TARGET SERVICE GROUP AND ELIGIBILITY CRITERIA FOR SERVICES. The target service group and eligibility criteria for Medicaid Managed Specialty Supports and Services, the Healthy Michigan Program and Substance Use Disorder Community Grant services hereunder are as specified in the MDHHS/PIHP Contract, which is incorporated by reference into this agreement and made a part hereof.
TARGET SERVICE GROUP AND ELIGIBILITY CRITERIA FOR SERVICES. The target group for the ABA benefit includes CONSUMERs from birth through twenty (20) years of age, ending on the 21st birthday with a diagnosis of Autism Spectrum Disorder (ASD) based upon a medical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of ASD, who have the developmental capacity to clinically participate in the available interventions covered by the benefit, and who have Medicaid insurance. A well-established DSM-5 diagnosis of Autistic Disorder, Asperger’s Disorder or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) should be given the diagnosis of ASD. In addition, only CONSUMERs who have received an independent needs-based evaluation, , is eligible to receive ABA.
