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Medicaid EPSDT… Most children enrolled in Medicaid receive services through a Medicaid health plan, such as an HMO or other insurance company. The state Medicaid … agency and the Medicaid health plan determine if treatments are medically necessary and which providers can be reimbursed for services. Under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit of Medicaid, beneficiaries … too much to qualify for Medicaid, the Children’s Health Insurance Program  may be able to provide publicly funded health coverage. Coverage for the treatment of autism under EPSDT The EPSDT program has been around for decades. However, the …
New CPT codes approved for ABA… New CPT codes are available for applied behavior analysis (ABA) and will go into effect January 1, 2019. The new CPT codes provide recognition from the … that ABA is an empirically supported medical intervention. Proper implementation of the new codes will help secure reliable coverage of ABA services by health benefit plans. What are CPT codes? Current Procedural Terminology (CPT) is a listing of … Are there different types of CPT codes? Yes. Category I codes are permanent and accepted by the Centers for Medicare and Medicaid Services (CMS) and other third-party payers. Category III codes are temporary. They are intended for data …
Oklahoma Medicaid Coverage under Soonercare… Soonercare is Oklahoma’s Medicaid health coverage program and is administered by the Oklahoma Health Care Authority (OHCA). Most children with autism in Oklahoma receive health care benefits through Soonercare. Prior to 2019, Soonercare did not include coverage for medically necessary care of children with autism. This was in violation of a  2014 mandate by the Centers for Medicare …
Accessing comprehensive health care… Health care outcomes are poorer for children and adults with autism. Adults with autism face difficulties in accessing the health care services they need, … necessary care (e.g., psychological and psychiatric services as well as pharmacy care) varies widely across payor and age. Coverage and provider limitations exist in both public and private sectors. As a result, individuals with autism are not … approach must be taken to address the health care needs of our community, including: Protecting and Strengthening Medicaid Medicaid is the single most important insurer for people with autism. It covers autism treatments for nearly half …
Home and Community Based Services (HCBS) WaiversMedicaid is a joint federal-state program providing health benefits for those who meet eligibility requirements. The program provides for people with disabilities, including autism spectrum … as income level. The intention is to allow individual states to accomplish certain goals, such as reducing costs, expanding coverage, or improving care for certain target groups. Through these waivers, states can provide services that wouldn’t …
Autism and driving: Car insurance… It ensures that every driver who could potentially cause an accident has insurance to cover a minimum level of costs for any injury and damage. It holds drivers accountable for the risk that comes with driving a vehicle. Are you required to … your state, check out Autism drives. If you own a car or are looking to buy a car, your state will have a minimum level of coverage you must carry in your car insurance policy.  If you don’t own a car, you aren’t legally required to have car … Minimum liability coverage: 50/100/10 Additional requirements: six PIP options / minimum $50,000 for insureds on Medicaid   Minnesota Minnesota auto insurance requirements Minimum liability coverage: 30/60/10 Additional requirements: …
Recently Passed COVID-19 Congressional Legislation and Ongoing Advocacy Efforts  … the country.   Below are summaries of the three COVID-19 bills that have passed thus far and our advocacy priorities moving forward.   The Coronavirus Aid, Relief and Economic Security (CARES) Act was signed into law on March 27, 2020.  This … the law contains billions of dollars for schools and extends through November the Money Follows the Person program, a Medicaid program that gives people needing long-term support services more choice about where they live and receive care. To … First Coronavirus Response Act are available here . Also read our statement asking the DOL to ensure paid sick leave coverage for caregivers of adults who have to stay home due to the closure of an adult care facility or loss of access to …
Policy Pulse Newsletter - October 2024… In this newsletter: One week left - are you ready to vote? State Advocacy Spotlight: California National Disability Employment Awareness Month sheds lights on policy opportunity Post-election, Congress will … Act called " Senate Punts on Autism Act." Disability Scoop quotes Autism Speaks in article, " States Told Not To Skimp On Medicaid Coverage For Kids With IDD ," highlighting new CMS guidance on EPSDT coverage of autism services.   Autism Speaks Action …
2017 Autism Law Summit: "A gathering of doers"… Speaks and the Autism Legal Resource Center, the 2017 Autism Law Summit took place on October 27-28 in San Diego, California. Advocates and leaders from across the country attended sessions on an array of disability-related topics including health insurance, Medicaid, and transition to adulthood. Speakers included members of the Autism Speaks Advocacy Team; Dan Unumb, Esq., … Particular appreciation was given to individuals whose work was instrumental in the passage of meaningful autism insurance coverage in Alabama earlier this year. Catey Hall and Lisa Riley each earned the title of "Parent of the Year" and Bama …
Vermont State-Regulated Insurance Coverage… Vermont requires meaningful coverage for autism under state-regulated plans. Vermont’s autism insurance bill, S.262 , was enacted in 2010 and became effective on … legislation was amended in 2012 by S.223 which raised the age cap and required the same benefits be provided by the state Medicaid program or any other public health care assistance program. To which plan types does the state autism insurance law …