Bill Text: NY A09073 | 2023-2024 | General Assembly | Introduced

---

Bill Title: Directs the commissioner of health to make publicly available on the department of health website a report concerning access to applied behavior analysis for enrolled children diagnosed with autism spectrum disorder.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-02-06 - referred to health [A09073 Detail]

Download: New_York-2023-A09073-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                          9073

                   IN ASSEMBLY

                                    February 6, 2024
                                       ___________

        Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
          tee on Health

        AN ACT to amend the social services law, in  relation  to  studying  the
          adequacy of applied behavioral analysis provider networks

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Paragraph (jj) of subdivision 2 of  section  365-a  of  the
     2  social  services  law,  as  added by chapter 733 of the laws of 2022, is
     3  amended to read as follows:
     4    [(jj)] (nn) applied  behavior  analysis,  under  article  one  hundred
     5  sixty-seven  of the education law, provided by a person licensed, certi-
     6  fied, or otherwise authorized to provide applied behavior analysis under
     7  that article. By December first of each year, the commissioner of health
     8  shall make publicly available on the department of  health's  website  a
     9  report concerning access to applied behavior analysis for enrolled chil-
    10  dren  diagnosed  with  autism  spectrum  disorder  meeting the following
    11  requirements:
    12    (i) the data in the report shall be organized  by  current  procedural
    13  terminology (CPT) code;
    14    (ii) the report shall include the following information from the imme-
    15  diately preceding fiscal year regarding the Medicaid program:
    16    (A)  the  number  of licensed behavior analysts and certified behavior
    17  analyst assistants practicing in this state who are Medicaid providers;
    18    (B) the number of Medicaid enrollees who are children with  an  autism
    19  spectrum disorder diagnosis;
    20    (C)  the  number of Medicaid enrollees who are children with an autism
    21  spectrum disorder diagnosis who received applied behavior analysis;
    22    (D) the number of licensed behavior analysts  and  certified  behavior
    23  analyst  assistants  with  whom  each  Medicaid managed care plan in the
    24  state has contracted, by county;
    25    (E) the median number of days between diagnosis of  a  child  with  an
    26  autism  spectrum  disorder  and  the  time at which such child begins to
    27  receive applied behavior analysis;

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14099-01-4
        A. 9073                             2

     1    (F) the number of Medicaid enrollees who are children with  an  autism
     2  spectrum  disorder diagnosis who did not receive applied behavior analy-
     3  sis, despite it being recommended by the child's health  care  provider,
     4  if ascertainable;
     5    (G)  the  number  of prior authorization requests for applied behavior
     6  analysis that were denied and the number of appeals resulting from those
     7  denials and partial denials;
     8    (H) the median of recommended hours and the median of  received  hours
     9  of  applied  behavior  analysis  for Medicaid enrollees who are children
    10  with an autism spectrum disorder diagnosis who  were  approved  for  and
    11  received  applied  behavior  analysis  but did not receive the number of
    12  hours of treatment recommended by the child's health care  provider,  if
    13  ascertainable;
    14    (I) the median of recommended hours and the median of covered hours of
    15  applied  behavior  analysis for Medicaid enrollees who are children with
    16  an autism spectrum disorder diagnosis  for  whom  the  Medicaid  program
    17  covered  fewer  behavior  analysis  hours  than  were recommended by the
    18  child's health care provider, if ascertainable;
    19    (J) recommendations to improve the adequacy of the network of  applied
    20  behavior analysis providers who are Medicaid providers; and
    21    (K) other recommendations to improve access to applied behavior analy-
    22  sis;
    23    (iii)  the  department shall make every effort to collect from applied
    24  behavior analysis providers and enrollees any information  necessary  to
    25  compile the report required by this section; and
    26    (iv)  the  department  shall  develop education and outreach materials
    27  that do both of the following:
    28    (A) inform and educate parents and legal guardians of  enrolled  chil-
    29  dren  with an autism spectrum disorder diagnosis about relevant services
    30  for which those children are eligible; and
    31    (B) explain how to access those services.
    32    § 2. This act shall take effect immediately.