Autism – Federal Health Program to Require Applied Behavior Analysis (ABA) Coverage

The U.S. Office of Personnel Management (OPM) announced that all health plans within the Federal Employees Health Benefits Program – which covers federal employees, retirees and their dependents – must include ABA therapy starting next year. “OPM has now determined that appropriate coverage of ABA treatment by all plans/options is necessary,” according to a letter sent to insurance carriers. “Therefore, for the 2017 plan year, carriers may no longer exclude ABA for the treatment of autism spectrum disorder (ASD). We expect all carriers to offer clinically appropriate and medically necessary treatment for children diagnosed with ASD,” the letter states. This directive is a victory for advocates who have fought for years for ABA to be recognized as an evidence-based treatment by insurers. To date, legislation has been passed in 43 states requiring at least some insurance plans to cover ABA

Autism – Bipartisan Bill Introduced to Address Wandering By Children with Autism Spectrum Disorder (ASD) and Other Developmental Disabilities

Kevin and Avonte’s Law (S. 2614) was introduced by Senators Chuck Grassley (R-IA), Chuck Schumer (D-NY), and Thom Tillis (R-NC) on March 1. This legislation reauthorizes an existing program designed to assist in locating persons with dementia who wander from safe environments and it adds new support for children with developmental disabilities, including ASD. It allows Justice Department grants to be used to develop training and emergency protocols, supply first responders with additional information and resources, and make local tracking technology programs available for individuals who may wander because of their condition. The Arc supports this legislation as it seeks to prevent and reduce the harm from wandering (or “elopement”) by the 27% of children with developmental disabilities who are reported to wander from safe settings each year. Read Senator Grassley’s statement for the Congressional Record here.

Autism – Federal panel determines evidence is insufficient for universal ASD screening

Last week, the U.S. Preventive Services Task Force (USPSTF) issued a final recommendation statement on “Screening for Autism Spectrum Disorder in Young Children.”  The USPTF concluded that evidence is insufficient to recommend that all children be screened for autism, stating that “…the current evidence is insufficient to assess the balance of benefits and harms of screening for autism spectrum disorder (ASD) in young children for whom no concerns of ASD have been raised by their parents or a clinician.”  The USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine convened by the Agency for Healthcare Research and Quality.  The Arc and several other disability organizations submitted comments last year on the USPSTF’s draft recommendation.  We expressed support for guidelines from the American Academy of Pediatrics that call for continuous developmental surveillance and for specific autism screening at 18 months, 24 months, and whenever a parent or provider expresses concern.  The Arc is concerned that the USPSTF final recommendation statement could be used by insurance companies to discontinue reimbursement to physicians for screening work, despite the availability of free brief evidence-based screening tools.  Visit the USPSTF web site to view its final recommendation.

Senate Briefing on Wandering (also known as elopement) by Persons With Autism

Senator Chuck Schumer (D-NY) is sponsoring a briefing on “Elopement in Children and Adults with Autism Spectrum Disorders” on Tuesday, May 19th from 1:00 pm to 2:30 pm EDT in the Russell Senate Building, Room 485. Speakers will include: Scott Badesch, President/Chief Executive Offi­cer, Autism Society of America; Robert Lowery, Jr., Vice President, Missing Children Division, National Center for Missing & Exploited Children; Scott Martin, Director, SafetyNet Division of LoJack Corporation; former State Police Captain (Retired), Connecticut State Police; and Lori McIlwain, Co-founder & Board Chairperson, National Autism Association.   This briefing aims to raise awareness of the problem of wandering and how law enforcement agencies are responding.

TRICARE Autism Demonstration Program Launched; Rate Cut Delayed

On Sept 19, The Department of Defense’s TRICARE program published its new Autism Care Demonstration guidance.  While the program includes several improvements, it also includes a nearly 50% reduction of reimbursement rates for board certified behavior analyst (BCBA) delivered therapy and more. The program was subsequently launched on Oct. 20; however, after strong opposition from advocates, the BCBA reimbursement policy has been delayed by 180 days. Learn more at Autism Speaks.

Autism CARES Signed by President Obama

The Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2014 was signed into law on August 8, 2014 by President Obama. This bipartisan legislation, introduced by Senators Robert Menendez (D-NJ) and Mike Enzi (R-WY) and Representatives Chris Smith (R-NJ) and Mike Doyle (D-PA), reauthorizes the Combating Autism Act of 2011 for an additional five years and makes a number of improvements to it. Since its original enactment in 2006, the law has significantly advanced the science and practice in the disability field by increasing the number, scope, pace, and coordination of research, surveillance, public awareness, and professional training efforts. This has resulted in an increase in the proportion of infants screened for autism spectrum disorder (ASD), an increase in the proportion of children diagnosed by the age of three, and continuing improvements to decrease the time between diagnosis and intervention. The new law continues these efforts and makes the following improvements – a name change that uses more respectful language, a designated ASD position in the Department of Health and Human Services to oversee the law’s implementation, increased representation of self-advocates and family members on the Interagency Autism Coordinating Committee (IACC), and requiring a report on the needs of transitioning youth.For more information on the accomplishments of the prior legislation see, “Report to Congress on Activities Related to Autism Spectrum Disorders and Other Developmental Disabilities Under the Combating Autism Act of 2006 and Combating Autism Reauthorization Act of 2011 (FY 2010-FY 2012)”.

Autism CARES Is Law

The Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2014 was signed into law on August 8, 2014 by President Obama. This bipartisan legislation, introduced by Senators Robert Menendez (D-NJ) and Mike Enzi (R-WY) and Representatives Chris Smith (R-NJ) and Mike Doyle (D-PA), reauthorizes the Combating Autism Act of 2011 for an additional five years and makes a number of improvements to it. Since its original enactment in 2006, the law has significantly advanced the science and practice in the disability field by increasing the number, scope, pace, and coordination of research, surveillance, public awareness, and professional training efforts. This has resulted in an increase in the proportion of infants screened for autism spectrum disorder (ASD), an increase in the proportion of children diagnosed by the age of three, and continuing improvements to decrease the time between diagnosis and intervention. The new law includes continues these efforts and make the following improvements – a name change that uses more respectful language, a designated ASD position in the Department of Health and Human Services to oversee the law’s implementation, increased representation of self advocates and family members on the Interagency Autism Coordinating Committee (IACC), and requiring a report on the needs of transitioning youth.For more information on the accomplishments of the prior legislation see, “Report to Congress on Activities Related to Autism Spectrum Disorders and Other Developmental Disabilities Under the Combating Autism Act of 2006 and Combating Autism Reauthorization Act of 2011 (FY 2010-FY 2012)”.

Senate Passes Autism CARES Act

Late on July 31, the Senate unanimously passed “Autism Collaboration, Accountability, Research, Education, and Support Act of 2014” or the “Autism CARES Act” (S. 2449), sponsored by Senators Robert Menendez (D-NJ) and Mike Enzi (R-WY) and Representatives Chris Smith (R-NJ) and Mike Doyle (D-PA) . The bill reauthorizes the Combating Autism Reauthorization Act of 2011 for an additional five years. Since its original enactment in 2006, the law has advanced the science and practice in the autism field by increasing the number, scope, pace, and coordination of research, surveillance, public awareness, and professional training efforts.   The new measure will continue these efforts and includes a number of welcome changes: a name change that uses more respectful language, a designated ASD position in the Department of Health and Human Services to oversee the law’s implementation, increased representation of self-advocates and family members on the Interagency Autism Coordinating Committee (IACC), and requiring a report on the needs of transitioning youth. For more information on the accomplishments of the Combating Autism Act, visit the HHS website.

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.

Autism CARES Act Passed by House of Representatives, Action Pending in Senate

On June 24, the House passed a bill to reauthorize the Combating Autism Act – now renamed the Autism CARES Act (H.R.4631) – by voice vote. The bill was brought up on the suspension calendar, meaning no floor debates or amendments. The Senate bill (S.2449), was passed by the Senate Health, Education, Labor and Pensions (HELP) Committee the next day. It is expected to be considered by the full Senate in early July. This legislation extends research, surveillance, public awareness, and professional training activities for an additional five years. The Arc strongly supports the CARES Act. Learn more about these efforts at http://iacc.hhs.gov.