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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
SENATE BILL 1420 By: Rosino
AS INTRODUCED
An Act relating to the state Medicaid program;
amending 56 O.S. 2021, Section 1011.12 , which relates
to state plan amendment for applied behavior analysis
treatment; removing obsolete language; broadening
scope of state plan amendment; describing treatment;
removing and adding definitions; modifying
applicability of certain provisions; providing an
effective date; and declaring an emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 56 O.S. 2021, Section 1011.12, is
amended to read as follows:
Section 1011.12. A. The Oklahoma Health Care Authority, in
conjunction with the Department of Mental Health and Substance Abuse
Services, the State Department of Health and the State Department of
Education shall examine the feas ibility of a state plan amendment to
the Oklahoma Medicaid Program for applied behavior analysis
treatment of autism spectrum disorders .
B. On or before December 31, 2016, the Auth ority and partnering
agencies shall submit a report to the President Pro Tempore of the
Senate, the Speaker of the House of Representatives and the Governor
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estimating the poten tial costs to the state, clinical findings,
reviews of pilot projects and research from other states on the
effects of applied behavioral analysis treatme nt on autism spectrum
disorders.
C. 1. Beginning July 1, 2017, and subject Subject to the
availability of funding, the Authority and partnering agencies shall
draft a state plan a mendment for applied behavior analysis treatment
of individuals diagnosed with an intellectual or developmental
disability including, but not limited to, an autism spectrum
disorders. The provisions of this subsection shall only apply if
the report required by subsection B of this section demonstrates
applied behavioral analysis treatment to be evidence -based and
essential to qualifying participants in the Oklahoma Medicaid
Program disorder.
2. Treatment described in paragraph 1 of this subsection shall
consist of evidence-based care and related equipment prescribed or
ordered for an individual diagnose d with an intellectual or
developmental disability including, but not limited to, an autism
spectrum disorder by a licensed physician or a licensed doctoral -
level psychologist who determines the care to be medically necessary
including, but not limited to:
a. behavioral health treatment,
b. pharmacy care,
c. psychiatric care,
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d. psychological care, and
e. therapeutic care.
D. As used in this section:
1. “Applied behavior analysis ” means the design, implementation
and evaluation of environmental modifications, using behavioral
stimuli and consequences, to produce socially significa nt
improvement in human behavior, including the use of direct
observation, measurement and functional analysis of the relationship
between environment and behavior;
2. “Autism spectrum disorder ” means any of the pervasive
developmental disorders or autism spectrum disorders as defined by
the most recent edition of the Diagnostic and Statistical Manual of
Mental Disorders (DSM) or the edition that was in effect at the time
of diagnosis;
3. “Behavioral health treatment ” means counseling and treatment
programs, including applied behavior analysis, that are:
a. necessary to develop, maintain or restore, to the
maximum extent practicable, the functioning of an
individual, and
b. provided by a board-certified behavior analyst or by a
licensed doctoral-level psychologist so long as the
services performed are commensurate with the
psychologist’s university training and supervised
experience; and
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4. “Treatment for autism spectrum disorder ” means evidence-
based care and related equipment prescribed or ordered for an
individual diagnosed with an autism spectrum disorder by a licensed
physician or a licensed doctoral -level psychologist who determines
the care to be medically necessary, including, but not limited to:
a. behavioral health treatment,
b. pharmacy care,
c. psychiatric care,
d. psychological care, and
e. therapeutic care
“Intellectual or developmental disability ” means a condition
characterized by significant limitations in both intellectual
functioning and adaptive behavior that originates before the age of
twenty-two.
SECTION 2. This act shall become effective July 1, 2024.
SECTION 3. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and after its pas sage and approval.
59-2-3245 DC 12/15/2023 3:52:54 PM