Getting Insurance Coverage

One of the biggest struggles a number of families face is getting insurance coverage for ABA therapy. Speech therapy and occupational therapy are often approved despite the lack of data of their effectiveness compared to ABA.

Why?
There are a few thoughts on this. Often speech or occupational therapy only recommended at 30minutes to 2 hours a week. This is much less than the 20-40 hours of recommended ABA.

But State Laws Have Been Passed!
There are many states which have state laws requiring at least some ABA be covered by insurance companies (when recommened by a doctor of course.) In Texas, HB 1919 was passed in 2007, and insurance companies were supposed to start providing coverage in 2008. However, they found a caveat. They stated that they would defintely pay for it if it was being provided by a state liscensed provided. The certification for ABA, BCBA, is a national certification. There currently is no state license. Basically, they were saying that unless you had a psychology license from TX and your BCBA, or perhaps your MD and BCBA, they weren't going to cover it due to a technicallity.

Is that Really Fair?!
No. And now the courts of California have official ruled on this issue. They stated that failing to provide coverage due to a lack of a state licensed person (repeat: there isn't a state license!) is against the California Mental Health Parity Act. In essense, it is not fair to not treat a whole population due to a lack of state licenses, when the provided are adequetly trained due to their national certification.

Now we just need that ruling to slowly make its ways around the country!