I’ve posted several times before about how the insurance coverage I have through work (a company based in California) in theory covers treatments such as ABA, and yet there are no providers in my state (Maryland) that are on the insurance plan. The reason for this is simple – here, ABA is not defined as “appropriate and medically necessary”, so insurance providers are not required to cover this proven treatment.
To be fair – our current insurer has told the wife that if we can find a provider here who is covered for other services, they would be amenable to discussing payment. I have no idea if the new provider in January will feel similarly, but I can fight that battle when we get there.There is, though, a glimmer of hope finally in Maryland.
Today was the first meeting of the state’s Autism Technical Advisory Group, created under a recent law passed in Annapolis. As the article from Autism Speaks points out correctly – we can’t assume that anything substantial is going to happen today aside from everyone getting to know one another and getting down to business. Their goal, however, is quite clear: to define what treatments fit the definition above, and therefore are to be mandated for insurance coverage by companies working in our state.
I don’t have the highest of hopes of this process going quickly or even smoothly, since I would expect that we’ll see substantial push-back from the insurance companies. I do know that it is certainly a vast improvement over the very simple “ABA is not a covered service” that I hear folks around me who are covered by in-state providers.
I’m half-debating taking the day off of work to go down and see what the panel actually says, when they meet in 2 weeks.