Bill Text: HI SCR132 | 2023 | Regular Session | Introduced

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Bill Title: Requesting The Department Of Human Services' Med-quest Division To Take Steps Necessary To Ensure That Adequate Provider Rates Are Established For Applied Behavior Analysis Services.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2023-05-22 - Certified copies of resolutions sent. [SCR132 Detail]

Download: Hawaii-2023-SCR132-Introduced.html

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THE SENATE	S.C.R. NO.	132
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

 

 

requesting the department of human services' med-quest division to take steps necessary to ensure that adequate provider rates are established for applied behavior analysis services.

 

 

 

     WHEREAS, applied behavior analysis is a medically necessary service provided for Med-QUEST beneficiaries under the age of twenty-one with an autism spectrum disorder diagnosis; and

 

     WHEREAS, the Med-QUEST reimbursement rates for applied behavior analysis services were set in 2015 and have not increased; and

 

     WHEREAS, the State's current reimbursement rate for applied behavior analysis services, and in particular for registered behavior technicians, is below the current market rate; and

 

     WHEREAS, Medicaid agencies in other states have increased their reimbursement rates over the years while Med-QUEST reimbursement rates have remained the same; and

 

     WHEREAS, other public payors in the State, including the Department of Education and Department of Health's Developmental Disabilities Division pay higher rates for applied behavior analysis services, with the Department of Education paying a difference of $25 per hour on the neighbor islands and the Developmental Disabilities Division paying a difference of $19.45 per hour; and

 

     WHEREAS, because the American Medical Association's Current Procedural Terminology codes for applied behavior analysis services are carrier priced, the Centers for Medicare and Medicaid Services Medicare Physician Fee Schedule does not currently set rates for these services; and

 

     WHEREAS, wages in the State have increased by thirty percent since 2015, forcing applied behavior analysis service providers to shoulder increased staff costs without a proportionate rate increase; and

 

     WHEREAS, applied behavior analysis service providers across the State have reported an inability to meet the demand for services by Med-QUEST beneficiaries, largely due to difficulty in hiring and retaining providers given the State's high cost of living and the demand for increased wages; and

 

     WHEREAS, families who have been able to access services report not being able to access the full amount of services recommended for their child due to a lack of providers; and

 

     WHEREAS, families also report significant delays in timely access to services and being placed on years long waitlists for services; and

 

     WHEREAS, research demonstrates that early intensive intervention and the provision of services in line with professional standards of care produces the best outcomes for individuals and can decrease the cost of care over the individual's lifetime; and

 

     WHEREAS, under federal law, all covered Medicaid services must be provided with "reasonable promptness"; and

 

     WHEREAS, as part of the Early and Periodic Screening, Diagnostic and Treatment benefit established pursuant to Section 1905(r) of the Social Security Act, Medicaid agencies must employ processes to ensure timely initiation of treatment; now, therefore,

 

     BE IT RESOLVED by the Senate of the Thirty-second Legislature of the State of Hawaii, Regular Session of 2023, the House of Representatives concurring, that the Department of Human Services' Med-QUEST Division is requested to take steps necessary to ensure that adequate provider rates are established for applied behavioral analysis services; and

 

     BE IT FURTHER RESOLVED that the Med-QUEST Division is further requested to assess current reimbursement rates for applied behavior analysis services; and

 

     BE IT FURTHER RESOLVED that the Med-QUEST Division is requested to submit a report of its findings and recommendations on appropriate reimbursement rate increases, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2024; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Human Services and Administrator of the Med-QUEST Division.

 

 

 

	OFFERED BY:	_____________________________

Report Title: 

Applied Behavioral Analysis; Reimbursement Rates; Med-QUEST