Iowa Admin. Code r. 441-22.5 - Initial service authorization and renewal of service authorization
(1) All services
reimbursed through the program shall be prior-authorized by the
administrator .
(2) An autism
service provider shall submit an initial treatment plan to the administrator
specifying a plan of treatment for a period of no more than six months. The
initial treatment plan shall specify the amount of units of applied behavioral
analysis services requested for the eligible individual and include a baseline
standardized assessment score.
(3)
Family engagement and participation are required for participation in the
autism support program . Treatment plans shall identify specific activities and
responsibilities of parents or guardians in the treatment plan .
(4) The treatment plan shall reflect the
autism service provider 's engagement with the school in which the eligible
individual is enrolled. Treatment plans shall identify specific actions taken
by the autism service provider to engage the eligible individual 's school and
the results of such actions.
(5)
The treatment plan may include services provided by staff with a minimum of a
bachelor's degree in a human services or education field, working under the
supervision of an autism service provider who is board-certified as a behavior
analyst. The treatment plan shall identify which services shall be provided
directly by the board-certified behavior analyst and which services shall be
provided by staff under the supervision of a board-certified behavior
analyst.
(6) For renewal or
modification of service authorizations, the autism service provider shall
submit an updated plan of treatment with a request for the number of units of
applied behavioral analysis the provider believes is medically necessary to
address the eligible individual 's ongoing treatment needs. The autism service
provider shall also provide evidence of the eligible individual 's progress on
identified treatment goals. The administrator shall consider the eligible
individual 's updated standardized assessment score along with other clinical
information when reviewing requests for renewal or modification of service
authorizations. Ongoing service authorization requests shall not exceed six
months in duration.
(7) The
administrator shall provide approval, request for modification, or denial
within five business days of receipt of all service authorization
requests.
Notes
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