Saturday, June 27, 2009

NEWS: Passed Wisconsin Budget Bill Specifies Mandated Autism Insurance Services

The just-passed Wisconsin budget bill, (The state Assembly approved 51-46 Thursday evening. The state Senate approved the measure 17-15 early Friday morning) includes some language that might be of interest to Wisconsin Behavior Analysts and their client families.

ASSEMBLY SUBSTITUTE AMENDMENT 1, TO 2009 ASSEMBLY BILL 75 (1903pp.)

Mandates insurance coverage of autism treatment, including "intensive-level services" including "evidence−based behavioral therapy" and "non-intensive-level services",

Pages related to autism coverage and providers in the mammoth bill are those starting at,
1594: 609.87 Coverage of treatment for autism spectrum disorders.
1615: 632.895 (12m) TREATMENT FOR AUTISM SPECTRUM DISORDERS.
1868: (8L) INSURANCE COVERAGE FOR AUTISM TREATMENT
p. 1615,
3. “Intensive−level services” means evidence−based behavioral therapy that is designed to help an individual with autism spectrum disorder overcome the cognitive, social, and behavioral deficits associated with that disorder.
4. “Nonintensive−level services” means therapy that occurs after the completion of treatment with intensive−level services and that is designed to sustain and maximize gains made during treatment with intensive−level services or, for an individual who has not and will not receive intensive−level services, therapy that will improve the individual’s condition
although the details of what those terms exactly define and who are service providers are, are specified to be worked out in regulation via the Wisconsin Insurance Commissioner.
p. 1617,
"(f) 1. The commissioner shall by rule further define “intensive−level services” and “nonintensive−level services” and define “paraprofessional” for purposes of par. (b) 4. and “qualified” for purposes of providing services under this subsection. The commissioner may promulgate rules governing the interpretation or administration of this subsection."
It is also possible that Wisconsin Gov. Jim Doyle could alter the passed budget bill through partial veto power, however in the past Gov. Doyle has thrown his support behind obtaining an autism insurance mandate.

For more information,

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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,

Friday, June 26, 2009

NEWS: Michigan's Autism Insurance Bills Pass in the Michigan House

On Wednesday, June 24, Michigan's Autism Insurance Bills, passed in the Michigan house by a large margin.
HB 4476 : insurance; health care corporations; coverage for certain treatments related to autism; provide for. Amends 1980 PA 350 (MCL 550.1101 - 550.1704) by adding sec. 416e.

and

HB 4183: Insurance; health; coverage for certain treatments related to autism; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406s.

The bills now require approval on the Senate side and as of 6/25/09 are in the COMMITTEE ON ECONOMIC DEVELOPMENT AND REGULATORY REFORM. According to the Michigan legislative website, the legislature is on vacation/adjournment until July 14, 2009 at 9:00AM.

Previous posts on Michigan
Related,

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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,

Thursday, June 25, 2009

NEWS: Reports that US House Passes Expansion of Autism Treatment Coverage For Military Dependents Under TRICARE

News stories are coming out saying that the U.S. House of Representatives has approved expansion of mandated autism treatment coverage under TRICARE for military dependents with autism, via an amendment to U.S. HR 2647: To authorize appropriations for fiscal year 2010 for military activities of the Department of Defense, to prescribe military personnel strengths for fiscal year 2010, and for other purposes.

We are seeking information on whether or how much the specific language of the amendment to H.R. 2647 replicates the provisions specified in the previously submitted HR 1600: To amend title 10, United States Code, to provide for the treatment of autism under TRICARE. (Introduced in House -Rep. Stesak + 20 Co-sponsors).

The proposal still needs approval by the U.S. Senate.

The story reported from 6/25/09 Newsblaze [with links added]
House Passes Congressman Sestak`s Historic Autism Legislation
" Today, the House voted to pass legislation authored by Congressman Joe Sestak (PA-07) to mandate the treatment of autistic children of service personnel under the military's healthcare program (TRICARE). The legislation, which was included as an amendment to the National Defense Authorization Act [H.R. 2647: To authorize appropriations for fiscal year 2010 for military activities of the Department of Defense, to prescribe military personnel strengths for fiscal year 2010, and for other purposes. ] , is the successful culmination of a two year effort led by Congressman Sestak to provide treatment for the 13,000 autistic children of military personnel and will serve as a model for similar federal and state efforts.

"With this bill's passage, we have supported the critical needs of many military families and addressed the growing epidemic of autism among children of both military and civilian families. It is unacceptable that 1 in 84 military families are reported to have a child with autism, but receive less than 16 of the 25 minimum recommended hours of therapy," said Congressman Sestak, a member of the House Armed Services Committee and the highest ranking Veteran in Congress.

Under current law, the military's Extended Care Health Option provides limited coverage to military families afflicted by autism. Only five percent of eligible military children receive care because of excessive delays- as long as two year waiting periods- and arbitrary coverage denials..."
FULL ARTICLE describes current coverage and the improvements from Rep. Sestak's amendment.
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Other articles:

House Bill Mandates Autism Coverage For Military
By Michelle Diament
Disability Scoop
June 26, 2009


Congressman Sestak Includes Key Provisions in National Defense Authorization Act
June 20,2009
NewsBlaze


Monday, June 8, 2009 Blogpost
NEWS: Federal S. 1169 joins H.R. 1600 to provide for the treatment of autism under TRICARE

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Practitioner Issues in Behavior Analysis SIG
-----------
Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,

NEWS: New Jersey A2238 Autism Insurance Bill Passes Concurrence in the NJ Assembly

At approximately 5:40PM EDT/2:40 PDT as heard on the legislative website live audio stream,

NJ Bill A2238 : Requires health benefits coverage for certain therapies for the treatment of autism and other developmental disabilities

passed the NJ Assembly with a vote of 74 affirmative-5 negative -0 abstentions. Bill declared passed and take the usual course of passed bills.

Links and past posts:

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Practitioner Issues in Behavior Analysis SIG
-----------
Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,

NEWS: PA Autism Insurance Act (Act 62) Goes Into Effect July 1, 2009

On July 1, 2009, PA Act 62 [formerly bill HB 1150, signed into law July 9, 2008] goes into effect.

There are quite a few questions about this on the web. Fortunately, there are also resources to help navigate changes and answer FAQs.

PA Autism Insurance Act (Act 62)
Pennsylvania Department of Public Welfare

Autism Insurance - Act 62 of 2008 (HB 1150)
Prepared by PA Health Law Project
7.17.08

Pittsburgh Pennsylvania Chapter
How Will Act 62 Affect YOU?
By: Luciana Randall
Apr 1, 2009
Autism Society of America

How will Autism Insurance Act 62 affect coverage and services?
February 20, 11:08 AM
Kim Goff
Philadelphia Special Needs Kids Examiner

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Practitioner Issues in Behavior Analysis SIG
-----------
Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,

Tuesday, June 23, 2009

ANNOUNCE: New Jersey Autism Insurance bill A.2238 Scheduled for Voting Session in the Assembly

NJ Bill A2238 : Requires health benefits coverage for certain therapies for the treatment of autism and other developmental disabilities

is currently scheduled for Thursday, 6/25/2009 11:00:00 AM for an
Assembly Voting Session in the Assembly Chambers.

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Links and past blog posts

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Practitioner Issues in Behavior Analysis SIG
-----------
Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,

Monday, June 22, 2009

TIME SENSITIVE: US DOHHS Requests Comment on Medicaid Program: Home and Community-Based Services (HCBS) Waivers

The Centers for Medicare and Medicaid Services (CMS) has published an Advance Notice of Proposed Rulemaking on the Section 1915(c) Home andCommunity-Based Services waivers.

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Advance notice of proposed rulemaking.

SUMMARY: This advance notice of proposed rulemaking announces the intention of CMS to publish proposed amendments to the regulations implementing Medicaid home and community-based services waivers under section 1915(c) of the Social Security Act and solicits advance public comments on the merits of providing States the option to combine or eliminate the existing three permitted waiver targeting groups, and on the most effective means to define home and community.

DATES: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on August 21, 2009.

FULL NOTICE

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Practitioner Issues in Behavior Analysis SIG
-----------
Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,




NEWS: Supreme Court Decision Issued in "Forest Grove School District v. T.A."

This news just broke from Wrightslaw.

Supreme Court Issues Decision in Forest Grove School District v. T.A.
by Peter Wright, Esq. and Pamela Wright, MA, MSW


[Decision issued in ]
FOREST GROVE SCHOOL DISTRICT v. T. A. CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT
No. 08–305. Argued April 28, 2009—Decided June 22, 2009
(...)

"In their 6-3 decision, the [U.S.] Supreme Court held that:

". . . IDEA authorizes [tuition] reimbursement for the cost of private special education services when a school district fails to provide a FAPE and the private-school placement is appropriate, regardless of whether the child previously received special education or related services through the public school." (page 16 of the decision)"

The full text of this decision, including a 3 page Syllabus, 17 page Opinion, 2 page Appendix to the Opinion, and 12 page Dissent by Justice Souter (joined by Justices Scalia and Thomas) is posted on Wrightslaw. (...)"

---------
Practitioner Issues in Behavior Analysis SIG
-----------
Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed
to their website,