Autism New Jersey Advocates for Medicaid Regulations
December 16, 2024
On November 14, 2024, the New Jersey Department of Human Services (DHS) sent out a notice that they intend to propose amending the contents of N.J.A.C. 10:77 which are regulations titled “Rehabilitative Services for Children.” The proposed amendments will add a new subchapter which will contain rules related to the provision of autism spectrum disorder (ASD) related services for EPSDT (Early and Periodic Screening, Diagnostic and Treatment) eligible individuals. EPSDT is a Medicaid benefit that provides comprehensive high-quality health services to youth under the age of 21.
The areas covered by the rule will include:
- Beneficiary eligibility
- Provider requirements
- Reimbursement
- Recordkeeping requirements
- Available ASD services, which may include, but not be limited to:
- Applied Behavior Analysis (ABA) Services
- Augmentative and Alternative Communication
- Developmental Individual-differences and Relationship-based Model (DIR® services)
- Sensory Integration Therapy
- Physical therapy
- Occupational therapy
- Speech-Language therapy
- Skill Acquisition and Capacity Building
Autism New Jersey provided comments to DHS that include practice papers and recommendations to maximize the efficiency and effectiveness of administering and delivering EPSDT benefits to children with autism. DHS is starting this process with a “blank slate” as there is no proposed language at this moment. While the regulations for these ASD services are in the early stages of development, the benefit has been available statewide since April 1, 2020.
READ AUTISM NEW JERSEY’S COMMENTS
If you have questions about access or providing these services, call our 800.4.AUTISM Helpline or email us at information@autismnj.org.