NCAAS Defends ABA Providers in Response to Massachusetts OIG Report

NCAAS is concerned with the most recent report from the MA Office of the Inspector General (OIG) that appears to be missing critical information from its analysis of ABA provider Medicaid claims payments. In addition to measuring “adequate ABA” using a quantitative treatment limitation prohibited by federal law, the OIG report ignores the fact that a significant percentage of supervision activities are not billable, so an analysis of paid claims will not yield an accurate picture of supervision hours. Additionally, the report implies that services provided on federal holidays did not occur, wholly disregarding the diverse demographics of its Medicaid population and the fact that autism—like other conditions—does not take a holiday. Read the full letter here.

Op-ed in The Hill: "The Autism Act is again up for reauthorization... there is a new opportunity for America to get this right."

Op-ed in The Hill: "The Autism Act is again up for reauthorization... there is a new opportunity for America to get this right."

What if 1 of every 218 American children [the CDC calculation is 1/(4.59/1000)] faced lifetimes of pain and panic, unable to communicate their distress, having a much shorter life expectancy than their unafflicted peers, their families usually broke and often broken as they seek medical care and services that are terribly inadequate

NCAAS Supports CMS's Guidance As Continuous Coverage Comes to an End

The National Coalition for Access to Autism Services (NCAAS) supports the Centers for Medicare and Medicaid Services guidance to maintain continuity of care for Medicaid enrollees as Medicaid continuous coverage comes to end and urges states to provide guidance to state agencies to prevent disruptions to ongoing treatment. Continuing to advocate for access to quality autism services for the children and families that need it, NCAAS recognizes that the end of continuous Medicaid coverage may disrupt care for thousands of children if states fail to provide proper guidance.   

Opinion: Insurance cos. vs. autism therapy

In the coming decades, almost every American will have a friend or relative whose child has been diagnosed with autism — or will have a child with autism themselves.

That’s among the implications of the most recent data on autism from the Centers for Disease Control and Prevention. Today, the CDC says that one of every 44 children has been diagnosed with autism spectrum disorder.

NCAAS Applauds Omnibus Legislation for Promoting Access to Autism Therapy

The National Coalition for Access to Autism Services (NCAAS) today applauded the newly enacted Consolidated Appropriations Act 2023 for its focus on expanding mental health parity, which will increase equitable access to mental health services including applied behavior analysis, a scientifically proven therapy for people with autism and their families.

NCAAS Seeks Postponement of New TRICARE Policies in Absence of Clarification to Providers

NCAAS has submitted letters to the House and Senate Armed Services Committees seeking a postponement of the implementation of new policies described in the TRICARE Operations Manual (TOM) published in March. Find a list of specific concerns in the NCAAS letters, including the elimination of services in a school setting; changes in assessment requirements; risks of recoupment for issues outside of the provider’s control; and the contractors’ general lack of clarity about how to administer the benefit in the context of this new TOM.

CMS Increases MUE For 3 Billing Codes

NCAAS is pleased to announce that CMS has increased the Medically Unlikely Edits for three of the adaptive behavior codes: 97152 (increased from 8 to 16 units); 97154 (increased from 12 to 18 units); and 0362T (increased from 8 to 16 units). NCAAS continues to work with CMS to increase the MUE for 97151. Although the MUE on the Medicaid side is 32 units, it remains at 8 units for Medicare, and insurers’ claim processing predominantly defaults to Medicare MUE.