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MEDICAL SERVICES POLICY MANUAL,SECTION C C-200 Alternative Application Processes

C 220 Autism Waiver Application Process

• If the child no longer resides in the State of Arkansas • If the child dies during the 12-month coverage period

C-220 Autism Waiver Application Process MS Manual 07/01/20 1915 (c) of the Social Security Act The Autism Waiver program is operated by a contracted entity under the administrative authority of the Division of Medical Services. The Autism Waiver brochure and the telephone number for the contractedentity are available at local DHS County offices. Interested individuals should contact Partners for more information or to start the application process. To apply for services, the child must be between eighteen months and five years old. A child five years and one day old is over the age limit for application. If approved, coverage will be for a minimum of two years and a maximum of three years. The three-year coverage period starts on the first (1st) date of a billable service by a provider. If coverage has not ended prior to the child’s eighth birthday, coverage will end the day before the child’s eighth birthday.

C-230 TEFRA Application Process MS Manual 07/01/20 P.L. 97-248 TEFRA applications (DCO-9700) will be available at local DHS offices or by mail, through hospitals, including Arkansas Children’s Hospital, and Federally Qualified Health Centers. Information will be available through the Division of Developmental Disabilities (DDS) Services Coordinators and Providers. Information will also be available on the DHS/DMS website. To complete the eligibility determination, the following steps must be completed: • The application must be made by an adult responsible for the care of the child. • A DMS 2602, Physician’s Assessment of Eligibility, must be completed by the child’s physician to determine Medical Necessity and Appropriateness of Care. If disability has not previously been established by the Social Security Administration, a Medical Review Team (MRT) disability review must be completed.