Existing law requires the Aging and Disability Services Division of the Department of Health and Human Services to prescribe by regulation a statewide standard for measuring outcomes and assessing and evaluating persons with autism spectrum disorders through the age of 21 years who receive services through the State or a local government or an agency thereof. Existing law requires those regulations to designate a protocol based upon accepted best practices guidelines which includes at least one standardized assessment instrument that requires direct observation by the professional conducting the assessment for determining whether a person is a person with autism spectrum disorder. Existing law requires such direct observation to include an evaluation to measure behaviors of the person which are consistent with autism spectrum disorder, cognitive functioning, language functioning and adaptive functioning. (NRS 427A.872) Section 3 of this bill removes the requirements that the statewide standard include a specific protocol, a standardized assessment instrument and an evaluation to measure behaviors which are consistent with autism spectrum disorder. Instead, section 3 requires the statewide standard to require direct observation and an assessment to determine whether a person is a person with autism spectrum disorder. Section 3 authorizes any provider of health care acting within his or her scope of practice to conduct such direct observation and assessment. Section 4 of this bill makes similar revisions relating to early intervention services provided by the Division for children with autism spectrum disorders. Specifically, section 4: (1) replaces references to an evaluation of a child who may have autism spectrum disorder by the Division with references to an assessment of such a child; and (2) authorizes any provider of health care acting within his or her scope of practice to conduct such an assessment. Section 1 of this bill defines the term “provider of health care” for those purposes, and section 2 of this bill prescribes the applicability of that definition.
Existing law requires the Division to ensure that employees and contractors of the Division who provide early intervention services to children with autism spectrum disorders possess the knowledge and skills necessary to serve children with autism spectrum disorders, including the screening of a child for autism spectrum disorder at certain age levels and frequency. (NRS 427A.878) Section 4 specifies that such persons must possess the knowledge and skills necessary to conduct early and periodic developmental screening of a child for that purpose.
Existing law requires certain plans of health insurance, including insurance for public employees and Medicaid managed care plans, to cover screening for and diagnosis of autism spectrum disorders and for treatment of autism spectrum disorders to persons under the age of 18 years or, if enrolled in high school, until the person reaches the age of 22 years. In order for coverage of such treatment to be required, existing law requires: (1) the diagnosis to be rendered by a licensed physician or psychologist; (2) the treatment to be included in a treatment plan developed by a licensed physician or psychologist; and (3) the treatment to be provided by or under the supervision of a licensed physician, psychologist or behavior analyst. (NRS 287.0276, 287.04335, 689A.0435, 689B.0335, 689C.1655, 695C.050, 695C.1717, 695G.1645) Sections 5-10 of this bill remove requirements that, in order for such coverage to be required, the diagnosis must be rendered by specific providers of health care and the treatment plan must be developed and carried out by specific providers of health care. Instead, sections 5-10 require certain plans of health insurance to cover such diagnosis and treatment if the diagnosis, development of a treatment plan and treatment are performed by any provider of health care acting within his or her scope of practice. Sections 5-10 also require an insurer to accept as dispositive for the purposes of such coverage any diagnosis of an autism spectrum disorder that is rendered in accordance with the statewide standard prescribed pursuant to section 3.