The Office of Developmental Programs, Bureau of Autism Services (BAS) has announced the availability of the first two modules in the newly developed SPeCTRUM 2.0 BAS Autism Competency Training. This training is designed as a free online resource for professionals who are supporting individuals with Autism Spectrum Disorder (ASD) and their families.
The Department of Human Services (DHS) has just issued a Medical Assistance (MA) Bulletin for providers relating to Act 62 titled, Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder (ASD). The purpose of this bulletin is to remind providers enrolled in the MA Program, both fee-for-service (FFS) and HealthChoices, of the requirement to bill a child’s or adolescent’s private health insurance company before submitting a claim for the diagnostic assessment or treatment of ASD. It is also to inform providers of the diagnosis codes and procedure codes which will be included in the MA FFS cost avoidance process, effective Friday, September 30. HealthChoices managed care organizations will provide guidance and information to contracted practitioners and providers in the Medicaid managed care system with regard to implementation by September 30.
The DHS clinical staff has identified behavioral health, physical health, and rehabilitation procedure codes that reflect services for the diagnostic assessment and treatment of ASD covered under Act 62. The procedure codes that are on the MA Program fee schedule will be subject to the cost avoidance process for MA FFS claims beginning September 30.
Registration is open now for two webinar sessions on Thursday, August 25 that are being held by DHS in collaboration with RCPA:
A recent news release from the American Psychiatric Association reports that diagnosis of autism spectrum disorder before the age of 4 means that a child is more likely to get effective, evidence-based treatment, such as behavioral therapy. When children are diagnosed after that threshold, they are less likely to receive such treatment, but they are more likely to be treated with medication, according to research published online in the August 1 release of Psychiatric Services in Advance. The strongest evidence for effective treatment for autism is for behavioral intervention therapy directed at core autism symptoms, such as social skills and inflexible behaviors. Early intensive treatments may have long-term benefits for children’s functioning. Other therapies, including complementary and alternative medicine and medication treatments for autism, are more controversial and are not as strongly supported by scientific studies. Psychiatric Services in Advance articles have been peer reviewed but have not yet appeared in the print journal. Publication ahead of print allows articles to become available in a rapid and timely manner.
The American Academy of Pediatrics recommends that all children be screened for autism at 18 months and again at 24 months. Current information suggests that only about half of primary care practitioners screen for autism. The average age at diagnosis in the United States is more than 4 years old.
On November 23, the leadership of the Office of Mental Health and Substance Abuse Services (OMHSAS), including Deputy Secretary Dennis Marion and Medical Director Dr. Dale Adair, provided a webcast presentation on the development of Applied Behavior Analysis (ABA) services for children with an Autism Spectrum Disorder (ASD). The webcast to more than 130 RCPA members reviewed the current concepts and recommendations developed by a clinical work group, assisting OMHSAS in the development of ABA medical necessity guidelines, clarifying the authorization pathway for Behavioral Health Rehabilitation Services for children and adolescents diagnosed with Autism Spectrum Disorder.
RCPA Input Session for Medical Necessity Guidelines for BHRS including Applied Behavioral Analysis
In August 2015, OMHSAS convened a small, time-limited clinical work group to assist in the development of new Medical Necessity Guidelines (MNG) for children and adolescents with ASD. The guidelines are specific to Applied Behavioral Analysis within the home and community based services level of care. The work group is seeking stakeholder feedback on preliminary MNG content prior to issuing recommendations to OMHSAS.
OMHSAS will present an update with Dennis Marion via webcast on Monday, November 23, 2015 from 9:30 – 10:30 am. OMHSAS Deputy Secretary Marion will provide RCPA members with updates from OMHSAS;