LOS ANGELES (July 1, 2013) -- Autism Speaks and Autism Deserves Equal Coverage have filed a friend-of-the-court brief with a California appeals court to enable state workers to access applied behavior analysis (ABA) therapy for their dependents with autism. Nearly 3,700 Californians with autism are currently being denied ABA because of a dispute over licensure for ABA providers.
The California Department of Managed Health Care (DMHC) has prevented the coverage for state workers insured by CalPERS by insisting that providers hold a state license. California has no state license for ABA providers. DMHC claims that it is prohibited under the California Business and Professions Code from requiring health plans to cover ABA provided by non-licensed providers and that to do so would constitute a criminal act.
In the joint brief filed by the Autism Speaks Legal Resource Center, it was noted that ABA providers are nationally certified and routinely provide therapy in California that is reimbursed by private insurance. In the vast majority of states, Board Certified Behavior Analysts (BCBAs) deliver ABA reimbursed by insurance without a state license. In addition, California's Regional Centers have contracted for years with BCBAs to provide ABA to their clients.
"Applied behavior analysis is a basic health care service that must be provided when prescribed for a child with autism, regardless of what plan is involved," the biref states. "Families with CalPERS coverage and similar plans are entitled to the same quality care and the same accessibility to care as those under private plans. Nothing in the law prevents this. This Court should so hold enabling all families to have access to the crucial care they need."
The joint brief was filed by Robert Barnes with Kaye Scholer LLP, representing Autism Deserves Equal Coverage and on behalf of the Autism Speaks Legal Resource Center.