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Last October California formally ended autism insurance discrimination by passing SB 946 requiring insurance companies and health care service plans to provide coverage of medically necessary treatments for autism as a medical benefit. California Insurance Commissioner Dave Jones applauded passage of the bill within days of passage. ”Behavioral therapy is widely considered to be an [Continue reading...] California BlueShield ABA settlement with Dept. of Insurance Late last week U.S. Department of Health and Human Services (HHS) indicated they will be permitting states to maintain coverage for autism behavior therapies, such as Applied Behavior Analysis (ABA), as part of their essential health benefits package when provisions of the new federal health care law take effect in 2014. “HHS has committed to [Continue reading...] “Essential Health Benefits” Bulletin – Good news for autism! Will Washington state go green? 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 Medicaid Personal Care The Medicaid Personal Care Program includes hands-on, in-home services provided to those who aremedically and financially eligible. A medical assessment is completed. Services are provided by Personal Care agencies; these agencies must have an approved certificate of need, (not all have well qualified providers for ASD’s). Services provided in Personal Care include assistance with(more [Continue reading...] MTE v. DSHS – Orders DSHS to authorize MPC hours for eligible children The 6th Annual Autism Law Summit, dedicated to the passage, implementation and enforcement of meaningful autism insurance reform across the nation convened last week at the University of Utah’s Susan J. Quinney School of Law. Lorri Unumb, Autism Speaks VP of State Government Affairs, facilitated the Summit, as she has for the past six [Continue reading...] Autism insurance coverage, family-by-family, plan-by-plan and state-by-state 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 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 “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 Medicaid Personal Care The Medicaid Personal Care Program includes hands-on, in-home services provided to those who are medically and financially eligible. A medical assessment is completed. Services are provided by Personal Care agencies; these agencies must have an approved certificate of need, (not all have well qualified providers for ASD’s). Services provided in Personal Care [Continue reading...] Update-Medicaid Personal Care for eligible children with ASD’s |
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