UnitedHealthcare is "strategically limiting" access to applied behavior analysis for children with autism, according to a Dec. 13 report from ProPublica.
According to internal Optum documents obtained by ProPublica, the company has moved to limit new ABA therapy providers from joining its Medicaid managed care networks. Optum, part of UnitedHealth Group, manages behavioral health for UnitedHealthcare.
According to ProPublica, utilization of ABA services among UnitedHealthcare Medicaid members has increased 20% over the past year, an increase of $75 million in spending.
The company has also made efforts to terminate some ABA providers from its networks, according to ProPublica, and uses an approach to approve fewer hours of therapy than requested by providers.
The tactics are a "blunt instrument" to cut costs, Tim Clement, vice president of federal government affairs at Mental Health America told ProPublica.
In a statement shared with Becker's, a spokesperson for Optum said the article "grossly misrepresents our efforts to ensure the people we serve are getting the most effective, evidenced-based care for their needs."
The spokesperson said the company has expanded its ABA provider network by more than 110% over the past three years over all its lines of business.
"Our programs are compliant with all applicable federal and state laws, align with widely accepted industry standards for clinical evidence, and result in expanded access to high quality care," the spokesperson said.
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