How to Handle ABA Payer Policy Updates: Policy as Data in 7 Steps

Medicaid and payers change ABA requirements several times a year. In TargetFlo, those requirements live in Programming → Policy & Rules as a versioned policy — so an update is a reviewed data change, not a software release.

What a policy version holds

• Thresholds — weekly hour limits, maximum authorization periods, supervision ratios, telehealth share, assessment and order validity, goal date limits, units per hour.
• Checklist rules — the requirement text, what it applies to, severity, and the template section it belongs to. NC Medicaid CCP 8F loads 114 rules; 27 are checked automatically.
• AI instruction guides — how the POC assistant drafts and cross-checks for initial and reauthorization plans.

The update in 7 steps

1. Classify the change — a number, a requirement's wording, an AI instruction, or a brand-new kind of check (the only case that needs engineering).
2. Create a draft from the published version — a full copy.
3. Edit the draft and write change notes citing the source and section.
4. Diff the draft against the published version and check every changed row against the official text.
5. Dry-run the checklist on a sample initial and reauth plan under the draft.
6. Publish with an effective date (it can be in the future). The previous version retires on that date.
7. Handle in-flight plans — drafts can be previewed and moved to the new version; finalized plans stay on the version they were written under.

Rules that never bend

• Published versions can't be edited.
• Automatic rules clear only when the data passes — never because the AI says so.
• One payer's limits are never applied to another payer's plans.

Related: NC Medicaid CCP 8F guide · POC template best practices · Plan of Care & BIP