Legislative Efforts & Advocacy Recap: June 2021

Thank you to all the autistic individuals, parents, caregivers, organizations, and providers who continue to advocate on behalf of the autism community to ensure equitable healthcare coverage for the diagnosis and treatment of autism. BHCOE is committed to supporting high quality patient centered care and we appreciate all our accredited providers who have committed to excellence and ongoing improvement.

Please share any advocacy or legislation occurring in your state with Anna Bullard, VP of Government Relations at [email protected].

Oregon

BHCOE is excited to congratulate all the organizations, providers, parents, and advocates on the passage of SB358 to prevent the sunset of the autism mandate in the state. The bill has been sent for the Governor’s signature with no anticipated concerns.

North Carolina

BHCOE’s team continues to follow the progress in the forming of the licensure board in lieu of the passage of SB103 that will allow BCBAs to practice independently.

Utah

A new Medicaid fee schedule is being released to include updated RBT rates for ABA services.

California

AB-32 Maintains the expansions of telehealth for Medi-Cal that were created due to Covid-19:
https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB32

Florida

Effective July 1, the Agency for Health Care Administration also will limit the frequency and duration of Medicaid behavioral health services and will reinstate prior authorization requirements for behavioral health services starting July 15.

Tricare

As you all know there are many updates to the new Tricare Operations Manual (TOM). We recently received information that 97155 code (8.11.6.2.2) has been changed to reflect the following:

  • Can only be used to demonstrate a new or modified protocol to a BT with the beneficiary present
  • The focus of the code is the change or addition to the protocol
  • It must be completed one time per month by the authorized ABA supervisor
  • The contractor will perform a post-claims payment review and if this requirement is not met, a 10% penalty on all ABA claims for that beneficiary shall be recouped for the entire six month authorization

BHCOE will continue to advocate on behalf of the individuals with autism covered by Tricare and their families to receive high quality ABA therapy that is delivered through best practice. We will continue to provide updates. Please email us your concerns or questions and we will work to get answers for you.

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