In July 2014, the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees state Medicaid programs, provided an informational bulletin to Medicaid agencies throughout the nation. The bulletin informed state Medicaid agencies that they must begin providing autism spectrum disorder (ASD)-related services to children under 21 through the general Medicaid benefit. This is a significant change from previous CMS guidance. (A copy of the July 2014 CMS Informational Bulletin, Clarification of Medicaid Coverage of Services to Children with Autism is here: CIB-07-07-14).
Through a home and community based waiver program, Utah Medicaid currently offers ASD-related services to a limited population (children ages 2 through 6). Under the recent CMS guidance, Medicaid will be required to serve any Medicaid eligible client under 21.
Over the past few months, the Medicaid agency has been developing draft ASD services policy. Throughout the initial development, Utah Medicaid sought the advice and guidance of experts from Primary Children’s Medical Center, the University of Utah and Utah State University.
At this point, we would like to discuss the CMS guidance, Utah Medicaid’s draft policy, and the impact the new policy will have on the current Medicaid Autism Waiver with a broader group of families, providers and other stakeholders. To facilitate this discussion, a meeting has been scheduled on:
Tuesday, March 31, 2015 from 1:00 PM – 3:00 PM
Utah Department of Health
Cannon Building, Room 125
288 North 1460 West
Salt Lake City.
Lots of information was shared; however, it is still in draft status.
A few highlights:
- Parents can enter public comments at http://health.utah.gov/autismwaiver/PublicComments.html
- You can also stay informed by joining the listserv http://health.utah.gov/autismwaiver/Listserv.html
- ABA will be covered as a benefit for those who qualify for Medicaid
- Those on the waiver will be switched over to their primary insurance in January and for those who have been on the waiver, who will not have coverage, will be able to stay on the waiver