ARC 3619C
HUMAN SERVICES DEPARTMENT[441]
Notice of Intended Action
Proposing rule making related to eligibility to participate in autism support program and providing an opportunity for public comment
The Department of Human Services hereby proposes to amend Chapter 22, “Autism Support Program,” Iowa Administrative Code.
Legal Authority for Rule Making
This rule making is proposed under the authority provided in Iowa Code section 225C.6 and 2017 Iowa Acts, House File 215.
State or Federal Law Implemented
This rule making implements, in whole or in part, Iowa Code section 225C.6 and 2017 Iowa Acts, House File 215.
Purpose and Summary
The proposed amendments bring the rules in Chapter 22 into alignment with 2017 legislative changes to Iowa Code chapter 225D.  2017 Iowa Acts, House File 215, requires certain health insurance policies, contracts, or plans to provide coverage of applied behavior analysis (ABA) treatment for certain individuals with autism spectrum disorder.  Individuals who gain private insurance as a result of this legislation will no longer be eligible for participation in the Autism Support Program (ASP).
Fiscal Impact
This rule making does not result in any additional costs to the Department. It may result in some reduction to the costs of the ASP, which is funded with 100 percent state dollars, but savings are expected to be less than $100,000 annually.
Jobs Impact
After analysis and review of this rule making, no impact on jobs has been found.
Waivers
Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).
Public Comment
Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 6, 2018. Comments should be directed to:

Harry Rossander	
Bureau of Policy Analysis	
Department of Human Services	
Hoover Building, Fifth Floor	
1305 East Walnut Street	
Des Moines, Iowa 50319	
Fax: 515.281.4980	
Email: policyanalysis@dhs.state.ia.us	
Public Hearing
No public hearing is scheduled at this time. An oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, an agency, or an association of 25 or more persons as provided in Iowa Code section 17A.4(1)“b.”
Review by Administrative Rules Review Committee
The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).
The following rule-making actions are proposed:
	Item 1. Amend rule 441—22.1(225D), definition of “Eligible individual,” as follows:
“Eligible individual” means a child less than 14 years of age who has been diagnosed with autism based on a diagnostic assessment of autism, is not otherwise eligible for coverage for applied behavioral analysis treatment or applied behavior analysis treatment under the medical assistance program, Iowa Code section 514C.28, Iowa Code section 514C.31, or private insurance coverage, and whose household income does not exceed 500 percent of the federal poverty level.
	Item 2. Amend subrule 22.2(4) as follows:
	22.2(4) An individual shall be determined ineligible for coverage of applied behavioral analysis services under the medical assistance program, Iowa Code section 514C.28, Iowa Code section 514C.31, or other private insurance coverage. Proof of insurance coverage and noneligibility for coverage for applied behavioral analysis shall be provided at the time of application and shall include a written denial of coverage or a benefits summary indicating that the applied behavioral analysis treatment or applied behavior analysis treatment is not a covered benefit for which the applicant is eligible under the Medicaid program, Iowa Code section 514C.28, Iowa Code section 514C.31, or other private insurance coverage.