Homeostasis: Ethical Guidance for Navigating Payor Policy Adjustments

Current Status
Not Enrolled

The Defense Health Agency, providing oversight of the TRICARE military benefit, released information on changes to the Autism Care Demonstration program. The modifications will require providers to make significant adjustments across the landscape of service delivery with clinical integrity. The Behavior Analysis Advocacy Network (BAAN) will share ways to ethically address concerns with funding sources, and effective processes to support this transition. Guidance will be given on methods for implementing practices associated with Category I CPT codes pertaining to applied behavior analysis (ABA) therapy. Recommendations will be aligned with the Behavior Analyst Certification Board (BACB) Compliance Code standards. Attendees will be equipped ways to address concerns with this funding source, strategies for aligning business practices with the new requirements and suggestions for maintaining the necessary supervision associated with the Registered Behavior Technician (RBT) certification.

All participants will receive:

  • 2 Learning BACB® CEUs that count towards ethics requirement
  • A review of challenges being posed by the implementation of policy changes
  • Ethical guidance for conflict resolution with funding sources
  • Attendees will learn ways to apply TRICARE Operation Manual requirements to their session content and subsequent documentation
  • Examples and discussion about how to implement the recommendations


Michele Silcox

With her 25+-year Accounting career, quickly learned that the basic principles of Accounting apply across all industries. She developed a keen sense of controls and successfully managed teams of accounting staff in exceeding goals for all levels of back office functions. With her experience and desire to help others, she is a seasoned, natural leader and trainer for employees, executives, and colleagues. For the last nine+ years, Michele has focused her career in ABA administrative services, founding ABA Therapy Billing and Insurance Services, a nationally recognized Autism Services billing, consulting, and credentialing company. Her software background puts her in a position to help providers maximize the use of the PMS software they have chosen. Michele is furthering these efforts by gaining her Certified Medical Professional Auditor certification which will allow her to provide even more in-depth risk assessments for providers to support compliance and profitability of their practice. With tighter regulations on healthcare services, providers need to know when they are at risk for non-compliance and remain out of harm’s way of fraudulent activity. Helping providers find that peace of mind is her goal.

Rebecca Womack

Since graduating from her master’s program at North Dakota State University, Rebecca has been privileged to serve adults and children using applied behavior analysis (ABA) in a variety of capacities. From facility-based care, to working group homes, day centers, schools, and homes of families, her experience includes implementing evidence-based therapy across multiple settings. She has traveled across the United States and overseas to provide consultation for families with children who have autism. Additional experiences include administrative work, presentations, oversight of center and home-based services, staff and parent training, and supervision. As the Executive Director for the Behavior Analysis Advocacy Network (BAAN), she works closely with policy makes to preserve services and the continuity of care for children with autism. In addition to facilitating provider and family concerns, she also disseminates information on clinical and ethical practices relating to funding source requirements. Whatever the role, her ultimate goal is to always make a significant impact through effective and efficient services utilizing the science of behavior analysis.

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