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Wednesday, January 1, 2014

Autism Approved Legislation/Insurance Denials


I wanted to spend some time reviewing the laws relating to autism and their real world application.  What happens when a doctor refers a child for therapy that is critical to their social and emotional development and learning?  Will the cost for these services be covered by insurance? 

The answer is tricky and sometimes shocking.  Each state has their own laws applying to coverage of medical services for autism.  Some states do not require insurance companies to cover any services.  Also, a state may cover services, but there may be little loopholes that the public is unaware of thereby allowing insurance companies to deny the services. 

In New York State,  behavioral therapies are required to be covered.  However, prior to the passing of the legislation, an addendum was made that required applied behavior analysts to have a license in order for the therapy to be covered by insurance.  Guess what?  There is no licensure available in New York State for ABA therapists.   


Watch what happens when a couple find themselves in a similar situation, click below......

http://www.nbcnewyork.com/video/#!/investigations/video/I-Team:-Autistic-Kids-Denied-Insurance-Coverage/199640961


Here is a link to the Autism insurance laws across the United States........ 

http://www.ncsl.org/research/health/autism-and-insurance-coverage-state-laws.aspx


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