Substitute House Bill No. 7109 aims to improve Medicaid coverage for applied behavior analysis (ABA) services for children with autism spectrum disorder, effective July 1, 2025. The bill mandates the Commissioner of Social Services to increase Medicaid payment rates for ABA services provided by board-certified behavior analysts and to standardize reimbursement codes to align with commercial insurers. It also requires the Commissioner to submit a report by December 1, 2025, detailing progress and recommendations for further funding. Additionally, the bill introduces new reimbursement models for behavioral health services and expands the age limit for coverage of autism therapies from under 21 to under 26.

The legislation also enhances the responsibilities of mandated reporters by including professionals working under the supervision of behavior analysts, who must report suspected child abuse or neglect. It requires the Department of Children and Families to notify the Department of Public Health of any investigations involving behavior analysts, who may face disciplinary actions if necessary. An advisory committee will be established to recommend a regulatory framework for ABA services, with a report due by November 1, 2025. The bill includes fiscal implications, estimating costs of at least $1.3 million starting in FY 26 for increased Medicaid rates and coverage under the HUSKY B program.