Ohio Autism Insurance Coalition

Resources related to accessing intensive behavioral treatments, such as ABA , for autism, developmental disabilities and mental health disorders for all stakeholders: individuals with ASD/DD/MH and their families, employers, insurance carriers, legislators, providers, government, regulators, advocates and educators.

Public Policy Initiatives

#OHMedicaidABA – Reach out today and Educate!  Call, email or grab a cup of coffee in your district!  Find My Ohio Senator & Representative. Please consider sharing the outcomes from your discussions with Marla Root at the Ohio Autism Insurance Coalition by calling 614.565.5765 or through our contact page. 

Challenge: ABA in Ohio Medicaid

The Ohio Medicaid State Health Plan needs a benefit for individuals with autism prescribed intensive behavioral treatments using Applied Behavior Analysis (ABA) treatment.

Facts:

  • Currently, Ohio is one of only eight states without an EPSDT benefit for intensive treatments such as ABA.
  • All surrounding states to Ohio have benefits!
  • A total of 42 states offer ABA benefits to fund treatment in Medicaid.

The Ask:

  • For children ages 0 to 21, our state needs an EPSDT Medicaid Health Plan ABA benefit
    • We can accomplish this without legislation through the CMS/Federal Medicaid July 7, 2014 information bulletin stating ABA treatment is now required and can be reimbursed through Preventative Services.
    • Currently, some Medicaid members with autism are getting ABA services through member specific single case agreements through managed care plans but these out of network services are not an EPSDT state benefit. This is causing massive access issues with some Medicaid members being discharged or turned away from treatment due to lack of payment on authorized claims from the managed care plans.
  • For adults ages 21 and over, our state needs a benefit to fund Periodic & Focused ABA Interventions through the Medicaid system.
    • Focused ABA treatments target a certain number of behavioral targets and a limited number of key skills needed to support the individual at that moment in time.

The Request: Please ask your legislator to reach out to any of the following contacts to learn more: Ohio Department of Medicaid, Director Maureen Corcoran and The Ohio Autism Insurance Coalition http://www.asdohio.com.  Share the Disability Scoops article dated February 14, 2019, Link

More about EPSDT!  The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services. Source Link to learn more. 

 

 

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