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Showing posts from January 10, 2016

Indiana Medicaid Covers ABA

Effective February 6, 2016, applied behavioral analysis (ABA) therapy is covered for the treatment of autism spectrum disorder (ASD) for members 20 years of age and younger. ABA therapy is the design, implementation, and evaluation of environmental modification using behavioral stimuli and consequences to produce socially significant improvement in human behavior, including the direct observation, measurement, and functional analysis of the relations between environment and behavior. Coverage applies to dates of service (DOS) on or after February 6, 2016, for all IHCP programs, subject to limitations established for certain benefit packages.  ABA therapy is available to members from the time of initial diagnosis through 20 years of age when it is medically necessary for the treatment of ASD. ABA therapy services require prior authorization (PA), subject to the criteria outlined in Indiana Administrative Code 405 IAC 5-3. PA requests must include, at a minimum, the following:  

Action Alert: ABLE Act Bill Hearing 1.19 Write your Senators

from The Arc of Indiana: ABLE ACT – SB 11 SB 11 –  ABLE Act, introduced by Senator Luke Kenley (R-Noblesville).  Creates the “achieving a better life experience” (ABLE) authority.  Established the ABLE Board of the authority.  Requires the authority to establish a qualified ABLE program under which a person may make contributions for a taxable year for the benefit of an eligible individual with a disability to an ABLE account to meet the qualified disability expenses of the designated beneficiary in compliance with federal law.   The bill is being heard in the Senate tax and Fiscal Policy Committee on Tuesday, January 19 th  at 8:30 a.m. in room 431 of the Indiana State House.  Please take a moment to contact members of the committee and urge their support of SB 11: Chairman, Senator Brandt Hershman; Senator Travis Holdman; Senator Jim Buck; Senator Ed Charbonneau;  Senator.Charbonneau@iga.

Medicaid Rules for ABA in Indiana

Governor Pence has signed the   Final Rules relating to Applied Behavioral Analysis (ABA) therapy services through Medicaid. The rules pertain to Title 405 of Indiana Code (405 IAC 5-22-1 and 405 IAC 5-22-12).  These rules will be effective on February 7, 2016 .   Basically, the rules state the following: 1.  ABA will be available to an individual who has received an ASD diagnosis and a referral for ABA therapy that includes the projected length of treatment.  Services are available until the individual turns 20 years old.  ABA services will be covered for no more than 40 hours/week and available for a 3-year period. 2.  These providers may provide ABA services:  health services provider in psychology (HSPP), licensed or board certified behavior analyst (BCBA, BCBA-D, BCaBA), and credentialed registered behavior technician (RBT).  These providers shall develop a treatment plan  based on the individual's needs, age, school attendance, and other daily activities as docum

ACA Enrollment Resources

from 211: Find Outreach & Enrollment Events Learn about your healthcare options by attending an  outreach and enrollment event  in your area. Find a Healthcare Navigator Certified navigators  are available to assist you with each step of the enrollment process. Not sure what's right for you? Call  2-1-1  for a quick pre-screening to see which options might best match your situation. January 15, 2016: Last day to enroll in or change plans for new coverage to start February 1, 2016 January 31, 2016 :  2016 Open Enrollment ends. Enrollments or changes between  January 16 and January 31  take effect March 1, 2016.

Tax Forms to Report Insurance Coverage under Medicaid

from Covering Kids and Families Indiana: A 1095-B tax form will be mailed to all Indiana residents enrolled in an Indiana Health Coverage Program/Medicaid that meets the federal definition of "minimum essential coverage" - such as HIP 2.0 - for at least one day in 2015. This form, to be sent by the state, relates only to coverage provided by the state. Recipients of these forms may receive additional Form 1095-Bs and other health care tax documents (such as Form 1095-A and Form 1095-C) if they received other health care benefits in 2015.  These forms will be mailed by early February.   A cover letter will explain the federal requirements regarding health insurance and will indicate coverage status to be used when completing the tax forms. The 1095-B Form provides the information each person will need for the income tax return. It will also instruct members to review the 1095-B form for accuracy and,  if the information on the form is not correct, to call  1-855-673-0

Indiana Legislative Session 2016

from  Indiana Coalition for Human Services : The  Indiana General Assembly  kicked off the 2016 legislative session on January 6. Many bills have been filed and assigned to committees. The bill filing deadline is January 12. Here are some helpful links to help you follow the action during the session: House and Senate Bill List House Committee Schedule  and  Senate Committee Schedule ICHS Bill Tracking List  (updated regularly) Third House / Meet Your Legislator Events Guide to Key Human Services Programs 2016  ( email for booklet version) The Indiana Coalition for Human Services partners with Indiana Association of United Ways each year to bring you legislative updates throughout the session. The first update webinar will be held on  Thursday, February 4 at 10amET , we will also post to our website if you cannot make the live recording.  Register now  to watch the webinar live. The second legislative update webinar will be March 21.