Legislative and Public Affairs

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Medicaid Policy on Behavior Analysis Coverage

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FABA Legislative and Public Policy Committee

New Insurance Coverage Law for Down Syndrome Treatment Includes Behavior Analysis Services

On April 14, 2016, Governor Rick Scott signed House Bill 221, which requires health maintenance organization contract and certain insurance policies to cover behavior analysis services for the treatment of Down Syndrome. Previously, Florida statutes provided that behavior analysis services were only mandated for the treatment of autism, however this change significantly expands the law. Thank you to Senate President Andy Gardiner who help shepherd this long-overdue amendment to the insurance law. This change is effective July 1, 2016, and FABA will be working with the Office of Insurance Regulation to make sure families can access this new insurance benefit.

AHCA Holds Workshop On Medicaid Policy For Behavior Analysis Service & Contracts With Beacon Health Options For Utilization Management

On April 7, 2016, the Agency for Health Care Administration held its third workshop on the new policy for behavior analysis services. FABA participated in the workshop and commented on the need to include an accurate definition of behavior analysis as well other issues that should be addressed before the policy is finalized. AHCA is expected to publish a revised policy and a notice of hearing on the policy in the near future. AHCA also selected Beacon Health Options as its vendor to handle utilization management for behavior analysis services for the treatment of autism under the Medicaid program. FABA met with members of Beacon’s leadership team to discuss their role in authorizing and reviewing behavior analysis services for the Florida Medicaid program. Beacon has considerable experience working with BCBAs in other states and FABA looks forward to Beacon presenting at the Annual Meeting in September.