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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."
-
by Louis P. Hagopian & Eric W.
Boelter of The Kennedy Krieger Institute and Johns Hopkins University School
of Medicine
- Provides information that is intended to support the
argument to any agency (e.g., school, insurance company, etc.) that ABA
is both the best research supported method for treating Autism and
definitely not experimental.
-
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 Connecticut
General Assembly, in 2006, commissioned a report, by
Janet L. Kaminski, Associate Legislative Attorney,
on what other states had enacted into law regarding
Insurance Coverage for service related to Autism Spectrum Disorders.
- Based on the report: "Sixteen
other states (besides CT) have insurance laws relating to autism
coverage (California, Georgia, Illinois, Indiana, Iowa, Kansas,
Kentucky, Louisiana, Maine, Maryland, Montana, New Hampshire, New
Jersey, New York, Tennessee, and Virginia). Of these, 10 require
coverage for autism through their laws mandating coverage for mental
illness (California, Illinois, Iowa, Kansas, Louisiana, Maine, Montana,
New Hampshire, New Jersey, and Virginia). The other six states have
specific laws regarding insurance coverage for autism (Georgia, Indiana,
Kentucky, Maryland, New York, and Tennessee)."
- 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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