Medicaid and CHIP Plans to Cover Autism Services for Children

The CMS directive could mean ABA (applied behavior analysis) coverage, which is quite effective in autistic children.

When Yuri Maldonado's 6-year-old son was diagnosed with autism four years ago, she learned that getting him the therapy he needed from California’s Medicaid plan for low-income children was going to be tough.

Medi-Cal, as California's plan is called, does provide coverage of autism services for some children who are severely disabled by the disorder, in contrast to many states which offer no autism coverage. But Maldonado’s son was approved for 30 hours a week of applied behavioral analysis (ABA), a type of behavior modification therapy that has been shown to be effective with autistic children, and she was worried that wasn’t enough.

So she and her husband, neither of whose jobs offered health insurance, bought an individual private policy for their son, with a $900 monthly price tag, to get him more of the comprehensive therapy.

"I don't know any family that can really afford that," says Maldonado. "We made some sacrifices."

That should be changing soon. In July, the Centers for Medicare & Medicaid Services announced that comprehensive autism services must be covered for children under all state Medicaid and Children’s Health Insurance Program plans, another federal-state program that provide health coverage to lower-income children.

Read the CMC guidance here: http://bit.ly/1rxibxE

Read the complete report here: http://bit.ly/1ltOwTD

Source: Kaiser Health News