General Assembly Raised Bill No. 7109 seeks to enhance Medicaid coverage for applied behavior analysis (ABA) services, particularly for children with autism spectrum disorder, by mandating the Commissioner of Social Services to increase Medicaid payment rates for board-certified behavior analysts and to provide coverage under the HUSKY B health program. Effective July 1, 2025, the bill also includes caregiver training in ABA services and requires the standardization of codes for ABA to align with those used by commercial insurers and Medicaid programs in other states. Additionally, it modifies the definition of "behavioral therapy" in section 38a-488b of the general statutes, changing the age limit for eligible children from "less than twenty-one" to "under twenty-six," and specifies that therapy must be provided or supervised by licensed professionals.

The legislation further establishes a framework for delivering ABA services through community-based organizations, emphasizing quality assurance through comprehensive background checks and oversight structures. It introduces a planning grant for Certified Community Behavioral Health Clinics to support acuity-based care coordination and a value-based payment model. The bill also mandates a review of private health insurance coverage for treatment of children at urgent crisis centers, requiring the Commissioner of Health Strategy to submit a report by October 1, 2025, analyzing claims data and providing recommendations for improving access to these services. Various provisions of the bill will take effect on different dates, with some as early as July 1, 2025, and others on January 1, 2026.