Autism – Federal Health Program to Require Applied Behavior Analysis (ABA) Coverage

The U.S. Office of Personnel Management (OPM) announced that all health plans within the Federal Employees Health Benefits Program – which covers federal employees, retirees and their dependents – must include ABA therapy starting next year. “OPM has now determined that appropriate coverage of ABA treatment by all plans/options is necessary,” according to a letter sent to insurance carriers. “Therefore, for the 2017 plan year, carriers may no longer exclude ABA for the treatment of autism spectrum disorder (ASD). We expect all carriers to offer clinically appropriate and medically necessary treatment for children diagnosed with ASD,” the letter states. This directive is a victory for advocates who have fought for years for ABA to be recognized as an evidence-based treatment by insurers. To date, legislation has been passed in 43 states requiring at least some insurance plans to cover ABA

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