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Another Victory for ABA Coverage in Washington State

July 16, 2012

SEATTLE -- The Washington State Health Care Authority (HCA) has settled with a group of state employees who sued for coverage of applied behavior analysis (ABA) therapy to treat autism under the state'’s Uniform Medical Plan.
Called "Shayan's Settlement" after one of the plaintiffs, the new autism benefit will cover ABA therapy when recommended by an autism expert to treat behaviors that have an impact on development, communication or adjustment, according to the plaintiffs' law firm, Sirianni Youtz Spoonemore. The coverage provided under the settlement will include ABA therapy provided in a natural setting such as a child’'s home or community by therapy assistants working under the supervision of licensed providers.
"“The Mental Health Parity Act promised that services to persons with mental conditions, including autism, would be covered at parity with medical and surgical services,"” said Eleanor Hamburger of Sirianni Youtz Spoonemore. “"This settlement fulfills that promise.”"
The settlement applies to prospective or future coverage of ABA therapy; still remaining to be decided is whether HCA will have to reimburse the plaintifs for their out-of-pocket expenses paid for past ABA therapy. That issue will be decided in an upcoming damages phase of the case.
"“This settlement achieves what we tried to do at the legislature with ‘Shayan’'s Law,’”" said Arzu Forough, parent of two named plaintiffs and chief executive officer of the Washington Autism Alliance & Advocacy. “"This is a watershed moment for Washington families with autism. With HCA'’s leadership, we are entering a new era of full coverage for persons with autism.”"