Centers for Medicare and Medicaid Services Clarifies Medicaid Coverage of Autism-Related Services

Last week, the Centers for Medicare and Medicaid Services (CMS) released an information bulletin outlining options for Medicaid to provide children with coverage of autism-related services. The bulletin discusses the opportunities and associated requirements for covering services under a variety of authorities including the Medicaid EPSDT mandate.  The bulletin does not require states to cover the services but clarifies how states can cover the services if they choose.  View the information bulletin.

The Department of Health and Human Services Announces Availability of Navigator Grants

The Department of Health and Human Services released a Notice of Funding Availability for grants for the navigator program authorized by the Affordable Care Act. The grants are available to organizations in states that the federal government is running or partnering with to maintain the private health insurance marketplaces. Navigators assist people with enrolling in health insurance programs. Organizations that are interested must submit a letter of intent by July 10. For pre-application webinars or more information, visit the Centers for Medicare and Medicaid Services website.

Senate Confirms New Health and Human Services Secretary

The Senate confirmed Sylvia Mathews Burwell as the new Secretary of the U.S. Department of Health and Human Services (HHS) last Thursday. The vote was 78 in favor and 17 voting against confirmation. Burwell is moving into the position from her post as the director of the Office of Management and Budget where she was easily confirmed in a 96-0 vote last April.

House Subcommittee Advances Combating Autism Reauthorization Act

On May 28, the Health Subcommittee of the House Energy & Commerce Committee approved an amendment in the nature of a substitute to H.R. 4631 that had been introduced by Representatives Chris Smith (R-NJ) and Michael Doyle (D-PA).   Changes in this latest version include adding a new autism position at the Department of Health and Human Services, increasing the number of non-federal members on the Interagency Autism Coordinating Committee (IACC), and studying the needs of children with autism as they transition to adulthood, as well as the services available to them. During the markup, Representative Pallone (D-NJ), Ranking Member of the Subcommittee, noted that two issues were outstanding for the full committee to address – determining which agency was responsible for conducting the transition study and renaming the law, which The Arc supports.   H.R. 4631 largely extends the research, surveillance, public awareness, and professional training activities under the Combating Autism Act for an additional 5 years. Senators Menendez (D-NJ) and Enzi (R-WY) are expected to introduce a Senate bill to reauthorize the law in the next couple of weeks.

House Subcommittee Hearing on Federal Response to Autism Spectrum Disorders

On May 20, the Government Operations Subcommittee of the House Oversight and Government Reform Committee, chaired by Rep. John Mica (R-FL), held a hearing entitled “Examining the Federal Response to Autism Spectrum Disorders.”  The hearing focused largely on the report of the Government Accountability Office (GAO) that found many of the research programs funded by the Combating Autism Act had the potential for duplication. Dr. Thomas Insel, Director of the National Institute of Mental Health and Chair of the Interagency Autism Coordinating Committee, strongly defended the research programs, arguing that no actual duplication was found and that duplication should be encouraged in scientific research to validate results.   Tor read the testimony and see the archived webcast at the Committee website.

House Subcommittee Markup Scheduled on the Combating Autism Act

On May 28, the Health Subcommittee of the House Energy & Commerce Committee is scheduled to markup H.R. 4631, the reauthorization of the Combating Autism Act. H.R. 4631 largely extends the research, surveillance, public awareness, and professional training activities under the Combating Autism Act for an additional 5 years. It would, however, reform the Interagency Autism Coordinating Committee (IACC) to promote greater coordination among federal agencies and require the Government Accountability Office (GAO) to review the existing landscape of services (federal, state, local government, and the private and non-profit sectors), conduct a survey of stakeholders, and make recommendations to enhance coordination, efficiency, and the value of the services currently provided to assist individuals with Autism Spectrum Disorder (ASD). Unfortunately, this bill does not include a name change. For more information on the House markup, see the Committee website.

Reauthorization of the Combating Autism Act Introduced in the House

On May 9, the Combating Autism Reauthorization Act of 2014 (H.R. 4631) was introduced by Representative Chris Smith (R-NJ).   The bill largely extends the research, surveillance, public awareness, and professional training activities under the Combating Autism Act for an additional 5 years. It does, however, include a few changes. The bill reforms the Interagency Autism Coordinating Committee (IACC) to promote greater coordination among federal agencies. The bill also requires the Government Accountability Office (GAO) to review the existing landscape of services (federal, state, local government, and the private and non-profit sectors), conduct a survey of stakeholders, and make recommendations to enhance coordination, efficiency, and the value of the services currently provided to assist individuals with Autism Spectrum Disorder (ASD). Unfortunately, this bill does not include a name change. Learn more about the Combating Autism Act on The Arc’s website.

Senate Bill Introduced for Military Coverage of Behavioral Health Therapy

On May 14, Senators Patty Murray (D-WA), Roy Blunt (R-MO), Kirsten Gillibrand (D-NY), and Marco Rubio (R-FL) introduced the Caring for Military Children with Developmental Disabilities Act of 2014. This bill requires TRICARE, the Department of Defense and retiree health program for members of the uniformed services and their families, to provide coverage for behavioral health treatments, including applied behavior analysis (ABA).   Under current TRICARE policies, many children are denied coverage for ABA, and those children who do receive care often receive less than the prescribed treatment.  Thirty-four states and the District of Columbia currently require private insurers to cover ABA as a medically necessary service for most children with a developmental disability and the U.S. Office of Personnel Management also categorizes ABA as a “medical therapy” and covers ABA for federal employees’ dependents. Learn more at Senator Murray’s website.

Senate to Hold Confirmation Hearings for Secretary of the Department of Health and Human Services

This week, the Senate Health, Education, Labor and Pensions Committee will hold the first hearing on the nomination of Sylvia Mathews Burwell to be Secretary of the Department of Health and Human Services (HHS).  If confirmed by the Senate she would replace the current Secretary, Kathleen Sebelius.  Last April, Burwell was confirmed 96-0 as the Director of the Office of Management and Budget.  It is likely that questions about the Affordable Care Act will dominate the hearings.  The Senate Finance Committee will also hold a hearing before a Senate confirmation vote is scheduled.

Over 8 Million Americans Enrolled in Private Health Insurance Through the Marketplaces

The Obama Administration estimates that over 8 million Americans have enrolled in private health insurance through the marketplaces, surpassing the target goal of 7 million. Information is not yet available on whether or not these individuals were previously uninsured or whether they had paid their first premiums. The Arc recently joined other advocacy organizations in requesting that HHS make available other demographic information, such as disability status, when releasing future enrollment information.