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Wednesday, July 6, 2011

Insurance in Washington State

The Seattle Times reports on developments in Washington State:
Two recent events come as good news for parents of children with autism — some of whom have struggled to pay for an expensive therapy not now covered by state-funded insurance plans.

In a case involving three children with autism-spectrum disorders, a judge has ruled that state coverage plans can't impose a blanket exclusion on the therapy, Applied Behavioral Analysis (ABA).

And a state panel has voted to cover — with qualifications — the two most promising types of ABA therapy. The panel decides what treatments the state should cover for state employees, injured workers and people on Medicaid.
In the first, King County Superior Court Judge Susan Craighead last month ruled that the state Health Care Authority's blanket exclusion conflicts with the state's Mental Health Parity Act. That act says mental-health treatments must be covered like physical-health treatments, when medically necessary for a patient.

The court has not yet decided on the case's class-action status.

More recently, the state's Health Care Technology Clinical Committee voted 7-2 that while effectiveness of ABA is unproved, two of six types of the therapy should be covered, so long as the children are enrolled in a research trial.

The committee will provide details about that requirement after seeking advice from experts.