What's happening
This bill requires Medicaid in New York to cover applied behavior analysis for treating autism spectrum disorder.
Why it matters
Expands access to evidence-based autism care for low-income families. By mandating Medicaid coverage for applied behavior analysis (ABA), the bill ensures that children and adults with autism spectrum disorder (ASD) from lower-income households can access a therapy that is often recommended but can be prohibitively expensive without insurance coverage.
Standardizes provider qualifications for ABA services. The bill specifies that only licensed behavior analysts or certified behavior analyst assistants can provide these services, helping to ensure quality and consistency in treatment and protect patients from unqualified practitioners.
Could improve long-term outcomes and reduce future costs. Early and consistent access to ABA therapy has been shown to improve functional outcomes for people with ASD, which could help individuals become more independent and potentially reduce the need for more intensive (and costly) services later in life.
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Who cares
Headline styles
Cover Autism ABA Therapy
Plain English, a few words. Used as the page title.
Sponsors
2 Co-sponsors
History
- Referred to health
- Returned to senate
- Died in assembly
- Referred to ways and means
- Delivered to assembly
- Passed senateVote 59–1
- Advanced to third reading
- 2nd report cal.
- 1st report cal.720
- Reported and committed to finance
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Medicaid Covers Autism Therapy
In Assembly Committee · Ways And Means · Sponsor Richard Gottfried
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1821
2019-2020 Regular Sessions
IN SENATE
January 16, 2019
Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to including applied behavioral analysis for treatment of autism spectrum disorder under standard coverage for Medicaid recipients
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (ff) to read as follows:
(ff) applied behavior analysis, as defined in section eighty-eight hundred one of the education law, where such service is provided by a licensed behavior analyst or certified behavior analyst assistant, licensed or certified under article one hundred sixty-seven of the education law, for the treatment of autism spectrum disorder.
§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law. Effective immediately, the addition, amendment, and/or repeal of any rules and regulations necessary to implement the provisions of this act on its effective date are authorized and directed to be completed on or before such effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03868-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to including applied behavioral analysis for treatment of autism spectrum disorder under standard coverage for Medicaid recipients
Purpose
To amend the Social. Services Law in relation to providing Medicaid beneficiaries who have autism spectrum disorder access to applied behav- ior analysis services, comparable to commercial insurance coverage.
Summary of provisions
Section one of the bill amends subdivision 2 of section 365-a of the social services law by adding a new paragraph (ff), which adds coverage of applied behavior analysis for the treatment of autism spectrum disor- der to the standard Medicaid benefits.
Section two of the bill establishes the effective date.
Justification
Although applied behavior analysis (ABA) for the treatment of autism spectrum disorder (ASD) was added-to New York commercial insurance coverage requirements in 2011, it is still not a covered benefit for the thousands of New Yorkers who rely on Medicaid for health insurance. This means that children with treatable conditions are denied the vital care they need to achieve significant improvements in behavior that can have a great impact on both the children and their families. This bill would correct that omission.
ABA is the design, implementation and evaluation of modifications to produce socially significant improvements in human behavior. ABA inter- ventions are supported by scientific evidence as medically necessary for people with ASD, and are covered based on a written prescription from a physician or psychologist who states that such services are medically necessary to develop, maintain, or restore the functioning of an indi- vidual with a diagnosis of ASD.
In May of 2018, the Centers for Disease Control and Prevention released an update of autism's estimated prevalence amongst the nation's chil- dren. One key finding stated that 1 in 59 children had a diagnosis of autism spectrum disorder by the age of 8 in 2014, a 15% increase from 2012, when the number was 1 in 68.
Most states cover ABA in their Medicaid programs. New York, a leader in so many ways, has fallen behind. This bill would correct that injustice and enable access to this lifesaving service.
Legislative history
New bill.
Effective date
This act shall take effect on the one hundred eightieth day after it shall have become a law. Effective immediately, the addition, amendment, and/or appeal of any rules and regulations necessary to implement the provisions of this act on its effective date are authorized and directed to be completed on or before such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.