The Michigan Department of Health and Human Services (MDHHS) issued final bulletin MMP 26-18 updating Medicaid Behavioral Health Treatment (BHT) requirements for autism services, including applied behavior analysis (ABA).  

Key updates include:  

• Removing the requirement that a child receives a physical examination before accessing BHT services.  

• Clarifying that autism diagnostic re-evaluations are not required unless determined medically necessary by a physician or other qualified licensed practitioner, or requested by the beneficiary’s family or legal guardian.  

• Updating qualifications to reflect Michigan licensure requirements and specifying that BHT services must be provided under the direction of a licensed behavior analyst.  

• Clarifying that ABA assessments and treatment plans must follow current, evidence-based, generally accepted standards. Interim progress assessments must be submitted at least every six months, with more frequent assessments permitted when warranted by individual circumstances. 

• Stating that treatment should not be denied or withheld based on caregiver’s availability and that discharge should generally involve a gradual reduction in services rather than a set timeline. 

Hospitals and providers involved in autism screening, diagnosis or treatment referrals are encouraged to review the bulletin and coordinate with their community mental health services program or prepaid inpatient health plan regarding applicable requirements. 

Members with questions may contact the MHA policy department. 

Phone: (517) 323-3443
Fax: (517) 323-0946

Phone: (517) 703-8601
Fax: (517) 703-0628