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Kaiser HeaIth News examines impact of federal directive to states to expand autism coverage
(August 26, 2014) -Kaiser Health News (KHN) has examined how the states are reacting tothe federal government's July directivetocover medically necessary treatments for autism for individuals under age 21. An estimatedone-third of all children with autismreceive primary coverage through Medicaid.
Theannouncementby the Centers for Medicare & MedicaidServices (CMS) makes clear thatautism treatment mustbe addressed under Early and Periodic Screening, Diagnostic and Treatment (EPSDT)serviceswhich cover Medicaid-eligible children up to the age of21. The states are now assessing how to implement the change.
While coverage ofapplied behavioral analysis"isn't explicitly required" by the new guidance, KHN noted,advocatesexpect it to be covered.
"Since ABA is the most accepted, effective treatment that isn't experimental and investigational, you can't just exclude it entirely," Daniel Unumb, executive director of Autism Speaks' Legal Resource Center told KHN.
In California, where the state has already begun steps to expand Medicaid coverage, an additional 6,000 children with autism could benefit under the new federal guidelines, said Kristin Jacobson, co-founder and president of Autism Deserves Equal Coverage.
“For them it's going to be a huge deal,” said Jacobson, who worked with Autism Speaks to help enact California's 2011 autism insurance reform law.
Unumb said over a dozen states had reached out to himforguidance on how to implement the new directive.Read more from Kaiser Health News.