LINCOLN — Advocates for young Nebraskans with autism worry that access to services will take a hit as the state cuts Medicaid reimbursement rates for therapies by a range of 28% to as much as 79%.

“All these kids that have Medicaid will have more difficulty having access to vital treatment that will help them become more independent,” said Cathy Martinez, president of the Autism Family Network in Nebraska.

“We’re either going to pay it on the front end, doing these therapies necessary to their success, or on the back end for care provision when you don’t gain skills through their ABA therapy programs.”

Martinez commented Friday as officials with the Nebraska Department of Health and Human Services discussed plans to, on Aug. 1, adjust Medicaid reimbursement rates for providers of applied behavior analysis services.

Also known as ABA, the therapy and support helps youths with autism spectrum disorder and other developmental and social communication delays function better in society.

Highest In Nation

State officials say Nebraska currently has the highest reimbursement rates of any state ABA program — leading to an increase in state expenses of more than 2,000% since 2020. Five years ago, Nebraska Medicaid paid about $4.6 million for ABA services and last year the amount soared to $85.6 million.

DHHS, which is a code agency under the governor’s supervision, has said previously it wanted to re-examine and set new guardrails so services can be sustainable, as federal auditors were scrutinizing states’ behavioral health programs to ferret out possible misuse, fraud and inefficiencies.

Steve Corsi, DHHS chief executive, said Friday that state leaders “fully understand this is an important service” and said they were “unequivocally committed” to ensuring families have “access to necessary services.”

But he said his agency is obliged to be aligned more with neighboring states, and said that even with the adjustments, commonly billed ABA rates for services remain higher than the national average and median.

Corsi said the ABA changes follow a comparative analysis and were in the works prior to the Trump administration. He said they had “zero” to do with budget woes facing the state.

“Even if we had an excess,” he said of state funds, “this is still the right thing to do.”

Defending The Change

Corsi led a news conference Friday to defend the adjustments, contending that the changes would not result in “a lapse of care for clients or their families.” He said the press conference was spurred by inquiries from families and advocates and what he described as misinformation from some sources.

Medicaid-eligible youths served in Nebraska have grown from about 169 in 2020 to about 1,150 three years later. Experts say the number of affected youths nationally has grown: One in 31 youths has autism spectrum disorder, a developmental disability with challenges ranging in social communication to repetitive behaviors.

Supporting DHHS at the conference was Drew Gonshorowski, the state agency’s Medicaid and Long-Term Care Director, and Károly Mirnics, dean and director of the Munroe-Meyer Institute, a large provider of ABA services.

A DHHS spokesman said that while the new rate schedule is effective Aug. 1, providers could still try to negotiate rates with one of the state’s three managed care organizations, which contract with Nebraska to manage health care benefits for Nebraskans enrolled in Medicaid.

Martinez said that as of Friday, she knows of no rates that have been negotiated. She was critical of the one-month public notice that DHHS gave on the rate cut, but said that families and advocates have been calling their state senators, DHHS and Gov. Jim Pillen’s office. 

“Rather than talking to families and providers on the impact of cuts, they decided to implement it without public notice or a public hearing,” Martinez said. “We believe if Governor Pillen really knew the impact to our kids around the state he would not have allowed such a huge cut to services.”

State ‘Overcorrected’

Mariel Fernandez of the Council of Autism Service Providers, which represents members across the nation, said the “writing was on the wall” that cost reductions were coming. She acknowledged that Nebraska’s reimbursement rate, in a few service areas, was out of whack and that a change was appropriate.

But, she said, DHHS “overcorrected” with other announced changes. The reductions range from 28% to 79%, she said, depending largely on the training and expertise of the provider and whether the service is provided on an individual or group level.

Fernandez said state officials should consider the difficulty in recruiting ABA behavioral health care and other talent to the state, as well as “the cost to do business” in Nebraska.

The national council on Friday was wrapping up a survey of about 100 providers, Fernandez said, asking if they would remain part of the Nebraska network with the new rates. She said about 74% indicated they are not sure, and another 10% said they would not.

Fernandez said some member organizations indicated they would look at cost-cutting measures, including lower compensation for employees. Advocates worry that would push analysts and technicians out of the state.

“If those folks quit, it will impact everybody, not just children with Medicaid.” she said.

This story was published by Nebraska Examiner, an editorially independent newsroom providing a hard-hitting, daily flow of news. Read the original article: https://nebraskaexaminer.com/2025/07/18/advocates-fear-for-autistic-nebr...