§ 26-18-407. Medicaid waiver for autism spectrum disorder. (Effective 5/13/2014)

(1) As used in this section:

(a) "Autism spectrum disorder" is as defined by the most recent edition of the Diagnostic and Statistical Manual on Mental Disorders or a recent edition of a professionally accepted diagnostic manual.

(b) "Program" means the autism spectrum disorder program created in Subsection (3).

(c) "Qualified child" means a child who is:

(i) at least two years of age but less than seven years of age; and

(ii) diagnosed with an autism spectrum disorder by a qualified professional.

(2) The department shall apply for a Medicaid waiver with the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services to implement, within the state Medicaid program, the program described in Subsection (3).

(3) The department shall offer an autism spectrum disorder program that:

(a) as funding permits, provides treatment for autism spectrum disorders to qualified children; and

(b) accepts applications for the program during periods of open enrollment.

(4) The department shall:

(a) convene a public process with the Department of Human Services to determine the benefits and services the program shall offer qualified children that considers, in addition to any other relevant factor:

(i) demonstrated effective treatments;

(ii) methods to engage family members in the treatment process; and

(iii) outreach to qualified children in rural and underserved areas of the state; and

(b) evaluate the ongoing results, cost, and effectiveness of the program.

(5) The department shall annually report to the Legislature's Health and Human Services Interim Committee before each November 30 while the waiver is in effect regarding:

(a) the number of qualified children served under the waiver;

(b) success involving families in supporting treatment plans for autistic children;

(c) the cost of the program; and

(d) the results and effectiveness of the program.

Amended by Chapter 302, 2014 General Session