By David Gorn, California Healthline
CMS officials released federal guidance for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.
"It's a good day. It's such a good day," said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. "Whenever you get a decision that we've been seeking for years, that is a good day."
Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid -- and therefore it also must be covered under Medi-Cal, California's version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame.
"ABA therapy must be covered under EPSDT. It's very, very clear," Jacobson said. "Any coverable benefit must be provided under the age of 21. If it's coverable in any way, then you have to provide it."