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