The Centers for Medicare & Medicaid Services (CMS) has released the State Medicaid and Children's Health Insurance Program (CHIP) Applied Behavior Analysis (ABA) Toolkit, a comprehensive resource to help state Medicaid and CHIP agencies better oversee autism services, address rising costs, and crack down on fraud targeting children with autism spectrum disorder (ASD).

HHS Secretary Robert F. Kennedy, Jr. said the toolkit gives states practical tools to identify bad actors, protect families, and hold providers accountable, calling the protection of vulnerable children and taxpayer dollars a top priority for the Trump Administration. CMS Administrator Dr. Mehmet Oz added that every dollar lost to fraud is a dollar that cannot reach a child who genuinely needs it, and that families deserve confidence that ABA services are clinically appropriate and delivered by qualified providers.

CMS data shows that between 2021 and 2025, ABA spending in Medicaid and CHIP jumped 421%, while the number of children with an ASD diagnosis receiving services grew by only 67%. That gap raises serious questions about whether spending is consistently tied to medical need, and a troubling number of fraud investigations, prosecutions, and convictions related to kickbacks and harm to children have added urgency to the issue.

It is important to note what this toolkit is not. It does not create new federal requirements, reduce Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) obligations, endorse any single ABA treatment approach, or direct states to cut access to medically necessary care. It is a practical guide to help states ensure children get individualized, evidence-based care that is free from fraud and delivered by qualified providers.

The toolkit covers a wide range of areas including clinical standards, Medicaid benefit design, payment methodologies, provider enrollment and credentialing, utilization management, and program integrity strategies. A checklist is also included to help states assess whether their ABA policies support strong oversight and responsible use of Medicaid funds.

The toolkit was developed using Medicaid data, peer-reviewed research, and input from a broad group of stakeholders. It draws on a review of more than 40 literature sources, an assessment of more than 240 publicly available state-level Medicaid coverage and policy references, and qualitative input from state agencies, providers, advocates, and others.

The ABA toolkit is available at https://www.medicaid.gov/medicaid/downloads/autism-services-aba-toolkit.pdf