Medicaid and Autism

The Health Care Authority is developing a proposal that would extend an Applied Behavior Analysis (ABA) therapy benefit to all Apple Health for Kids clients with a diagnosis in the Autism Spectrum Disorder classification. We are consulting with advocates, parents and providers as well as its federal partners to develop a workable funding arrangement for the new benefit. We anticipate obtaining a federal decision by January 2013.

Pending federal approval, we will help families and providers arrange for these children to access medically necessary services that they may need to use to access the federally approved benefit. Children who currently have a valid order for Applied Behavior Analysis therapy and a treatment plan may start receiving therapy now with prior authorization. For children who do not have an order in place, providers can start the process of developing the necessary information so that we can consider a request for services. A child who gets a diagnosis of autism, an order for Applied Behavior Analysis therapy, and an Applied Behavior Analysis treatment plan pending federal approval may be ready to receive therapy services starting in January 2013.

If you treat a child or are the parent of a child covered by Medicaid who has a diagnosis of autism spectrum disorder and you believe the child is a candidate for Applied Behavior Analysis therapy or needs a consultation with a specialist, please contact Gail Kreiger at the Health Care Authority to learn about coverage pending federal approval or how to start this process. Ms. Kreiger's contact information is as follows: 360-725-1681 (phone); 360-725-1328 (fax); P.O. Box 45506, Olympia, WA 98504-5506.

Behavior Challenges in School Age and Adults with Autism and Related Developmental Disabilities:

Childhood Autism and Early Intervention Strategies:

Applied Behavioral Analysis Center for Excellence:

Overview of Applied Behavior Analysis Benefit model for primary care providers and provider’s staff who work with Children’s Administration, Division of Developmental Disabilities, Regional Support Network, Managed Care, Department of Early Learning, and other Health Care Authority stakeholders:

Overview for Applied Behavioral Analysis (ABA) Service Providers:

Email ABA@hca.wa.gov to ask questions about the benefit or for assistance accessing Applied Behavior Analysis services. 

University Of Washington BCBA Distance Education Program

The University of Washington (UW) established a Board Certified Behavior Analyst (BCBA) cohort program in fall of 2012 utilizing distance education technology to bring the program to students. The revised program allows the UW to continue live synchronous instruction while utilizing a new delivery platform - Blackboard Collaborate. This technology allows students from all over the Pacific Northwest to access the course of study from any location with a computer, broadband internet access, and a headset microphone. For more information visit the UW's website or call Terry Werner at 206- 221-3060.

Resources

ABA Fee Schedule - look for the most recent fee schedule under Applied Behavioral Analysis (ABA).

ABA Interpreter Services and Transportation FAQs

Applied Behavior Analysis form in word pdf - for establishing level of support required to be used by Applied Behavior Analysis providers

Enrolling Applied Behavior Analysis providers

How to request an interpreter

How to submit a prior authorization form for Applied Behavior Analysis providers

Pathway to Care to Applied Behavior Analysis services

ProviderOne Billing and Resource Guide

Training webinars