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Resources for Addressing Insurer Claims
regarding ABA

 

 

  • Richard Saffran is "the father of a school-age child who has autism."  His webpages are "a collection of Internet and other resources which parents of children with PDD, PDD-NOS, autism, Asperger's Syndrome, or hyperlexia may find useful."

    • "All the information concerns teaching methods that are a branch of applied behavior analysis (ABA) called behavioral intervention. One of the methods is discrete trial training. Some (inaccurately) use the term "Lovaas method."  We worked hard to get complete information, implement a program, and have our school system pay for it. My hope is to help spare other parents (and their children) some of the pain and wasted time we went through, and to provide resources for professionals who are passionate about special education. Here is what I've learned, and what I've found."

 

 

 

  • The National Academy of Sciences Commission on Behavioral and Social Sciences and Education published the seminal work on what the science does and does not say about educating children with Autism in their 2001 book: Educating Children with Autism.  We at Reinforcement Unlimited, LLC urge every parent and service provider to read this critically important work.  To facilitate this we have added a link so that you can read the book for free.  NAS offers access to this book via a program called "open book" which allows you to read the entire work online at the National Academies Press website.  "The Open Book page image presentation framework is not designed to replace printed books. Rather, it is a free, browseable, nonproprietary, fully and deeply searchable version of the publication which we can inexpensively and quickly produce to make the material available worldwide."

 

  • Insurance Help for Autism  is specific to California but may be of help to parents in other states who are going though the same issues of seeking ABA and other appropriate therapies for their child in the Autism Spectrum and finding little help and some opposition. 
    • "This website was created as a starting point to help California parents obtain insurance coverage for autism related therapies, which include, but are not limited to: Applied Behavioral Analysis (ABA), Speech therapy, Occupational therapy, Physical therapy, etc. This is based on our personal experience getting coverage for our son's various therapies. I am just a mom and have no legal training or background in the insurance industry. My statements and advice are not intended to replace your own research. I have included copies of the documents that helped us along the way. This may not help everyone, but I hope that it gives you the information and tools you will need to obtain insurance coverage for your child."

 

 

  • The National Conference of State Legislatures has a report available on State Laws Mandating or Regulating Mental Health Benefits that was updated: July 2007. 
    • The webpage includes a state mental health statute chart that has links to the various state law codes online where available and appears to be kept relatively up-to-date.

 

 

  • "In a case involving therapies for a child diagnosed with Autism, a health insurance plan administrator acted arbitrarily and capriciously in denying coverage of autism- related speech, integrated sensory, and occupational therapies for a plan participant's son , the U.S. District Court for the Northern District of Illinois ruled July 21, 2003 (Wheeler v. Aetna Life Insurance Co., N.D. Ill., No. 01 C 6064, 7/21/03)."  The entire text of this ruling is available online.

 

  • Autism Insurance Information listserv on Yahoo.
    • "Autism Insurance Information is a collaborative environment in which families, professionals and volunteers share information regarding insurance coverage for procedures and treatments for autism and concurrent disorders. Discussions, resources and encouragement are the main focus of this group. The emphasis of this group is develop a positive and constructive problem solving arena for families to address the provision of services for children through appropriate financial means."

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