1. Program Definition and Services Provided 

Autism-specific services in Montana include Applied Behavior Analysis (ABA) therapy, speech and language therapy, respite services, habilitation services, and parent training programs. These services aim to support individuals with autism spectrum disorder (ASD) by enhancing communication, social interaction, and adaptive behaviors. 

2. Regulations 

Key regulations governing autism-specific services include: 

• Mont. Code Ann. § 33-22-515: This statute requires health insurance coverage for the diagnosis and treatment of ASD, including ABA therapy when medically necessary. 

• Montana Medicaid Applied Behavior Analysis Services: These services are covered under Medicaid for children with ASD, emphasizing early intervention and treatment flexibility. 

3. Licensing or Certification 

To provide autism-specific services, particularly ABA therapy, providers must ensure that services are delivered or supervised by a Board-Certified Behavior Analyst (BCBA). Certification in areas like speech therapy or occupational therapy is also necessary for respective services. 

4. Responsible State Agency 

The Montana Department of Public Health & Human Services (DPHHS) oversees Medicaid coverage for autism services, including ABA therapy. 

5. Application Process 

For providers interested in offering Medicaid-covered ABA services, they must enroll as Medicaid providers. This involves submitting an application through the state's Medicaid enrollment process. 

6. Required Documentation 

For Medicaid provider enrollment: 

• Completed application form 

• Proof of certification (e.g., BCBA for ABA services) 

• Proof of liability insurance 

• Staff training records 

For clients seeking services: 

• Proof of ASD diagnosis 

• Medicaid eligibility documentation 

7. Timeline for Approval 

The timeline for Medicaid provider enrollment can vary, depending on the completeness of the application and compliance with state regulations. 

8. Pre-Application Process 

There is no specific pre-license application process, but providers must ensure they meet Medicaid enrollment criteria. 

9. Pre-Application Training 

While not mandated, training in ABA and autism-specific interventions can enhance provider expertise. 

10. Additional Notes 

• Montana's Medicaid program has expanded eligibility and treatment flexibility for ABA services, aiming to increase access to necessary treatments for children with ASD 

• Organizations like AACT Montana offer in-home ABA services, emphasizing personalized care plans and family involvement