That depends on what one thinks the marginal utility of the dollars going to
@ClinicalABA are. That is, to what purpose will the funds that would be used to pay them be used for if they are not spent on reimbursement? If, say, they are going to some equally critical need and the pot is fixed in size, then your point is a good one. If, however, one thinks either that a) those dollars will otherwise be spent on a less worthy project than enabling them to continue their practice or b) that the pot is not really fixed in size, I'm not sure it has force. I am not a healthcare economist but my impression and understanding of how Medicaid/Medicare operate is that they try to control costs based on eligibility and specification of services they will pay for, +/- audits and clawbacks. they don't seem to decline to reimburse claims because they have hit the end of their operating budget for the quarter. Thus it might really be the case that if those dollars are not going to
@ClinicalABA, they might not be spent at all.