Autism advocates presented their case for applied behavior analysis last week to an Oregon evidence-based medicine review panel, whose recommendation can make or break the ability of autistic Oregonians to receive the therapy under the Oregon Health Plan.
The approval faces a high hurdle: a staff member for the Center for Evidence-Based Policy at Oregon Health & Science University, Dr. Alison Little, has testified nationally against the psychotherapy for autistic children, including a Florida case in March 2012.
She testified on behalf of Florida’s Medicaid program, which had denied coverage for ABA. But in a sharp ruling, U.S. District Court Judge Joan Lenard in Miami immediately ordered the state to begin coverage for people up to 21, calling the state’s opposition to ABA “unreasonable and arbitrary and capricious.”
Little advises the subcommittee for Oregon’s Health Evidence Review Commission, which will recommend whether the state will cover applied behavior analysis for the nearly 400,000 children on the Oregon Health Plan.
A previous panel rejected applied behavior analysis coverage for the Oregon Health Plan in 2008, but this time, a strong appeal from the Legislature, led by osteopathic physician and Sen. Alan Bates, D-Medford, has forced the panel and its parent body, the Health Evidence Review Commission to reconsider.
The Legislature unanimously passed SB 365 into law, requiring all private health insurance companies to cover ABA for kids up to 9 by 2016, as well as health plans for public employees and teachers by 2015. The law keeps the door open for older children if a specialist approves the therapy.
But for the 44 percent of Oregon children on the Oregon Health Plan, the decision rests with the evidence commission, which will decide whether to recommend the therapy for its prioritized list of health services.