Insurance carriers STILL not honoring Washington State Laws

For years we’ve been reporting “[U]nder the Mental Health Parity Act private insurers are required to cover medically necessary behavior therapies including Applied Behavior Analysis therapy, as well neuro-developmental therapy (speech, physical therapy, occupational therapy, sensory-motor, neuropsychological evaluation etc.).”

Furthermore, we’ve noted, Washington’s Network Adequacy Statute require health plans to ensure that enrollees are

[Continue reading...] Insurance carriers STILL not honoring Washington State Laws

Evidence Development Condition-ABA medicaid and state insurance coverage

The state of Washington Health Technologies Coverage Determination:

ABA based behavioral interventions for treatment of Autism Spectrum Disorder is a covered benefit with Evidence Development (CED)

HTCC Reimbursement Determination ␣ Limitations of Coverage

␣ Certain Applied Behavioral Analysis based behavioral interventions are a covered benefit for the treatment of Autism Spectrum Disorder

[Continue reading...] Evidence Development Condition-ABA medicaid and state insurance coverage

D.F. v. Washington State Health Care Authority

Provider Update

Please see the attached mailing that was sent to all UMP insureds who submitted health care claims with the DSM-IV diagnoses related to autism, aspergers and PDD in the last year.  Please feel free to distribute.

Please keep me informed about the responses you get to the claims submitted. The offices of Ele

[Continue reading...] D.F. v. Washington State Health Care Authority

Washington State Clinicians Committee Recommends Covering ABA For Autism

“This decision is a life-saver for many families who have a child with autism,” said Arzu Forough, a parent of two of the plaintiffs, and a representative of Autism Speaks, a national advocacy group for people with autism. “We urge the Health Care Authority to implement Judge Craighead’s decision immediately so that all children of public employees who have autism can get access to this essential therapy.”

[Continue reading...] Washington State Clinicians Committee Recommends Covering ABA For Autism

Shayan’s Law Update

Shayan’s Law was brought forward because insurance companies have not been following the letter and spirit of Washington State Mental Health Parity for individuals with autism spectrum disorders. Our collective advocacy has prompted legal experts to look into this very closely. We are awaiting the outcome of court cases testing Mental Health Parity and it’s protections for individuals with ASD’s in WA. We are prepared to block any action that will limit protection under Mental Health Parity for those with autism.

[Continue reading...] Shayan’s Law Update