AUTISM SPECTRUM DISORDER; REEVALUATION                                              H.B. 4059:

                                                                                                    SUMMARY OF BILL

                                                                                                  ON THIRD READING

House Bill 4059 (as reported by the Committee of the Whole)

Sponsor:  Representative Pauline Wendzel

House Committee:  Health Policy

Senate Committee:  Health Policy and Human Services

CONTENT

The bill would amend the Public Health Code to specify that if an initial evaluation was completed by a qualified licensed practitioner, a child with a confirmed diagnosis of autism spectrum disorder would not be required to have a re-evaluation to determine continued eligibility for behavioral health treatment unless a re-evaluation was medically necessary.

"Qualified licensed practitioner" would mean one of the following:

-- A physician with a specialty in psychiatry or neurology.

-- A physician with a subspecialty in developmental pediatrics.

-- A physician with a specialty in pediatrics or other appropriate specialty with training, experience, or expertise in autism spectrum disorder or behavioral health.

-- A psychologist with a specialty in clinical child psychology, behavioral and cognitive psychology, or clinical neuropsychology, or other appropriate specialty with training, experience, or expertise in autism spectrum disorder or behavioral health.

-- A clinical social worker with at least one year of experience working within his or her scope of practice who is qualified and experienced in diagnosing autism spectrum disorder.

-- An advanced practice registered nurse with training, experience, or expertise in autism spectrum disorder or behavioral health.

-- A physician's assistant with training, experience, or expertise in autism spectrum disorder or behavioral health.

Proposed MCL 400.109n                                          Legislative Analyst:  Stephen Jackson

FISCAL IMPACT

The bill would have a marginal impact on Medicaid costs for autism services. Reducing the number of re-evaluations would reduce program costs by a small amount relative to overall spending. Reducing the number of re-evaluations for those receiving services could, in cases in which the original evaluation was inaccurate, lead to increases in spending on services.

Date Completed:  10-21-21                                              Fiscal Analyst:  Steve Angelotti

This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.