04/15/2026
🚨 Sunshine Health Update (Effective May 11)
Sunshine Health is changing how authorized units are applied during claims processing—and this will directly impact how ABA providers bill and track services.
➡️ Units will now be applied based on the approved frequency (ex: weekly), not across the entire authorization period.
➡️ Example: If approved for 40 hours/week, only 40 hours are available each week.
➡️ Claims submitted outside that frequency or exceeding weekly units may deny.
✅ No changes to medical necessity or authorization requirements—this strictly impacts how claims are processed.
💡 Now is the time to review your authorizations and billing practices to avoid denials.
