(CBS SF) — Thousands of children enrolled in Medi-Cal, the state’s health plan for the poor, are now eligible to receive treatment for autism spectrum disorders in an effort to level the playing field for kids from families unable to afford the expensive therapy.

California is one of the first states to respond to a recent rule by the U.S. Centers for Medicare and Medicaid Services that requires therapy using intensive drills and rewards to teach kids how to communicate and interact socially to be covered for low-income people 21 and under.

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Kristin Jacobson, with Burlingame-based Autism Deserves Equal Coverage, told Kaiser Health News the additional coverage will give Medi-Cal beneficiaries, “access to this treatment that can help these children reach their potential.”

Roughly 1 in 68 kids in the country have been diagnosed with autism spectrum disorder, according to the Centers for Disease Control and Prevention.

Last year, the state Department of Developmental Services spent roughly $88 million on behavioral treatment for about 7,500 children believed to be eligible for Medi-Cal. Autism advocates say the state could be covering up to 6,000 additional children thanks to the new rule.

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Some observers say this new influx of kids now eligible for autism therapy could overwhelm an already bloated state healthcare system. But officials said California plans to control some of those costs by setting fixed rates for treatment.

The Department of Health Care Services is still working to define the services, set up reimbursement rates and determine exactly how many children may be eligible. A meeting is scheduled for Oct. 16 in Sacramento.


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