Insurance plans for fed workers can’t exclude Applied Behavior Analysis therapy anymore.

All health care plans that cover federal government workers, will be mandated to cover Applied Behavior Analysis (ABA). The Office of Personnel Management (OPM) has been encouraging, but not mandating, insurance companies to provide coverage to federal employees to cover ABA therapy since 2013. Currently, only 23 states offer federal worker health insurance plans that cover Applier Behavior Analysis (ABA) therapy for autism. That’s going to change because the overwhelming evidence shows ABA is both clinically appropriate, medically necessary and quite effective. The results of ABA could not be ignored anymore, so starting with the 2017 plan year, insurance plans may no longer exclude ABA as a treatment for autism spectrum disorder.

What is Applied Behavior Analysis therapy (ABA)?

Many children, especially those with autism or related disorders, exhibit unwanted behaviors. These behaviors can limit a child’s ability to communicate with others, make friends, learn in school, enjoy an event, etc. The parents of children with behavioral issues associated with autism put forth a lot of effort to reduce these undesirable behaviors. Unfortunately, many parents, make matters worse by discouraging a behavior with negative consequences.

ABA is based on the simple idea that children with behavioral issues are more likely to repeat positive behaviors that are rewarded versus stop negative behaviors that are reprimanded or ignored. ABA is a form of intense one-on-one therapy.  An ABA certified therapist would first do an evaluation to determine which skills the child already has and which ones he or she needs to develop. The therapist would then develop an ABA plan for the child to increase skills in communicating, learning, interacting socially and / or coping with the environment around them. The therapist will likely use discrete trial training with positive reinforcement, but ABA therapy is not a one size fits all process and other techniques would likely be needed.

For the last 50 years, research has show that ABA can help children with autism and is endorsed as a treatment by the AMA (American Medical Association), American Academy of Pediatrics and the US Surgeon General.

Kidmunication Point

This is great news for federal employees who live in states where federal healthcare insurance plans are not mandated to cover ABA. The intense therapy required with ABA can be costly and burdensome. The mandate from the nation’s largest employer sets a great example. Perhaps this move will result in more plans including ABA coverage. We know that speech therapy is much more effective when coupled with ABA for children with behavioral issues, so we often combine speech language therapy and ABA therapy with great results.

If you would like more information on ABA, please call our office.