Advocates say West Virginia’s Medicaid rates for autism therapy are so low that most Applied Behavior Analysis (ABA) centers will not take the coverage most children have. West Virginia Watch reported Sept. 29 that Mountaineer Autism Project is pressing the Bureau for Medical Services to finish and release a Medicaid rate study for ABA and update reimbursements.
Of roughly 20 ABA centers in the state, fewer than half currently accept Medicaid, the group said, while more than half of West Virginia children are covered by Medicaid. Advocates also cite 186 Board Certified Behavior Analysts supervising care — about 10.5 per 100,000 residents, sixth-lowest nationally — and long waits; one Birth to Three service coordinator said her children waited nearly two years for an ABA opening.
Mountaineer Autism Project argues higher rates would let providers offer competitive wages, hire and retain staff, and expand capacity. West Virginia Watch notes a 2024 rate increase under then-Gov. Jim Justice for some waiver providers serving vulnerable adults and children was meant to lift direct care pay near $11 an hour, but did not require providers to pass the money through as wages.
Why this matters for providers and DSPs
Low Medicaid ABA rates shrink the clinical pipeline that many children with autism need before or alongside HCBS waiver supports. I/DD agencies and DSPs inherit longer behavior and communication needs when early therapy is delayed. The missing wage pass-through in the 2024 bump is a reminder for managers watching any future BMS rate change: without pass-through rules, rate dollars may never reach frontline pay.