CMS Releases Toolkit to Assist States in Protecting Integrity of Autism Care for Children

Earlier this month, CMS published a lengthy Applied Behavior Analysis toolkit to help state Medicaid and Children’s Health Insurance Program (CHIP) agencies protect autistic children and maintain program integrity amid rapid spending growth and concerns over inconsistent clinical practices. The toolkit was developed using Medicaid data, peer reviewed literature, and stakeholder feedback. It provides practical strategies—such as setting prior authorization thresholds, tracking clinical outcomes, and establishing care duration limits—that will aid states in curtailing fraudulent schemes, preventing the overprescription of services driven by financial incentives, and ensuring that children receive individualized, evidence-based care.