she's able to join in church activities. Ella also previously required someone to take care of all of her hygiene needs by doing them for her or physically helping her now Ella can take a shower by listening
to verbal cues using the restroom with assistant and verbal cues. she can brush her teeth, she can put her clothes on, put her shoes on which promotes long term independency and her own dignity. Before ABA Ella would help herself to anything she wanted including getting too much food from the fridge or the pantry. Now Ella will come find me and tell me what she wants before she helps herself or she may go find her brother and sister and ask them because she knows they'll give her ice cream for breakfast and I will not healthth
when it comes to her health, Ellah understands and feels so much more than she can express even with multiple medications she takes,
Speaker 56
30:16
Ella experiences pain and discomfort daily sometimes so much that she cries for long periods of time or becomes physically aggressive because she is desperate for help and relief
Speaker 51
30:26
for us teaching Ella to recognize how she is feeling is critical for us being able to help her Now Ella can tell us when she needs eardrops when she wants a heated blanket for her arthritis and when she needs medicine generally
this has been huge for helping us to be mindful of not just giving her medicine and seeing if it works but rather knowing specifically from her communication what she needs and so long term medication management for all diagnosis is improved. Ella's current needs. Ella has shown so much improvement since she started ABA but we know she has so much more room left to grow and to reach our full potential. at school we have requested for insurance to allow Ella Grace to have an RBT with
her in her current classroom. For us, Ellah being able to participate in school and get as much of an education as possible is our top priority. It's actually listed as a service on her IEB. No teacher can devote all of their time and attention to one student. Having ABA therapists in the classroom to work with Ella one on one allows her to participate in ways that a teacher or a paraprofessional who are responsible for an entire class just cannot
provide. Recently outside of ABA therapy, Ella eloped from her classroom and was found in the library near the front of the building and this is a safety concern. because
Speaker 56
31:55
of Ella's medical condition because of Ella's medical comorbidities. she experiences extreme discomfort and will take off all of
Speaker 51
32:02
our clothes regardless of where she is or who she's with. This has happened in her classroom. this has happened while she's been in the van that transports transports her to school
and she's learning now where she can and cannot take off her clothes and is learning to ask for help when she needs it but without someone there to stop her while she's learning Ella's dignity is compromised.ellis's safety can also be compromised if someone were to take advantage of her which is a mom is terrifying and a very valid fear for me at this time Ella's ABA therapy is working on increasing joint attention increasing the amount
of time she participates in teaching her how to follow more complex instructions. at home with the help of our BCBA we're working towards what we can do at home to promote her independence while also keeping her safe. one of our biggest goals right now is continuing to teach her how to express her wants and widening her vocabulary so she can broaden her world while she has improved so much from where we started the garage example I provided shows you still she still has room for
improvement. We want Ella to be confident
Speaker 56
33:17
in coming to us to communicate her needs in order for her to be safe. As for her health concerns, Ella still cannot identify all of her body parts to let us know exactly where she hurts so that we can specifically help and target that medical condition ABA
Speaker 51
33:33
data allows us to communicate with Ella's doctors in a way that they will actually listen this has been huge for us to better advocate for her being able to track how often she hurts herself and specifically
we on her body she harms herself how long she cries, what time of the day she has her behavior episodes has validated to medical professionals that what we are reporting as parents. For instance, Ella pinched her chest for several months. We could not figure out what was causing this behavior after speaking with the RBts and the BCBA looking over data, we started to consider this was related to her digestive system versus her arthritis we were able to get her to have
a scope done and we found out that she did indeed have Eoe and the pinching and the bruising immediately stopped when she started taking medication. This is the fourth year that Ella Grace has received ABA until this year we've had we've been approved for goals hours, service locations that we've requested. She has had ABA in her pediatric early intervention day programme. she's had ABA in kindergarten at her public school, she's had ABA in our
home. she's had ABA at our church. she's had aBA at her current school for children with
Speaker 56
34:55
disabilities since May of 2025. In February of this year we began receiving denials of services for a variety of reasons for the first time sometimes
Speaker 51
35:05
goals were not considered medically necessary. for example, Ella started holding her pills in her mouth and spitting them out when nobody was looking. We didn't figure this out till we found the pills and realized this is
Speaker 56
35:21
why she was suddenly acting like she was in pain it's because she was she wasn't taking her medication. I asked my BCBA
Speaker 51
35:29
for help. She created a goal for Ella to learn how to tolerate swallowing pills swallowing candy that was the same size and shape as her pills. During the next authorization, insurance sent me a partial denial letter which included that teaching Ella to take medicine and I quote was not medically necessary Taking medicine was not medically necessary.
because it didn't address any of her current challenging behaviors and ABA had to agree to stop helping us with this daily debilitate debilitating challenge in order for ABA services to continue. Dealing with our insurance providers has become our biggest barrier to helping Ella. Insurance providers are not good communicators often sending us the same information they send ABA professionals worded in ways that are difficult for us to understand and interpret
Insurance has also changed some of their processes and guidelines in ways that have made it more difficult for us to get services that Ella needs it used to be will the school let ABA the ABA provider come in and now it's become will insurance let us continue having ABA I would like to tell you about our most recent in recent experience with insurance to give you a glimpse into what this process has been like for me as a parent. On July twentyeh the insurance coordinator for
our current ABA therapy provider called our insurance, Blue Cross Blue Shield specifically a department within Blue Cross Blue Shield called Luit. They deal with ABA services and coordinate with AA providers the call was made concerning Ella's continual continuing authorization for treatment and our clinical insurance coordinator was notified at that time that Ella's plan was scheduled for physician's review on July30th, which was two days after being notified. I was not
informed of this review by my insurance company. My ABA insurance coordinator was told having LSBCBA and I quote was optional. she was optional to be a part of the physician's review the day of the call, the insurance coordinator asked if I asellla's caregiver could be a part of the call and she was informed that caretakers were not typically invited to these calls and I would be informed of the decision 24 hours after it was made. I was not able to
speak to my child's needs or advocate for her during this call. On July30th, the decision was made to reduce Ella's therapy hours to 25 hours a week. I was not given this determination notice of determination by Luit when I called loose it myself four days later the BCBA that determined Ellis's plans should be under physician's review told me after reading her plan, she determined that multiple goals in Ella's plan for instance
showing aggression, chewing in edible objects, eloping, disrobing, etc all these behaviors went down so she didn't need as intense therapy. I argued with the BCBA that the reason there was a decrease in frequency was because of ABA intervention. I argued one time eloping could be fatal at the end of the school year as I mentioned, Ella walked out of her classroom and she ended up in the library that has a direct door access to the parking lot.
Again as a mom this is terrifying. She needs support constantly to be able to discern what is safe and not safe until she can independently do this on her own she has to have support in regards to decrease in chewing in edible objects we did up in the emergency room a few years ago because she swallowed a quarter again another instance had it been a battery could have been
Speaker 56
39:23
fatal. So even though the frequency is going down the severity of what she's doing is still a safety concern
Speaker 51
39:35
ayllah attends school for37.5 hours a week. We requested for Ella to receive34 hours a week of ABA therapy to support her during school and allow her to have speech and occupational therapy. She was approved for 25 hours citing that anything more was not medically necessary because her challenging behaviors had reduced from where they started. My BCBA was told you can make progress with less intense services. MybCBA was also told if we see regression we can include
data in a new request for additional hoursc according to the council of autism Service Providers in their guideline for the treatment of ASD evidence of failure at a lower level of service intensity should not be required to access higher intensity of care. Ella shouldn't have to fail for us to meet her where she's at. Ella received a psych evaluation in kindergarten that she was that was inconclusive because she did not
Speaker 56
40:32
have the ability level to be able to complete the
Speaker 51
40:39
assessment. We tested again in May of this year and Elle's results showed that she was performing at the level of a normative three year old. My BCBA informed me it was mentioned during the physician's review by the physician how would my BCBA work to close the gap between the developmental age and her chronological age and it was asking how she was working to do that my question to insurance is how are you working to do that if you reduce her hours?
this is just the most in recent instance of us battling with insurance over the past eight months we've had multiple appeals with multiple denials. I think it's relevant that Bluecross Blue Shield also referred in one
Speaker 56
41:21
of their denials of Ella they referred to her as a hymn in formal paperwork at this time, I'm going to have the
Speaker 51
41:30
clinical director and our previous BCBA Jessica Linahan take over to give you more context about the insurance process.
Speaker 71
41:44
Thank you Rachel. as Rachel mentioned, I am a clinical director for an ABA clinic currently. I have been at BCBA for two years and prior to that I actually did work with Ella as her RBT. today I'd actually like to speak with you about the general process of getting services approved to help you understand how insurance processes impact When a plan is submitted to any insurance provider for review.
they either accept the plan as is or they provide us with feedback on changes to make or they request more information to provide so services can be approved. nowadays despite our best efforts almost none of our plans are approved at the first submission with most plans requiring some change. Changing these plans delays care. The same form we receive is sent both to us as therapy providers and to families as a notice of a pending decision oftentimes the feedback is
unclear even to us as service providers with portions of the insurance guidelines quoted that include multiple options of improvements that could be made and no direction on which portion of the guidelines the plan does not meet. if this is unclear to me as a BCBA it is infinitely more confusing to families. the language of a denial, even a temporary denial is scary and can send many families into a panic. I have talked many stressed parents down after receiving a
letter from their insurance. while insurance is also willing to take these calls and answer questions. a change in the way this information is provided to families would solve this problem. if a family has more than one insurance provider, their treatment plan is sent to both providers sometimes one provider accepts a plan the other denies and services are often put on hold until both providers are in agreement to prevent a family from being charged if a family doesn't want to wait for services or pause their
current service indefinitely they have to accept the risk of paying out of pocket and this is a cost many people can't afford. Each insurance provider also has their own timelines and guidelines for submissions appeals and denials I'm going to give you an overview of the timelines for both of Ella's insurance providers just as an example of how this can differ from provider to provider. for Bluecross Blue Shield our direct contact is lucid. after a plan is submitted, Luit
may accept it as is fully deny it or additional information may be requested. Luose it's deadline for additional information is two weeks from the date of request. This is actually one of the longer windows of time we have experienced with an insurance provider and was very helpful for Ella's most recent request for additional information as we submitted a33 page document to address all seven of Luit's requests. If the additional information requires further review, the request is referred for physician review.
ga in caregivers are not permitted to participate in the physician review call even if they request to do so If services are denied we can file a formal request to loose it asking them to look at the decision again. if the internal appeal is denied we can ask for an independent review by an outside group with no ties to the insurance company and their decision is final. for medicaid a treatment plan is typically reviewed within two business days of submission.
If additional information is requested, we have to calendar days including weekends to respond. failure to submit the requested information within the twoday time frame results in an automatic denial. depending on the information or changes requested this can be several hours worth of work with no time left for review. I'll remind you we sent33 pages to loose it if we feel it is necessary at peer to peer review may be requested during this process,
but the timeline for scheduling varies and can further delay services. in our experience, Medicaid has denied some of our requests based on reasons not identified in the original request for additional information even when all requested information is submitted timely. The authorization may still be denied if Medicaid determines the documentation does not support the request. if the request is denied, our last option is to file an appeal with the state and argue our case in front of a judge.
Current appeal scheduling is approximately 2.5 months before a hearing or review is conducted Services are placed on hold during this time to prevent caregivers from being charged. over the past year guidelines have changed in ways that we as therapy providers are still trying to decipher some plans that were previously approved have been denied when we submit to continue services based on new criteria or new interpretations of old criteria sometimes we receive feedback
and send an amended plan only to receive new feedback on things that didn't change between the original and the amended plan. However, we only get so many chances to make changes before a plan is fully denied. when we receive new feedback, our best option is to pull the plan fully resubmit from square one and hope the new reviewers in agreement with the previous reviewer but even then the best case scenario can delay care for in our experience up to 2 or3 months. Furthermore, if two reviewers can look at a plan and be in
disagreement on whether or not it meets criteria. how can we as providers get it right this is a portion of Ella's most recent decision from Luci which was sent to her AA provider and to her parents underlined our portions of the letter both Rachel and I found difficult to interpret upon first reading you can note that services for our six month treatment term July to January were decided to be quote medically necessary however services following this
treatment term have already been deemed not medically necessary while both Rachel and I are able to reach out to Luit for clarification. This letter is meant to convey a decision and the decision is unclear. The letter is not doing its job. Sometimes despite our best efforts plans are only partially approved for example, during the physician review on July30th, Ella's treatment was approved
for 25 hours per week. which is a reduction of her previously approved hours and meets the criteria of a focused plan rather than a comprehensive plan. the physician recommended splitting Elliss reduce hours between school and home 15 hours in school,10 hours in home. in her treatment plan Ella's BCBA has included a plan to transition her services from school to home and to fade her ABA services overall using this fading plan, the
intention is for Ella to eventually be able to participate in school enough so ABA can reduce hours and we can work with her in home to continue learning There are specific measurable criteria Ella will need to meet to show that she is ready for services to transition and stop. c according to the plan created by LSBCA. forea's overall ABA hours to reduce to 25 hours per week Ella will need to reduce her challenging behaviors including elopement to a safer level
have no instances of injury to herself or others increase her ability to communicate her specific needs and answer questions to a certain level and show greater independence with her hygiene skills and daily living routines. we provided insurance with Ella's progress towards transition for each of these domains. and at this time Ella has not met the measure by measurable criteria for any of them. As a BCBA I like to say that I am constantly trying to work myself out of a job.
I would love for all of my clients to be discharged from ABA because they have accomplished everything and no longer need our support. a fading plan is our way of figuring out how to do that When insurance makes a decision that forces us forward it compromises care fading too soon often results in regression in skills. and a resurgence of challenging behaviors for some kids like Ellah, these behaviors present a concern for their own safety at this time I would like to
review some highlights from the cast guidelines with you all for those of you who don't know the Council of Autism Service providers or CAp is a nonnational nonprofit trade association that represents organizations that provide services to autistic individuals. its purpose is to improve the quality, consistency and sustainability of autism services by providing guidance to providers, payers, regulators and other stakeholders this is a section from their ABA practice guidelines for the treatment of autism spectrum
disorder which outlines consensus standards for assessment, treatment planning, implementation, supervision, documentation and evaluating outcomes. on pages33 and34 they say multiple studies have shown that30 to40 hours of direct treatment per week produces better outcomes than treatment at lower dosages and comprehensive programs for young children with autism Similar intensities would typically be medically necessary and comprehensive programs for
adolescents and adults to meet treatment objectives Focused ABA typically involves fewer domains than comprehensive treatment models with services often compromising 10 to25 hours of direct treatment per week. However, there are exceptions For example, treating challenging behaviors or severe feeding concerns that threaten the patient's health and safety were significantly interfere with their progress may be so complex that it requires substantial intensity to achieve
an acceptable outcome, ie greater than 10 to25 hours of direct treatment per week. for those of you who are not familiar with CAS, I would encourage you to investigate them as an organization they have a lot of great resources and are very mindful about the overall ethics of providing care to individuals with autism, especially with their independence and dignity in mind. at this time I'm going to let Rachel conclude her statement.
Speaker 55
52:41
ABA therapy is typically offered for individuals up to 21 years of
Speaker 51
52:46
age. Arkansas Medicaid specifically states ABA services are available to qualifying children with autism diagnosis who are between the ages of 18 months and 21 years of age. I've also researched that ABA services can extend into adulthood, although not every insurance reimburses after 21. My daughter is 9. she's going into the third grade starting on Monday
She was denied the entirety of her behavior plan and her therapy minutes in February after appeals court in May we resubmitted and were awarded her therapy hours back. In the meantime, me and my husband paid for services for her wo months later my ABA provider was asked how we would begin to quote transition her from services. she's 9. she has 9 more grades to complete until she graduates high school. how is it possible when she's
still needing assistance to use the restroom, she cannot write independently she cannot initiate a greeting with the peer. She cannot state her address or her full name. the list goes on and on. we're not done with ABA therapy in reality we have just begun to experience the incredible support it brings in Ella's classroom and we've now get to watch theendence she is now seeking for herself and beginning to achieve.
We like so many other families depend on insurance. Ellis career is at the mercy of her of insurance decisions. I hope that by showing you who Ella Grace is, how ABA has helped her and what we continue to need help with to help her you will understand that our experience is just one example of a family in need I'm able to advocate for my daughter but so many other parents don't have the time or the resources to help themselves disagreements with insurance
that's my biggest barrier to getting Ellah help and this complicated process has only gotten harder I believe change needs to happen in ways that insurance providers communicate with families and how they allow families to participate in their own care and how they determine any child's needs. Thank you. thank you
Representative Denise Jones Ennett
Unverified
55:08
for that wonderful testimony by Ella Grace and and your guests for explaining
the issues senator Boyd has a question to ask. thank
Speaker 80
55:21
you for being here and presenting your your
Senator Justin Boyd
Unverified
55:24
testimony so and and just so everybody knows I have an unavoidable conflict at 10:30 so I'm about to let me go. so just to clarify when we we saylue Cross Blue Shield but is it specific or is it the teacher's insurance the public school education system OK I asked that
for a specific reason because if they're you know if if you're advocating and saying hey we want to change this. there are specific rules in place on changes to state employees public school educator insurance. so there are timelines that have to be followed and so on and so forth and so you know if they're moving forward if if if there's legislation drafted to understand that it's there's commercial insurance
there's EIA insurance which we can only do certain things then there's state funded insurance and the rules are are going to be different on all of those and have to be considered think that's all I just wanted to oh yeah
Speaker 28
56:32
I think that's it thank you thank you again do we have any questions from the task
Representative Denise Jones Ennett
Unverified
56:39
forcece? I have a question Missrieey
did I say your name right can you offer
any guidance with this since she worked for the state can you
offer any guidance as far as the medicaid is concerned madamurn in regards to to
Representative Denise Jones Ennett
Unverified
57:09
they're having with billing definitely appreciate you being here and sharing your
Speaker 91
57:19
story under medicaid specifically we have the passes and there's four of them and then we have Medicaid fee for service and so all all of those entities
Speaker 90
57:30
cover ABA and some do have you know, different notifications and just sharing that we continue to work with our passes and our partners that do our medicaid fee for service authorizations on that language and making it more clear and
more plain and so if a constituent has a concern and gets an unclear notice, we appreciate bringing those to our attention so we can address that and continue to work with our partners on making sure that that is more understandable on those notifications. I I know myself like it it is like my own insurance denials I'm like what does this mean and so anything we can do to help continue to make that more clear we're here for thank you
Representative Denise Jones Ennett
Unverified
58:24
right well next week on our list we have Courtney Slack
from Empower Healthcare Solutions. He recognized thank you. We invited empower and Miss
Speaker 91
58:43
Slack here today in case there were any questions specifically related to the past. I don't I don't know if there's a formal presentation but we wanted past representation here in case the
committee had any past questions.
Representative Denise Jones Ennett
Unverified
58:59
all right if
Courtney Slack
Unverified
59:01
you could recognize yourself please. my name is Courtneylack.
Speaker 95
59:07
I'm the associ I oversee our pharmacy services care coordination I'm happy to answer any questions about Missdawson, do you have any
Representative Denise Jones Ennett
Unverified
59:25
questions for her? you don't have any questions Anybody have any questions for all right you
Senator Justin Boyd
Unverified
59:38
recognized thank you just just to clarify so the passes normally would cover autism services yes
Courtney Slack
Unverified
59:45
sir all four passes pe c ific ally yes sir. OK. and are
Senator Justin Boyd
Unverified
59:50
there just any clearcut limitations with your pass on,
you know, hours of treatment or or limits that we all would want to know ahead of time that
Speaker 95
1:00:06
we would want to consider so we utilize Interal criteria. It is a national recognized medical necessity criteria, for aBA specifically there are functioning adaptability. there's there's all kinds of things that go into that. We work closely with our ABA providers especially in situations where there's a thirdpar insurance company they have
to to help with some of the burdensome we have these timelines they have those timelines and so we we don't have any hard limits per se it's based on medical necessity criteria. through Interal. However, if there is a request that would be denied or a request that looks like it would be partially denied that would go to our physician upfront. So before we before that letter ever goes to a
member that is reviewed by a physician and then we also write all of our letters at 1/6 grade reading language so that they can help understand and some of those what's going on but then also our providers have access to our provider portal so that they can see the doctor's rationale directly as well so just out of curiosity do you
Senator Justin Boyd
Unverified
1:01:23
do you or DHS or some thirdparty ever survey your clients and or providers to see you know how how efficient how
how well it works on the the other side
Speaker 95
1:01:35
of it sir so we do a provider survey. we conduct a provider survey every year. we reach out to providers regarding empower members specifically nation you know how that relationship works utilization management. we also have a provider relations department. so our providers are always welcome to come through our provider relations and they will get them to the right department and connect it as well. think that's all I have. thank
Representative Denise Jones Ennett
Unverified
1:02:02
you. have a question I don't know if you can answer it since you work for Empower since we have four passes is there a standard that each pass uses is in regards to this subject area? Is it apples to apples? are you talking about the medical necessity
Speaker 95
1:02:21
criteria and the limits? I cannot speak fordily passes. I'm so sorry right thank you Doctor Taylor you recognized
Speaker 106
1:02:33
thank you so it's my understanding fir guidance we've received from Arkansas Medicaid and the schools is that we cannot bill for those services in the school setting for students who are under a pass and surprising information
Courtney Slack
Unverified
1:02:46
to me so that is not our that is not in powerer's stance on ABA We do not have a specific limit of of not being able to
Speaker 95
1:02:53
provide we've been the schools have been told we have not been
Speaker 106
1:02:57
successful in billing any students through medicaid in the schools for for ABA services we had a lot of
hurdles that we confronted last year at Bryant at least for the kids who were trying to serve. we have several students under a pass butittzs did tell us that the students who have waiver and students who have the pass that we cannot seek reimbursement for
Speaker 105
1:03:18
the services in the school setting can take that back and and
Speaker 108
1:03:26
get you you recognize Missrie and I may ask my
Speaker 91
1:03:29
boss over there to jump in so I think there is some confusion on that when
the school is the provider of services that the past is excluded from that and it has to go to medicaid. I know that that can be confusing sometimes and would be more than happy to look if you have a specific case you'd like us to look into it does so if the school has the medicaid Id and they are the Medicaid provider that has to go to medicaid for even past members and I don't know melissa anything to add to that OK.
Representative Denise Jones Ennett
Unverified
1:04:15
You recognize Miss Brie Any more questions from the task forcece? all right. right thank you so much ok I'm sorry can you
Rachel Dodson
Unverified
1:04:40
come back real quick? I'm sorry my button I didn't push fast enough. so
Speaker 51
1:04:46
something that I I'm noticing with ABA because my my daughter's got OT speech. she's had all the things. So in that process of all of that she's always had to have a prescription written from a pcp to get those services and then she also has to be observed you know, physically observed by the pcp obviously to write the script and then also she does an inperson evaluation with a therapist to get to be able to start the services. so my question is for a child to receive ABA is it do
y'all ever do a inperson for like actually see
Speaker 56
1:05:19
them physically see them in person or is it all just through documentation and paperwork. purpose of utilization
Speaker 95
1:05:28
management is to evaluate from a clinical perspective we have care coordination which is the lifeblood of the past obviously and they advocate for members and help connect those and so we coordinate utilization management and care coordination from a strictly utilization management perspective that
those are clinically train ed folks that are looking at clinical information and evaluating it against clinical criteria and then if that is going to result in a denial or a partial approval we also are looking at the care coordination piece that pCSp we're looking at the notes that are interactive with that family. but utilization management stays in a clinical fashion. to
Speaker 51
1:06:19
an inperson seeing the child physically seeing them in person that never happens It does from our care coordination. OK so who who would that be because like for my daughter I don't
Speaker 56
1:06:32
know that anybody came and and physically observed her in order to determine services. so who would I specifically be looking to see who that was
Speaker 95
1:06:41
is not going to do a a clinical observation for services. They are not trained to be like clinicians they are
going to discuss your needs with you discuss, what services are available for your daughter, what services she would benefit from they developed that personcented service plan and that helps guide utilization management that utilization management relies on our providers. We have, you know, providers that are contracted with us to complete the standard evaluations for autismc specifically and ABA we require an ABA assessment that
part of that assessment is that they have autism or another qualifying diagnosis to be eligible for ABA services so based on that provider's assessment we review that and then that is what determines how many hours of ABA are in the plan and and those kinds of things that what was talking about submitting so you said and I'm I'm I tried to write it down but I
Speaker 51
1:07:50
don't think I did but they're not clinically trained to make an observation
they're just clinically trained to read and decipher
Speaker 56
1:07:56
paperwork to make a decision. so care coordination are
Speaker 95
1:08:00
not clinically trained to to perform like autism assessments. care coordination, their job is to talk to the families, meet with the members identify their needs help them coordinate the care to services and access to services help you find a provider all of those kinds of things and they also develop the personcented service plan.
which is specifically tailored to each member. OK. so
Speaker 56
1:08:29
the care coordinator is not the one that decides if they receive it or not no
Speaker 51
1:08:35
ma'am ok so but no nobody in using pet if I have a past in power, no one is coming to actually physically observe her like through any of the process before making the determination if she should receive or not
Rachel Dodson
Unverified
1:08:47
receive. No ma'am we rely on our providers our clinically trained providers to do that
Representative Denise Jones Ennett
Unverified
1:08:58
all right any other questions? all right thank you
thank youext on on the agenda sorry we are going to discuss the legislative priorities that are going to be submitted to the
general assembly and it's in your handout oh you don't OK I'm sorry it's not in your handout you will receive it in your email but
I do have a question since this issue has come up is this something that we want to put on
our legislative agen priorities is that is that something Miss Barnett you think this should
be on our legislative priorities. I'm sorry we don't have I mean it's in your email sorry but we have to submit a priority list to the speaker and the prote and so my question to the task forcece is this something that we want to look into new policy that DHS has been
Senator Missy Irvin
Unverified
1:10:02
working tirelessly on that will affect this that is just about I'm not sure the timeline but pretty soon it's going to go out for public comment and so that is going to affect all of the how the and how it all works and they're they've been really working with a large task force of people to try to get input from folks to make sure that communication is clear and that if there are limits people understand what they are and they understand the criteria for exceeding those and so I think that is a pretty significant outcome that's about
to happen that may impact that so the this group may want to just you know stay in touch with that activity that's
Representative Denise Jones Ennett
Unverified
1:10:44
going forward. a lot'm sorry you recognize Miss
Speaker 124
1:10:47
Weatherford? Thank you Melissa Weatherton thank youarren no worries it's hard. it's everybodydy messes it up. we are working on ABA manual but I think what Rachel is talking about is a larger than ABA So I just want some
clarification like when you asked do you want this on the legislative wish list like what what is that exactly? What what are we can we frame up the topic or the request possibly and I'm going to defer to miss dotson I
Representative Denise Jones Ennett
Unverified
1:11:19
think and I'm excited to hear that there's more conversation going
Speaker 51
1:11:24
on and there's a bigger piece coming out. I think the thing about that is is
I I I have a nine year old that's everyday is growing so a year of something to be done in a year may seem fast to a committee but for a mom of a child that's doing this everyday like next week would be it's coming out quickly so I guess I need a little clarification too as far as like when you say that is that are we talking is it going to be close to completion in a year's it close in a few months because that does make a really big difference.
Speaker 91
1:12:07
You recognize Miss Bru you actually we are very close to starting the promulgation process but I wanted to call out the Cms tool kit that did come out we are digesting that and making sure that our changes are in alignment with the publication that Cms just released and so that may take a minute and then the process will start with internal approvals then we'll come to legislative approvals and so it does it does
take a minute for all of that all of our
Speaker 128
1:12:40
new policies to work their way through the process. Miss Weatherton
Representative Denise Jones Ennett
Unverified
1:12:48
is that more does she need to be more specific should
Speaker 129
1:12:55
not have like supervisory roles on this right it's going to be6 months. It it we can't run any role faster than6 months.
Speaker 124
1:13:03
and so we we are they have been working atdd tirelessly but she's right we're
gonna have to take that toolkitt which is like this thick and make sure that we're in line with what Cms is recommending. and then run that back through her work group thatarren was referring to who's she's an active member on it which we really appreciate. and then internal approvals and that goes to the governor's office and then it goes over to the legislature for two different committee meetings. So same thing though Rachel though if we're going to put it on the if we can frame up the topic of
what you wanted to add to the wish list that that also takes Tom, right? That that won't be close either unfortunately. So I think I'm glad that empower was present today. I just want to say that I extremely appreciate them being here. they're a great partner with DHS Courtney Slack is amazing to work with and I know she's been keeping me updated on paying secondary for you when Blue Cross BlueShield denies ours so I know that
that's a recent discussion you've been having with her so I'm glad that she's here and wants to connect with you afterwards to make sure that she understands and empower understands the hours that you're needing
Speaker 129
1:14:23
right now because I think that's your most immediate way to get some assistance right Mr Taylor you recognized or
Representative Denise Jones Ennett
Unverified
1:14:34
Doctor Taylor sorry you thank youmi's
Speaker 106
1:14:36
fine thank you can I just try to frame up from the school perspective what I see
the issue as being you know we're talking about aBA a lot today but like Melissa had mentioned when we were talking about all the kids with disability we're talking about so many different domains and I think the challenge in general for schools is just the costs that we're facing. I just got back from DC visiting with ument Cotton and and Bosman and all of our congressman and I was talking about so many of these things that we're talking about today are taking us back to federal issues that we're trying to solve but there are some they're definitely definitely some components to this work that are and some
guidance that's coming out at the state level that are creating what seems to be some additional barriers and you know we spend $12 million in state and local dollars that bryant taking care of kids with disabilities we get about $2 million in our federal grant to help absorb those costs and so we were not successful with billing ABA last year and we did confron t a lot of barriers that were in place and I want to work with everybody we have a lot of great people in here we have the department of edd we have DDS we have DhS we have the right minds in this room to help solve some of those issues but I think just
in general it's the cost that it's taking to provide these services because we're providing those services at a direct cost to the district and how can we support districts and be able to recoup some of these very you know high expenditures that we're having to occur thank
Representative Denise Jones Ennett
Unverified
1:16:04
you frogs that robust discussion on this subject. I am going to make a motion let me find my motion I make a motion that the final
approval of the report go through the chairs prior to the final submission to the general assembly I need a first I need a second second
OK. right. all in favor say aye on poste say no right
and we got the got it got it approved any other business before we conclude this meeting. and just I think I just got a little lost. so did we just we just
Speaker 134
1:16:58
approved to move forward the proposals but we haven't seen them. OK. I would really like to see them before I cast a
Speaker 124
1:17:07
vote on what moves forward unless I'm the only task member that wants to read them before we vote on them
Representative Denise Jones Ennett
Unverified
1:17:21
OK. Miss Washington said that you will receive them prior to submission. and then if you have some concerns then we can work on that before we submit it. Is that OK Miss
Speaker 136
1:17:36
Weatherford Miss Weatherton p re s ent ative Nna I
Speaker 124
1:17:39
just don't I'd really like to take the vote then unfortunately if we can I just don't wanna unless I'm the only one on the committee that is not comfortable with we all just voted on something that we haven't seen.
Representative Denise Jones Ennett
Unverified
1:18:07
OK. Miss Washington told me that this is this
Representative Denise Jones Ennett
Unverified
1:18:23
since we have not met consistently in four years this is how it's Miss Washington told me this is the procedure and this is how it's done so but we're open to suggestions
Speaker 124
1:18:43
No I think I'd like to record that my vote is no only because I'm not trying to be adversarial. I just have not read it so I'm uncomfortable and I have been on the task force since it was enacted as well as Miss Burnett and I don't, I don't remember how we did this in the past Karen might you recognize Miss Barnett understood
Senator Missy Irvin
Unverified
1:19:05
earlier that they had been distributed via email but I don't think I got them either. I got an agenda and the minutes from the last meeting but I and
I didn't see them in the packet today so I'm a little confused as well. I think typically what I remember and my memory is not as good as it once was but what I remember is that typically this group reviewed them and then they were the chair submitted them. Miss Washington
Representative Denise Jones Ennett
Unverified
1:19:31
informed me that it's not emailed yet but it will be in your emails sorry and then we can make revisions after the meeting.
we are making revisions to it after this meeting. that's why it's not available right now. go ahead so if
Senator Missy Irvin
Unverified
1:20:01
there's if it is going to be distributed via email if there's a time frame issue in terms of when it's a deadline for it to be submitted? could there be a vote then taken by email after people have reviewed the document we can schedule another meeting OK Mr Adams
Speaker 142
1:20:23
going to go on record as well. I did I refrained from saying that I was in approval because I was unsure of what we were actually voting for and and so I similar to Miss Weatherton, would like to go on record until we have seen what it is that we're actually recommending and and once we see it I'll be glad to participate just a second
Representative Denise Jones Ennett
Unverified
1:20:57
I'm going to make a motion to expunge that vote Those
in favor say aye those opposed say no the ayes have it thank you and this meeting is Sorry. OK. would you all like to schedule another meeting before we
OK, so I've been informed by Miss Washington that this report is due by the31st of this month so we will have to meet before the31st is that ok with everybody on the task forcece? all right well we'll we'll email you some dates and we will email you what we have already and we will meet before the31st of this month and I'm sorry for all the confusion. I
want to thank Misss Washington for being right here holding my hand as we go through this again and I want to recognizepresentative burkes for attending the meeting this morning. we are adjourned. thank you.
Agenda
A. Call to Order
B. Consideration of a Motion to Approve the June 4, 2026, Meeting Minutes [Exhibit B]
C. Update from Office of Arkansas Attorney General Regarding Medicaid Fraud Investigations - Justin Brascher, Senior Assistant Attorney General, Department of Intergovernmental Affairs, Office of Arkansas Attorney General
D. Discussion on Applied Behavior Analysis Behavior Plans [Exhibit D] 1. Rached Dodson, Member, Arkansas Legislative Task Force on Autism 2. Jessica Lenehan, Clinical Director, Every Little Step ABA, LLC 3. Courtney Slack, Associate Vice President of Clinical Strategy and Care Integration, Empower Healthcare Solutions, LLC
E. Discussion of Legislative Priorities to be Submitted to the General Assembly
F. Other Business
G. Adjournment
Documents
No documents posted.
Speakers
Representative Denise Jones Ennett
Unverified
Justin Brasher
Unverified
Senator Justin Boyd
Unverified
Speaker 30
Representative Nicole Clowney
Unverified
Rachel Dodson
Unverified
Speaker 51
Speaker 56
Speaker 71
Speaker 55
Speaker 80
Speaker 28
Speaker 88
Speaker 91
Speaker 90
Courtney Slack
Unverified
Speaker 95
Speaker 106
Speaker 105
Speaker 108
Senator Missy Irvin
Unverified
Speaker 124
Speaker 128
Speaker 129
Speaker 134
Speaker 136
Speaker 67
Speaker 142