What treatment is covered under the laws?
Treatment of autism and autism spectrum disorders (ASD) can include:
- Behavioral health treatment, such as applied behavior analysis (ABA) therapy,
- Pharmacy care,
- Psychiatric care,
- Psychological care, and
- Therapeutic care, such as services provided by licensed speech-language pathologists, occupational therapists, or physical therapists.
What is ABA Therapy?
The law defines ABA Therapy as “the individualized design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relationship between environment and behavior.”
ABA therapy is a process that involves systematic interventions (like positive reinforcement) based on the principles of learning theory to improve social behaviors of individuals diagnosed with autism or ASD.
Studies have shown that many children with autism or ASD experience significant improvements in learning, reasoning, communication, and adaptability when they participate in high-quality ABA therapy programs.
Keep in mind:
The law does not require health plans to begin covering these services, but if the plan does cover them, then there can be no exclusion of these services that applies only to individuals diagnosed with ASD.
Treatment must be prescribed by a licensed physician, psychiatrist or psychologist and it must be provided by a physician, psychiatrist, psychologist, behavior analyst, or assistant behavior analyst who is licensed or certified by the state.