ABA Therapy

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Long-Sought Autism Therapy A Medi-Cal Benefit, State Says

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

State officials Tuesday said autism therapy clearly is a covered Medicaid benefit, and they hope to submit a state plan amendment by Sept. 30 to start the process to make it a benefit for those under age 21, enrolled in the state’s Medi-Cal program. Medi-Cal is California’s version of Medicaid.

According to René Mollow, deputy director of benefits and eligibility at the Department of Health Care Services, Medi-Cal children are entitled to applied behavior analysis — known as ABA therapy.

“Right now we’re working on the development of a state plan amendment. We want to engage the stakeholders in developing that,” Mollow said. “We’re looking to have it submitted at the end of September, and having it retroactive to July 1.” Continue reading

Feds Say Autism Therapy Now Covered As Children’s Medicaid Benefit

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

CMS officials released federal guidance for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.

“ABA therapy must be covered (by Medi-Cal). It’s very, very clear.”

“It’s a good day. It’s such a good day,” said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. “Whenever you get a decision that we’ve been seeking for years, that is a good day.”

Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid — and therefore it also must be covered under Medi-Cal, California’s version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame. Continue reading