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Saturday, December 17, 2011

ABA and the Health Care Law

Previous posts have dealt with coverage of ABA in the new federal health care law. Now, from Autism Speaks:

Autism Speaks, the nation's largest autism advocacy organization, expressed optimism with today’s announcement by the U.S. Department of Health and Human Services (HHS) 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 giving states flexibility in determining benefits,” said Lorri Unumb, Esq., vice president for state government affairs. “Entering 2012, 29 states representing 70 percent of the U.S. population have already made that decision and it is to require coverage of autism benefits. Today’s guidance gives states the freedom to maintain the coverage they have designed for their citizens without having to defray costs for 'excess' benefits.”
Under the Patient Protection and Affordable Care Act of 2010, the HHS was directed to determine an "essential health benefits" package that would be offered in the individual and small group markets, both inside and outside of the Affordable Insurance Exchanges created under the law that begin operation in 2014. HHS, in its decision announced today, gave the states the flexibility to choose from four types of health plans in establishing a benchmark for what services should be covered.

"Autism Speaks is optimistic this will enable states to continue to provide comprehensive autism therapies, such as ABA, as part of their essential health benefits package," Unumb said. In the 29 states which have enacted autism insurance reform, Unumb said, most of the four plans would cover behavioral health treatments, such as ABA.
“We have worked hard to give families the access they need to necessary therapies and have succeeded in a majority of states,” said Unumb, who also teaches autism law at George Washington University Law School. “We intend to work hard to protect those successes and to fight for autism insurance laws in even more states in 2012 to end insurance industry discrimination against families dealing with autism.”