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Tuesday, April 12, 2016

Nebraska Medicaid to Cover ABA for Autism

In The Politics of Autism, I discuss state Medicaid services for people with intellectual and developmental disabilities.

At the Nebraska Radio Network, Mike Lozzo reports:
Nebraska’s Medicaid program will begin covering behavioral modification services for children with autism.
The move comes after the state was sued in 2012 for denying such coverage. The Department of Health and Human Services lifted that restriction in October 2015.
Vicki Depenbusch with the Autism Family Network says Medicaid covering some treatments, like Applied Behavioral Analysis (ABA), is a long time coming.
“It’s a huge expense. Parents were paying anywhere from $40,000-60,000 out-of-pocket,” Depenbusch tells Nebraska Radio Network. “We realize the benefit of that program, but we couldn’t get insurance to help cover that.”
 Martha Stoddard reports at The Omaha World-Herald:
"This is good news," she said. "Having access to these services will help many of the children we serve through the Medicaid program lead more fulfilling lives."
The approval was received March 30 and is effective retroactively to Oct. 1, when the state started offering the coverage.
Services approved for coverage include day treatment, community treatment aides and outpatient therapy. Treatment models approved for coverage include cognitive behavioral therapy, comprehensive behavioral intervention and applied behavioral analysis for children.

State officials long resisted efforts to add the coverage, citing concern about potential costs.
But they reversed course after a judge ruled against the state in a class-action lawsuit filed in the name of two boys, identified as K.D. and S.L.
Lancaster County District Judge John Colborn found that the prohibitions violated federal law and ordered the state to start paying for applied behavioral analysis and similar treatments if recommended by medical professionals.
State officials cited other factors as well in their decision to start coverage. Among them was a directive from the federal government and changes in what professionals consider best practices in autism treatment.
Courtney Phillips, chief executive officer of the Nebraska Department of Health and Human Services, announced Monday that the state has gotten federal approval for coverage of applied behavioral analysis and other behavioral modification services.