BILL NUMBER: S1821

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the social services law, in relation to including
applied behavioral analysis for treatment of autism spectrum disorder
under standard coverage for Medicaid recipients

 
PURPOSE:

To amend the Social. Services Law in relation to providing Medicaid
beneficiaries who have autism spectrum disorder access to applied behav-
ior analysis services, comparable to commercial insurance coverage.

 
SUMMARY OF PROVISIONS:

Section one of the bill amends subdivision 2 of section 365-a of the
social services law by adding a new paragraph (ff), which adds coverage
of applied behavior analysis for the treatment of autism spectrum disor-
der to the standard Medicaid benefits.
              

Section two of the bill establishes the effective date.

 
JUSTIFICATION:

Although applied behavior analysis (ABA) for the treatment of autism
spectrum disorder (ASD) was added-to New York commercial insurance
coverage requirements in 2011, it is still not a covered benefit for the
thousands of New Yorkers who rely on Medicaid for health insurance. This
means that children with treatable conditions are denied the vital care
they need to achieve significant improvements in behavior that can have
a great impact on both the children and their families. This bill would
correct that omission.

ABA is the design, implementation and evaluation of modifications to
produce socially significant improvements in human behavior. ABA inter-
ventions are supported by scientific evidence as medically necessary for
people with ASD, and are covered based on a written prescription from a
physician or psychologist who states that such services are medically
necessary to develop, maintain, or restore the functioning of an indi-
vidual with a diagnosis of ASD.

In May of 2018, the Centers for Disease Control and Prevention released
an update of autism's estimated prevalence amongst the nation's chil-
dren. One key finding stated that 1 in 59 children had a diagnosis of
autism spectrum disorder by the age of 8 in 2014, a 15% increase from
2012, when the number was 1 in 68.

Most states cover ABA in their Medicaid programs. New York, a leader in
so many ways, has fallen behind. This bill would correct that injustice
and enable access to this lifesaving service.

 
LEGISLATIVE HISTORY:

New bill.

 
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall have become a law. Effective immediately, the addition, amendment,
and/or appeal of any rules and regulations necessary to implement the
provisions of this act on its effective date are authorized and directed
to be completed on or before such effective date.