“Ultimately, we simply do not believe that the legislature intended to permit insurers to exclude coverage in the sensory-laden educational environment where children spend large portions of their days, or to require families to litigate the issue of medical necessity discretely in individual cases to secure such location-specific coverage for the treatment,” Pennsylvania Supreme Court …
“More children with Autism Spectrum Disorders (ASDs) are being served in community-based public school environments than ever before. This is due to many factors, including increased numbers of children being diagnosed with ASDs, the inability of specialized programs to serve the numbers of children identified, and the efforts of public schools to develop in-house ABA …
“Five insurers reached an agreement with the Ohio Department of Insurance to sell individual health plans in 19 of 20 counties that otherwise would have had no 2018 offerings on the subsidized federal Health Insurance Marketplace (ACA/Obamacare).” per Columbus Business First Only Paulding County in western Ohio still lacks an insurer on the exchange. What …
ndividuals with autism will be among the estimated 500,000 people expected to lose health insurance if a freeze on new Ohio Medicaid enrollees passes. Ohio’s Medicaid expansion mostly covers the state’s working poor population. Governor Kasich stood up for Ohioans and vetoed the Medicaid freeze line item in the proposed state budget. However, the House …
The proposed Medicaid ABA benefit called CIBS was pulled from JCARR and will not be a benefit available in August. The rule was pulled due to budgetary constraints. It has been well documented the State faced a $1.05 billion-dollar revenue shortfall in the State Budget. But with over a $2 billion in the rainy day …
After public testimony on May 15th, the new Medicaid ABA benefit called “Intensive Behavioral Services for Children with Autism (CIBS)” has been revised and refiled on Friday, May 26th. Now, the rule moves to JCARR scheduled for June 19, 2017 at 1:30 p.m. in the William McKinley hearing room at the Statehouse. JCARR consists of …
New Medicaid ABA Benefit Heads to JCARR on June 19th Read More »
The Coalition has concerns that the proposed Medicaid ABA rule language offers a barrier to accessing treatment due to limiting the number of eligible practitioners and organizations who can provide services. Currently, The Department of Medicaid’s proposed ABA Medicaid benefit does not allow hospitals and community mental health centers to provide ABA treatment services under the …
In July 2017, Functional Behavioral Assessments and Clinical Intervention will no longer be available to individuals with autism under the age of 21 through a SELF Waiver provider. These two services will move to the new Medicaid State Plan service called Intensive Behavioral Services for Children with Autism or CIBS. Which means, the impacted individuals with autism …
On July 7, 2014, Medicaid agencies were instructed to cover autism treatment services for children under age 21. The Ohio Department of Medicaid (ODM) released draft rule language for a new Medicaid state plan, medical therapy service covering treatment interventions such as applied behavior analysis in Draft Rule: 5160-34-01 Intensive Behavioral Services for Children with Autism (CIBS). …
Read The Coalition’s Public Testimony on New Medicaid ABA Benefit Read More »
On July 7, 2014, Medicaid agencies were instructed to cover autism treatment services for children under age 21. The Ohio Department of Medicaid (ODM) released draft rule language for a new Medicaid state plan, medical therapy service covering treatment interventions such as applied behavior analysis in Draft Rule: 5160-34-01 Intensive Behavioral Services for Children with Autism (CIBS). …
Public Testimony for new ABA Medicaid Service Monday, May 15, 2017 Read More »