By no later than December 31 of each year the Department of Healthcare and Family Services (HFS) shall submit a report, covering the State fiscal year immediately preceding that date, to the General Assembly regarding access to applied behavior analysis therapy for persons diagnosed with autism spectrum disorder. The report shall include, but is not limited to, the following information:
(1)The number of providers enrolled in the Illinois Medical Assistance Program certified to provide applied behavioral analysis therapy services in the Department of Healthcare and Family Services' fee-for-service or managed care service delivery system, in accordance with administrative rule and Department of Healthcare and Family Services policy.
(2)The number of HFS-enrolled children in Illinois with
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By no later than December 31 of each year the Department of Healthcare and Family Services (HFS) shall submit a report, covering the State fiscal year immediately preceding that date, to the General Assembly regarding access to applied behavior analysis therapy for persons diagnosed with autism spectrum disorder. The report shall include, but is not limited to, the following information: (1) The number of providers enrolled in the Illinois Medical Assistance Program certified to provide applied behavioral analysis therapy services in the Department of Healthcare and Family Services' fee-for-service or managed care service delivery system, in accordance with administrative rule and Department of Healthcare and Family Services policy. (2) The number of HFS-enrolled children in Illinois with an autism spectrum disorder diagnosis receiving applied behavior analysis therapy services pursuant to the Department of Healthcare and Family Services' fee-for-service or managed care service delivery system. (3) Subject to data availability, the number of HFS-enrolled children with an autism spectrum disorder diagnosis for whom applied behavioral analysis therapy services have been recommended or requested, but who are not receiving applied behavioral analysis therapy services. (4) Subject to data availability for HFS-enrolled children in Illinois with an autism spectrum disorder diagnosis, the number of prior authorization service denials for applied behavioral analysis therapy services and the number of appeals resulting from those denials for applied behavioral analysis therapy services. (5) Recommendations on improving applied behavioral analysis therapy provider network adequacy and enrollee access.