Oklahoma § 56-1011.12 - Feasibility study for state plan amendment for applied

§ 56-1011.12. Feasibility study for state plan amendment for applied

behavior analysis treatment of autism spectrum disorder.

A. The Oklahoma Health Care Authority, in conjunction with the

Department of Mental Health and Substance Abuse Services, the State

Department of Health and the State Department of Education shall

examine the feasibility of a state plan amendment to the Oklahoma

Medicaid Program for applied behavior analysis treatment of autism

spectrum disorders.

B. On or before December 31, 2016, the Authority and partnering

agencies shall submit a report to the President Pro Tempore of the

Senate, the Speaker of the House of Representatives and the Governor

estimating the potential costs to the state, clinical findings,

reviews of pilot projects and research from other states on the

effects of applied behavioral analysis treatment on autism spectrum

disorders.

C. Beginning July 1, 2017, and subject to the availability of

funding, the Authority and partnering agencies shall draft a state

plan amendment for applied behavior analysis treatment of autism

spectrum disorders. The provisions of this subsection shall only

apply if the report required by subsection B of this section

demonstrates applied behavioral analysis treatment to be evidencebased and essential to qualifying participants in the Oklahoma

Medicaid Program.

D. As used in this section:

1. "Applied behavior analysis" means the design, implementation

and evaluation of environmental modifications, using behavioral

stimuli and consequences, to produce socially significant

improvement in human behavior, including the use of direct

observation, measurement and functional analysis of the relationship

between environment and behavior;

2. "Autism spectrum disorder" means any of the pervasive

developmental disorders or autism spectrum disorders as defined by

the most recent edition of the Diagnostic and Statistical Manual of

Mental Disorders (DSM) or the edition that was in effect at the time

of diagnosis;

3. "Behavioral health treatment" means counseling and treatment

programs, including applied behavior analysis, that are:

Oklahoma Statutes - Title 56. Poor Persons

a.

necessary to develop, maintain or restore, to the

maximum extent practicable, the functioning of an

individual, and

b.

provided by a board-certified behavior analyst or by a

licensed doctoral-level psychologist so long as the

services performed are commensurate with the

psychologist's university training and supervised

experience; and

4. "Treatment for autism spectrum disorder" means evidencebased care and related equipment prescribed or ordered for an

individual diagnosed with an autism spectrum disorder by a licensed

physician or a licensed doctoral-level psychologist who determines

the care to be medically necessary, including, but not limited to:

a.

behavioral health treatment,

b.

pharmacy care,

c.

psychiatric care,

d.

psychological care, and

e.

therapeutic care.

Added by Laws 2016, c. 230, § 2, eff. Nov. 1, 2016.