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FABA Update Regarding South Florida Moratorium and Upcoming CPT Codes

 FABA Update Regarding South Florida Moratorium and Upcoming CPT Codes

 FABA Update Regarding South Florida Moratorium and Upcoming CPT Codes

You will see in the November 10, 2021 Medicaid Alert that AHCA has extended the Moratorium for Provider Enrollment another 6 months, to May 13, 2022.

In addition, AHCA has announced the forthcoming transition from the current Healthcare Common Procedure Coding System (HCPCS) to the national Current Procedural Terminology (CPT) Codes.  The Agency plans to have the CPT-based behavior analysis fee schedule in place effective July 1, 2022.

In anticipation of this transition, FABA met with the AHCA team who will be driving this change.  We agreed that as soon as the Provider Alert was published then additional messaging and training would be developed and provided incrementally to help providers have a smooth transition to this national standard. 

You may have heard that a strong coalition of behavior analysis supporting organizations have been collaborating on a model health insurance coverage policy since 2016 for the AMA with the model specifically for ABA providers developed in 2020.   The ABA Coding Coalition included representatives of the Association of Professional Behavior Analysts, Autism Speaks, Behavior Analyst Certification Board, Council of Autism Service Providers, and their CPT® consultant.

It is felt by providers both at the national and local level sampled here in Florida that this is a good change regardless of who your payers are.  At present there is considerable variability across payers in policies regarding ABA services.  In turn, to the extent that payers will adopt these standards there should be more consistency in the coverage of ABA services.  This should enable providers of ABA services to communicate with payers about appropriate coverage determinations, including indications, limitations, and competence level of those providers recommended to render services.

FABA will continue to meet with this AHCA transition team as information becomes available and to help develop language for policy and rule related to the transition to CPT Codes.

Thank you for staying engaged with us as we work with the Agency for Health Care Administration to help with this transition and address any questions or concerns you may have about this change.  Remember you can always contact us at:  [email protected] .


Regards, Steve Coleman, BCBA-D

FABA’s Public Policy Director

2021 Legislative Session Update

The 2021 Session is finished. With a total of 3,140 bills filed, the fact that only 275 bills passed reflects the impact that the pandemic had on the 2021 Session. The Legislature’s primary focus was on passing legislation that would shield health care workers, health care facilities, and all businesses from litigation that might arise due to COVID-19. Senate Bill 72 was the first bill the Legislature sent to the Governor during the Session and it creates civil liability protections for health care providers, individuals, businesses, governmental entities, and other organizations against COVID-19-related claims. Additionally, the Legislature prepared for economic challenges presented by the pandemic and expected to make across-the-board cuts. However, by the end of Session, Florida’s economy had already started to recover and additional federal recovery funds positively impacted the budget, resulting in a budget that is 10 percent larger than that passed in 2020. 

There were a number of bills and issues that were of particular importance to FABA this Session, and include:

  • CS/HB 1057 – Agency for Health Care Administration – Medical necessity determinations by BCBA-D’s – FABA supported the inclusion in statute of doctoral-level board-certified behavior analysts as able to make medical necessity determinations under Medicaid. This is an issue FABA has advocated for nearly five years as AHCA’s behavior analysis program policy has developed. We are appreciative of AHCA’s support for this change and believe it will assist in making accurate and appropriate medical necessity determinations. The bill has passed the Legislature but not yet been presented to the Governor.
  • HB 149 – Students with Disabilities in Public Schools – Restraint & Seclusion – FABA has supported additional limitations on restraint and seclusion for over ten years, starting with the original restraint and seclusion legislation by Rep. Dorothy Hukill and Sen. Andy Gardiner that passed in 2010. This legislation goes a step further by revising requirements for the use of seclusion and restraint and creates a pilot program for the use of video cameras in certain classrooms. The bill requires school districts to prohibit placing a student in seclusion and provides that restraint may only be used to protect students or school personnel and not for discipline. A student may be restrained only for the time necessary to protect the student and others and only after all positive behavior interventions and supports are exhausted. The bill requires the Department of Education to publish de-identified data on reported restraint incidents on the department’s public-facing website each month. The bill also implements a pilot program for video cameras in certain classrooms in Broward County. At the written request of a parent, the school district must install a video camera and record a classroom in which a majority of the students are provided special education services. The bill has passed the Legislature but not yet been presented to the Governor.
  • HB 1401 – Applied Behavior Analysis Services – RBT & clinic exemption – Rep. Rene Plasencia was again very successful in passing the ABA bill out of the House and over to the Senate that addresses the problem of making sure RBT’s can work in the K-12 classroom setting, and the concern that non-Medicaid behavior analyst groups could be interpreted to fall under health care clinic statute. However, the Senate bill, SB 1794 by Sen. Randolph Bracy, failed to move through any of its committee. The importance of addressing the RBT issue cannot be understated as school districts have used the statute’s silence on the matter to prohibit RBTs. FABA will continue to advocate for change to the statute in the 2022 Session. 
  • $95 million has been appropriated to address the wait-list at APD. Additional funds in the budget allowed the Legislature to direct more funds toward reducing the wait-list.

 Thank you to all of our members that assisted our legislative efforts this year!

Need EVV Survey Responses

In our last update we alerted you to the anticipated statewide roll out of the Electronic Visit Verification or EVV program on May 1st, 2021.  Obviously, that date has come and gone, however we expect a decision in the next 10 days of when statewide deployment will begin.  The decision to launch will be dependent on key elements of the systems being fully operational and glitch free.

In an effort to fully inform AHCA of continued system problems and to aid in the decision making process we will need your input.  Early next week we will send out a link to another EVV survey to capture your experiences with Tellus as well as concerns and challenges with system problems that persist so we can share that data with AHCA.  The rapid submission of your survey by the end of next week will be critical to allow time to compile and summarize results for our presentation to AHCA the following Wednesday.

Your participation in this upcoming survey is critical to the decision for deployment, so we hope you will take the time to complete the survey.  Also, please encourage your colleagues providing behavioral services in South Florida to participate.  We would like to see a healthy response to get broad representation of all the remaining issues from those who deal with the EVV system everyday.  Your FABA representatives have been communicating your concerns to AHCA for over a year, and would like to be able to counter Tellus reporting that all system problems have been resolved. 

If there is any thing else in the meantime, you can reach out to your FABA representatives ([email protected]) at any time or check out our website and Facebook page for any comments, experiences, or questions you may have.

FABA EVV Action Committee Update

FABA EVV Action Committee Update - January 7, 2021

The FABA EVV Action Committee wishes you a Happy New Year.  In addition, the Action Committee wants you to know that we continue into this New Year meeting regularly with AHCA to address implementation of the EVV system.  In fact, this week we have learned that there are a number of new actions and improvements that AHCA has implemented and will soon be appreciated by providers using the EVV system.  Included amongst these are, 

  • A solution to ensure a scheduled session is ended on time, and allowing the start of the next session.
  • A solution to eliminate overlapping recipient sessions
  • Cellular features to use the Tellus system off-line when cellular signal is weak
  • On-screen notification or reminder to providers when submitting claims that referring physician information is needed to avoid claims being denied
  • Tellus will create an identifiable customer service number that can be readily recognized by providers so that requested callbacks are not ignored or missed.
  • Tellus has a policy and will reinforce that policy with their customer service agents to leave a voice mail message when completing a callback.  In turn, it is important that providers clear out their saved voice mail messages so that callback messages can be left.

Finally, as providers, you have also made tremendous progress.  We know that this has been a real struggle, but you have come a long way.  FABA will continue to work with AHCA to address your concerns.  Because of our collective persistence, there are now only a handful of providers who have not registered to use the Tellus system, and only a very few who have not yet tried to submit and release their claims.  If you happen to be one of these providers, please be sure to register.  More importantly, if you are waiting to release claims, release them now so that you can be identified as attempting to submit billing through Tellus.  As soon as this is done your claims will be released from suspension and be processed.

Thanks again for your continued work with the Tellus system.  

Please continue to share your requests for help with Damon Rich at AHCA ([email protected]) and with us at [email protected] so we can assist you and work with AHCA. 


EVV Action Committee - Urgent Request for Information

FABA EVV Action Committee Update - December 16, 2020

We continue to meet with AHCA regarding challenges that you are having with the Tellus system. The data that they share with us does not reveal the actual status of provider challenges, at the very basic level with regard to EVV enforcement requirements cited in the 11/25/20 Medicaid Alert.
We need examples of the providers experience with Tellus in the past two weeks. If you are a medicaid provider in Services Areas 9, 10 or 11, please take a moment to complete the survey below.

EVV Action Committee Update - December 14, 2020

FABA EVV Action Committee Update - December 14, 2020

Based on our most recent contact with AHCA – as of Thursday (12/11/20) AHCA was reporting that of the 464 providers registered in Tellus, there were 23 who had not had visits or claims in the Tellus system.  Similarly, of registered providers, 78 have at least 1 visit in the Tellus system, also with no claims.  All 101 providers had at least one recipient with an active PA.  

The good news here, in addition to having registered, approximately 80% of providers have successfully attempted billing through Tellus.  Unfortunately, the window for billing through FMMIS is closing, effective December 21, 2020.  Claims made through FMMIS after that time will be denied.

So, please Communicate Your Tellus Challenges

If you encounter problems with PAs, scheduling events, missing or changed scheduled events, errors in visit location, lack of Tellus response or billing issues, please contact Damon Rich at AHCA.  Please use the Subject line, “FABA Referral” and avoid bombarding a variety of AHCA staff, so that your concerns are directly seen by Damon Rich.  Damon’s email is [email protected].

Please remember, if there is no PHI involved in your message, also copy the FABA PAC, [email protected], so we can assist you and work with AHCA

Thanks again for staying engaged with us as we work with AHCA to continue attempting to get EVV problems resolved.  Your continued sharing of your EVV challenges helps us put a face on continued EVV problems when meeting with AHCA.  Each day there are incremental improvements resulting from your input!

Regards, Steve Coleman, BCBA-D

FABA’s Public Policy Director

FABA EVV Action Committee Update

FABA EVV Action Committee Update - December 7, 2020

Here’s where we are today – on Friday (12/4/20) AHCA was initially reporting that they had determined that there were 144 out of 470 providers unregistered in the Tellus EVV System.  Later, they determined 12 of the 144 were still billing directly to FMMIS, although they were unregistered with Tellus.   It was also speculated that at least some of the 144 unregistered providers may not have been providing services and subsequently never registered.  Over the weekend, apparently, 3 more providers have registered, leaving 9 providers having a restriction on their file.  The good news is that most providers have registered.


The next hurdle for providers is to attempt to submit at least some claims to show a good faith effort to use Tellus for billing.  If there is no billing through Tellus, all claims submitted directly to FMMIS will suspend until AHCA can document the provider has begun using the Tellus EVV System to submit claims. Once confirmed, the claims in FMMIS will be released for payment without any further action by the provider.  Providers will not need to resubmit the claims.


So, please Attempt to Bill through Tellus


If you encounter problems billing through Tellus, please contact Damon Rich at AHCA.  Please use the Subject line, “FABA Referral” and avoid bombarding a variety of AHCA staff, so that your concerns are directly seen by Damon Rich.  His email is [email protected].


Thank you for staying engaged with us as we work with AHCA to continue attempting to get EVV problems resolved.  Your continuing response to surveys and sharing your EVV challenges with us and AHCA have been most helpful and are resulting in improvements to the system!


Regards, Steve Coleman, BCBA-D

FABA’s Public Policy Director

FABA EVV Action Committee Update

FABA EVV Action Committee Update

The FABA EVV Action Committee continues to meet regularly with AHCA. If you did not read the AHCA Alert from 11/25/20 you should know that as of Monday, December 7th, the Agency for Health Care Administration will be enforcing the use of the Tellus EVV System. This means that all Behavior Analysis Fee-for-Service providers funded through Medicaid must be registered in the Tellus system. If you are not registered in the Tellus system as of Monday you will no longer be able to bill through FMMIS. If you are NOT REGISTERED all claims submitted directly to FMMIS will suspend until the Agency confirms that you have registered and begun using the Tellus EVV System at least for scheduling and visit verification.

So, PLEASE REGISTER as soon as possible, if you have not done so already. If you are having PROBLEMS REGISTERING please contact Damon Rich at AHCA. His email is [email protected] Please use the Subject line, FABA Referral and avoid bombarding a variety of AHCA staff, so that your concerns are directly seen by Damon Rich.

Also, if you are not providing PHI, please copy the FABA PAC, [email protected], so we can assist you and work with AHCA to assure you get registered.

Click below to view a job aid, “AHCA BA Registration Process” that should help walk you through the registration process.

AHCA - Registering Your Agency with Tellus EVV

Legislative Update –FABA EVV Action Committee

Update from the FABA EVV Action Committee

The FABA EVV Action Committee met with AHCA this morning and we believe that some additional flexibility with the December 1st “go live” implementation of the EVV system has been achieved.  These flexibilities will help to ease providers into full implementation over the month of December.  This will mean that providers in the pilot areas (Area 9, 10 and 11) in South Florida will need to demonstrate a good faith effort to attempt implementation of all aspects of the EVV system.

The demonstration of participation will be monitored for all providers in these areas and FABA will be meeting weekly with AHCA to review this progress and update membership.  In the first phase this will mean that ALL providers must register and create an account in the system.  Currently, it appears that only 40% of providers in the Region are registered, while the data is showing that 98% of registered providers have a least 1 recipient listed.  In addition, providers need to attempt scheduling in the system, as only 72% of those currently registered are actually using the system to do this.  Lastly, attempts should be made to bill.  Currently, only 39% of those registered in the system have attempted billing.

To move this system forward, FABA strongly encourages providers to register into the system immediately.  If problems are encountered with registering, AHCA wants to know that so they can address the problem.  The same is true for scheduling and conducting sessions.  Similarly, as providers begin the transition of billing from FLEMMIS to Tellus, AHCA will need to know of any problems with this process.  Part of the agreement is to allow use of FLMMIS, if needed, until December 21st.

Any problems that you encounter should be sent to AHCA through encrypted mail or with a password protected Word document, followed by the emailed password.  AHCA has advised that you are more than welcome to continue copying Tellus, but AHCA will take lead on any direct referrals sent to them.  This means they will either resolve the issue directly without Tellus involvement, or specifically direct Tellus actions for prompt intervention and resolution.  

Legislative Update - Post-2020 Session

Post-2020 Session – Legislative Update – HB 731, Agency for Health Care Administration

Governor DeSantis did sign HB 731 – Agency for Health Care Administration on June 30, 2020, that contains an exemption from the health care clinic licensure for Medicaid providers. Now that the exemption is law, it is our understanding, after speaking with the Medicaid Policy Office at AHCA that the exemption will be automatic for behavior analysts enrolled as Medicaid providers and no further action will be needed to be taken by Medicaid providers. We also expect the Agency to announce that the December 1, 2020, health care clinic licensure requirement deadline for behavior analysis groups will be repealed from the Medicaid Enrollment Handbook and that administrative rulemaking will be necessary to effectuate the change. We are anticipating a Provider Alert soon from AHCA on this matter. Please stay tuned and attend the September  17, 2020, panel discussion with AHCA, APD, and CASP at 4pm during the 2020 FABA Conference for further information.