Bill > SB96

Introduced Session

Legislative Counsel's Digest: Existing law requires the Department of Health and Human Services to 1 administer the Medicaid program and the Children s Health Insurance Program. 2 (NRS 422.270) Section 4.8 of this bill requires the Department to submit to the 3 United States Secretary of Health and Human Services a request to amend the State 4 Plan for Medicaid to increase the rate of reimbursement which is provided on a fee-5 for-service basis for services provided by a registered behavior technician to $62 6 per hour, or as close to that amount as the Secretary approves. If the request is 7 approved, section 4.8 requires the Autism Treatment Assistance Program, which is 8 established within the Aging and Disability Services Division to serve as the 9 primary autism program within the Department, and the Children s Health 10 Insurance Program to pay a rate of reimbursement for such services that is equal to 11 or greater than the rate of reimbursement provided under Medicaid. (See NRS 12 427A.875) Sections 4.2 and 4.5 of this bill make appropriations to pay costs 13 associated with increasing the reimbursement rates for Medicaid and the Children s 14 Health Insurance Program. Section 2 of this bill requires the Department, beginning 15 on July 1, 2023, to biennially establish reimbursement rates provided on a 16 fee-for-service basis under Medicaid for behavior analysts, assistant behavior 17 analysts and registered behavior technicians that are comparable to reimbursement 18 rates paid by Medicaid programs in other states for such providers. Beginning on 19 July 1, 2023, section 2 also requires the Department to establish reasonable limits 20 on the number of hours that such a provider is authorized to bill for services 21 provided to a recipient of Medicaid in a 24-hour period. Additionally, beginning on 22 July 1, 2023, section 2 requires the Division of Health Care Financing and Policy 23 to: (1) provide training to such providers concerning such limits; and (2) annually 24 report to the Legislature, if the Legislature is in session, or the Legislative 25 Committee on Health Care, if the Legislature is not in session, concerning the 26 provision of services to recipients of Medicaid who have been diagnosed with an 27 autism spectrum disorder. Section 4 of this bill makes a conforming change to 28 provide that the provisions of section 2 are administered in the same manner as the 29 provisions of existing law governing Medicaid. 30 Existing law establishes the Autism Treatment Assistance Program within the 31 Aging and Disability Services Division of the Department to provide and 32 coordinate the provision of services to persons diagnosed or determined to have 33 autism spectrum disorders through the age of 19 years. (NRS 427A.875) Section 3 34 of this bill requires the Program to: (1) publish certain information on the Internet 35 website of the Program to assist persons in obtaining services for autism spectrum 36 disorders; and (2) when there is a waiting list for services from the Program, use a 37 risk assessment tool to assess and identify persons on the waiting list with higher 38 needs. 39 SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. (Deleted by amendment.) 1 Sec. 2. Chapter 422 of NRS is hereby amended by adding 2 thereto a new section to read as follows: 3 1. The Director shall: 4 (a) Biennially establish and include in the State Plan for 5 Medicaid rates of reimbursement which are provided on a fee-for-6 service basis for services provided by behavior analysts, assistant 7 behavior analysts and registered behavior technicians that are 1 comparable to rates of reimbursement paid by Medicaid programs 2 in other states for the services of those providers. 3 (b) Establish reasonable limits on the number of hours that a 4 behavior analyst, assistant behavior analyst or registered behavior 5 technician is authorized to bill for services provided to a recipient 6 of Medicaid in a 24-hour period. 7 2. The Division shall provide training to behavior analysts, 8 assistant behavior analysts and registered behavior technicians 9 who provide services to recipients of Medicaid concerning the 10 limits established pursuant to paragraph (b) of subsection 1. 11 3. On or before January 31 of each year, the Division shall: 12 (a) Compile a report concerning the provision of services to 13 recipients of Medicaid who have been diagnosed with an autism 14 spectrum disorder. The report must include: 15 (1) The number of recipients of Medicaid who were newly 16 diagnosed with an autism spectrum disorder during the 17 immediately preceding year and the number of those recipients for 18 whom assistance with care management was provided; 19 (2) The number of recipients of Medicaid diagnosed with 20 an autism spectrum disorder for whom assistance with care 21 management was reimbursed through Medicaid during the 22 immediately preceding year; 23 (3) The number of recipients of Medicaid for whom the 24 first claim for reimbursement for the services of a registered 25 behavior technician was submitted during the immediately 26 preceding year; 27 (4) The number of assessments or evaluations by a 28 behavior analyst that were reimbursed through Medicaid during 29 the immediately preceding year; 30 (5) The total number of claims for applied behavior 31 analysis services provided to recipients of Medicaid made during 32 the immediately preceding year; 33 (6) For the immediately preceding year, the average times 34 that elapsed between claims for each step of the process that a 35 recipient of Medicaid must undergo to receive treatment from a 36 registered behavior technician, beginning with initial diagnosis 37 with an autism spectrum disorder and, including, without 38 limitation, comprehensive diagnosis with an autism spectrum 39 disorder, evaluation and treatment by a behavior analyst and 40 treatment by a registered behavior technician; 41 (7) The number of recipients of Medicaid receiving services 42 through Medicaid managed care who were, at the end of the 43 immediately preceding year, on a wait list for applied behavior 44 analysis services; 45 (8) An assessment of the adequacy of the network of each 1 health maintenance organization or managed care organization 2 that provides services to recipients of Medicaid under the State 3 Plan for Medicaid for applied behavior analysis services, as 4 compared to the applicable standard for network adequacy set 5 forth in the contract between the health maintenance organization 6 or managed care organization and the Division; 7 (9) The number of behavior analysts and registered 8 behavior technicians who are currently providing services to 9 recipients of Medicaid who receive services through each health 10 maintenance organization or managed care organization 11 described in subparagraph (8); and 12 (10) The number of behavior analysts and registered 13 behavior technicians who provide services to recipients of 14 Medicaid who do not receive services through managed care. 15 (b) Submit the report to the Director of the Legislative Counsel 16 Bureau for transmittal to: 17 (1) In odd-numbered years, the next regular session of the 18 Legislature; and 19 (2) In even-numbered years, the Legislative Committee on 20 Health Care. 21 4. As used in this section: 22 (a) Applied behavior analysis services means the services of 23 a behavior analyst, assistant behavior analyst or registered 24 behavior technician. 25 (b) Assistant behavior analyst has the meaning ascribed to it 26 in NRS 437.005. 27 (c) Behavior analyst has the meaning ascribed to it in 28 NRS 437.010. 29 (d) Registered behavior technician has the meaning 30 ascribed to it in NRS 437.050. 31

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Teresa Benitez-Thompson (D)*,  Maggie Carlton (D)*,  Dallas Harris (D)*,  James Ohrenschall (D)*,  Christopher Brooks (D),  Carrie Ann Buck (R),  Nicole Cannizzaro (D),  Mo Denis (D),  Fabian Donate (D),  Marilyn Dondero Loop (D),  Pete Goicoechea (R),  Scott Hammond (R),  Ira Hansen (R),  Roberta Lange (D),  Dina Neal (D),  Julia Ratti (D),  Melanie Scheible (D),  Heidi Seevers Gansert (R),  James Settelmeyer (R),  Pat Spearman (D), 

Approved by the Governor. Chapter 394. (on 06/04/2021)

Official Document