WSR 24-11-043
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed May 9, 2024, 10:08 a.m., effective June 9, 2024]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The health care authority (agency) is amending WAC 182-531A-0900 Applied behavior analysis (ABA)—Covered services, to specify that the agency's applied behavior analysis program does not pay for services provided by a client's parent, guardian, caregiver, or other support person.
Citation of Rules Affected by this Order: Amending WAC 182-531A-0900.
Adopted under notice filed as WSR 24-08-053 on March 29, 2024.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: May 9, 2024.
Wendy Barcus
Rules Coordinator
OTS-5218.2
AMENDATORY SECTION(Amending WSR 22-08-035, filed 3/29/22, effective 4/29/22)
WAC 182-531A-0900Applied behavior analysis (ABA)—Covered services.
(1) The medicaid agency covers only the following applied behavior analysis (ABA) services, delivered in settings described in WAC 182-531A-0600, for eligible clients:
(a) The ABA assessments that determine the relationship between environmental events and the client's behaviors;
(b) The direct provision of ABA services by the therapy assistant (TA) or lead behavior analysis therapist (LBAT);
(c) Initial ABA assessment and development of a written, initial ABA therapy treatment plan, limited to one per year;
(d) Up to four additional ABA assessments and revisions of the initial ABA therapy treatment plan per year, if necessary to meet client's needs;
(e) One lifetime authorization of day treatment services. If a provider's request for covered services exceeds limitations in this section, the agency evaluates the request under WAC 182-501-0169.
(f) Supervision of the TA;
(g) Training and evaluation of family members or caregivers to carry out the approved ABA therapy treatment plans;
(h) Observation of the client's behavior to determine the effectiveness of the approved ABA therapy treatment plan; and
(i) On-site assistance in the event of a crisis.
(2) The agency covers the following services, which may be provided in conjunction with ABA services under other agency programs:
(a) Counseling;
(b) Dietician services;
(c) Interpreter services;
(d) Occupational therapy;
(e) Physical therapy;
(f) Speech and language therapy; and
(g) Transportation services.
(3) The agency does not ((authorize payment of))pay for ABA services:
(a) That duplicate services provided in another setting; or
(b) That are provided by a family member.
(4) If a provider's request for covered services exceeds limitations in this section, the agency evaluates the request under WAC 182-501-0169.