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Judge orders Medicaid to cover autism therapy for kids in need

Fri Mar 30th, 2012 on     Health Insurance,    

Commercial insurance providers cover a critical therapy program for children with autism. It’s called applied behavioral analysis and autistic children who go through the program usually experience dramatically positive effects on their condition, bolstering their language and cognitive abilities as well as improving their social interaction and behavioral skills. The program comes at a financial cost though, leaving impoverished families with little chance of sending a child with autism through ABA.

A federal judge in Miami, Florida recognized this health care dilemma and ruled that Medicaid has to begin paying for ABA services. There was no immediate word how the ruling would financially affect the insurance program, but the judge blasted the notion that ABA was an experimental treatment that was not universally accepted by the medical community, calling that stance “outrageous.”

The decision by the federal judge could be a landmark ruling as many states do not provide ABA coverage to poorer families under similar Medicaid programs.

When the ABA provision becomes official, both Florida citizens and Medicaid will feel the impact. The health care provider will have to extend its medical coverage, insuring a new program that utilizes a variety of resources. That may stretch the programs financial ability, directly affecting those who need Medicaid service. For some Florida families, it means their autistic son or daughter has the opportunity to combat their developmental disability.

The federal judge was clear that ABA is a needed expansion of the Medicaid program. “It is imperative,” she said, “that autistic children in Florida receive (behavioral therapy) immediately to prevent irreversible harm to these children’s health and development.”

Source: Tampa Bay Times, “Florida must pay for autism therapy for poor kids, judge says,” Carol Marbin Miller, Mar. 29, 2012

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