MEDI-CAL BHT SERVICES 2015

1.An RC client (under 21) must have a psychological evaluation that gives them the diagnosis of ASD. 2.In the future there will have to be a recommendation for ABA on the psychological evaluation if during the session it becomes clear that ABA is necessary. 3.If there is no recommendation for ABA on the psychological evaluation, in the future, we will have forms available that can be filled out by an RC psychologist that substantiates the need for ABA, including the DX if necessary. GENERAL INFORMATION FOR ALL MEDI-CAL HEALTH PLANS

MEDI-CAL LA CARE (CONT.) ANTHEM BC KAISER An individual who has had a comprehensive evaluation by a licensed psychologist, psychiatrist, or MD, with an ASD, and not currently receiving BHT/ABA services should contact: Intake: Option 1 then Option 2 (case will be opened and a provider suggested) Intake Intake fax: A client who is with RC and has a diagnosis of ASD should contact Kaiser/Medi- Cal member services to request ABA services. I

MEDI-CAL LA CARE LA CARE A client who is with RC, has had a comprehensive evaluation by a licensed psychologist, psychiatrist, or MD, with an ASD, and not currently receiving ABA services should contact: Masha Heshri xt 5381 See Teresa for form to have psychologist fill out and send to LA Care if Evaluation does not have BHT recommended CARE 1ST A client who is with RC, has had a comprehensive evaluation by a licensed psychologist, psychiatrist, or MD, with an ASD, and not currently receiving ABA services should contact:

MEDI-CAL HEALTH NET HEALTH NET A client who is with RC, has had a comprehensive evaluation by a licensed psychologist, psychiatrist, or MD, with an ASD, and not currently receiving ABA services should contact: Health Net’s Service MOLINA A client who is with RC, has had a comprehensive evaluation by a licensed psychologist, psychiatrist, or MD, with an ASD, and not currently receiving BHT services should contact: Maria Vargas ext

OTHER SCENARIOS RC client and medi-cal subscriber. RC funded ABA previously and discontinued service. Client now wants to resume ABA because of returning or new behaviors. At this time RC will fund ABA services. RC client and medi-cal subscriber. Is currently receiving ABA services funded by RC. At this time RC will continue to fund ABA services. EXCEPTION: Kaiser is contacting their subscribers with ASD to see if they are receiving ABA services. If they are, Kaiser is beginning the process to transfer to Easter Seals. RC client and has straight medi-cal. At this time RC will fund ABA services.