Iowa Department of Human Services addresses barriers to care for children with autism on Medicaid

March 23, 2021

Autism Speaks, along with other partners and advocates, has been working to reduce barriers to care for Iowa children with autism covered by Medicaid. Thanks to these joint advocacy efforts, the Iowa Department of Human Services will be taking action to ensure equitable access to care for children with autism.

In Iowa, children with autism who are on Medicaid are eligible for therapies including applied behavior analysis (ABA). This is in accordance with Medicaid's Early Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit which states that children under the age of 21 are entitled to any treatment, procedure or service that is medically necessary to address health conditions of a child.

Unfortunately, the state of Iowa currently places a burdensome requirement upon providers of ABA services. This unnecessary requirement is related to credentials under Medicaid that behavior technicians (BTs) must possess, which are not required within Iowa’s private insurance autism regulation. This is causing autistic children on Medicaid and their families to sometimes have reduced access to this medically-necessary treatment. 

Autism Speaks has been advocating within the state government, along with partners and other advocates, to close this inequity by eliminating the burdensome BT requirement. The Iowa Department of Human Services has recently agreed to file a Medicaid state plan amendment that would accomplish this change. We are thankful for and applaud their action to advance greater access to autism therapies and treatments. We will continue to update the community as these changes rollout.

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