Nevada § 422.27497 - State Plan for Medicaid: Inclusion of requirement for payment of certain costs for services provided by behavior analysts, assistant behavior analysts and registered behavior technicians; establishment of certain rates of reimbursement and limitations on hours for provision of such services; reporting of certain information concerning services provided to recipients of Medicaid diagnosed with autism spectrum disorder

§ 422.27497. State Plan for Medicaid: Inclusion of requirement for payment of certain costs for services provided by behavior analysts, assistant behavior analysts and registered behavior technicians; establishment of certain rates of reimbursement and limitations on hours for provision of such services; reporting of certain information concerning services provided to recipients of Medicaid diagnosed with autism spectrum disorder

1. The Director shall include in the State Plan for Medicaid a requirement that the

State pay the nonfederal share of expenditures incurred for services provided by behavior

analysts, assistant behavior analysts and registered behavior technicians to recipients

of Medicaid who are less than 27 years of age. 2. The Director shall: (a) Biennially establish and include in the State Plan for Medicaid rates of reimbursement

which are provided on a fee-for-service basis for services provided by behavior analysts,

assistant behavior analysts and registered behavior technicians that are comparable

to rates of reimbursement paid by Medicaid programs in other states for the services

of those providers. (b) Establish reasonable limits on the number of hours that a behavior analyst, assistant

behavior analyst or registered behavior technician is authorized to bill for services

provided to a recipient of Medicaid in a 24-hour period. 3. The Division shall provide training to behavior analysts, assistant behavior analysts

and registered behavior technicians who provide services to recipients of Medicaid

concerning the limits established pursuant to paragraph (b) of subsection 4. On or before January 31 of each year, the Division shall: (a) Compile a report concerning the provision of services to recipients of Medicaid

who have been diagnosed with an autism spectrum disorder. The report must include: (1) The number of recipients of Medicaid who were newly diagnosed with an autism spectrum

disorder during the immediately preceding year and the number of those recipients

for whom assistance with care management was provided; (2) The number of recipients of Medicaid diagnosed with an autism spectrum disorder

for whom assistance with care management was reimbursed through Medicaid during the

immediately preceding year; (3) The number of recipients of Medicaid for whom the first claim for reimbursement

for the services of a registered behavior technician was submitted during the immediately

preceding year; (4) The number of assessments or evaluations by a behavior analyst that were reimbursed

through Medicaid during the immediately preceding year; (5) The total number of claims for applied behavior analysis services provided to

recipients of Medicaid made during the immediately preceding year; (6) For the immediately preceding year, the average times that elapsed between claims

for each step of the process that a recipient of Medicaid must undergo to receive

treatment from a registered behavior technician, beginning with initial diagnosis

with an autism spectrum disorder and including, without limitation, comprehensive

diagnosis with an autism spectrum disorder, evaluation and treatment by a behavior

analyst and treatment by a registered behavior technician; (7) The number of recipients of Medicaid receiving services through Medicaid managed

care who were, at the end of the immediately preceding year, on a wait list for applied

behavior analysis services; (8) An assessment of the adequacy of the network of each health maintenance organization

or managed care organization that provides services to recipients of Medicaid under

the State Plan for Medicaid for applied behavior analysis services, as compared to

the applicable standard for network adequacy set forth in the contract between the

health maintenance organization or managed care organization and the Division; (9) The number of behavior analysts and registered behavior technicians who are currently

providing services to recipients of Medicaid who receive services through each health

maintenance organization or managed care organization described in subparagraph (8);

and (10) The number of behavior analysts and registered behavior technicians who provide

services to recipients of Medicaid who do not receive services through managed care. (b) Submit the report to the Director of the Legislative Counsel Bureau for transmittal

to: (1) In odd-numbered years, the next regular session of the Legislature; and (2) In even-numbered years, the Joint Interim Standing Committee on Health and Human

Services. 5. As used in this section: (a) “ Applied behavior analysis services ” means the services of a behavior analyst, assistant behavior analyst or registered

behavior technician. (b) “ Assistant behavior analyst ” has the meaning ascribed to it in NRS 641D.020 . (c) “ Behavior analyst ” has the meaning ascribed to it in NRS 641D.030 . (d) “ Registered behavior technician ” has the meaning ascribed to it in NRS 641D.100 .