In a major legal victory for Nebraska families, a state court judge, John Colborn, has ruled that Nebraska is obligated to cover medically necessary treatments for children affected with autism. An estimated one-third of all children with autism receive primary coverage through Medicaid.
In 2014, the Centers for Medicare & Medicaid Services (CMS) reaffirmed states’ obligations to cover medically necessary treatments for children with autism enrolled in Medicaid. The federal agency directed the states to cover medically necessary treatments for autism for children and young adults, including behavioral health treatments such as Applied Behavior Analysis (ABA).
The CMS announcement made clear that autism treatment must be addressed under Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, which cover Medicaid-eligible children up to the age of 21.
“We are pleased that District Judge John Colborn resoundingly affirmed that the state Medicaid agency must provide the full range of of medically necessary services children and their families need and are entitled to by law, , including Applied Behavior Analysis,” said Dan Unumb, Esq., the Executive Director of the Autism Speaks Legal Resource Center. “We will continue to work with families across the country to make sure children have access to these life-changing treatments.
If your family has been denied medically necessary treatment (including ABA) under Medicaid, please contact the Autism Response Team at 888-288-4762 (en Espanol 888-772-9050) or by email at email@example.com or visit the Autism Speaks Legal Resource Center or the National Disability Rights Network to get information about accessing Medicaid benefits.