Change is coming for Washington State low income families with kids on the Autism spectrum. Starting January 2013, Applied Behavior Analysis therapy (ABA therapy) will be covered by Medicaid. This applies to children with Autism who are insured by the state’s Apple Health program, including those on Medicaid.
The Health Care Authority is developing a proposal that would extend an Applied Behavior Analysis (ABA) therapy benefit to all Apple Health for Kids clients with a diagnosis in the Autism Spectrum Disorder classification.~Washington State Health Care Authority
ABA therapy for kids with Autism is an important part of the treatment plan. In many cases, ABA therapy can help children with Autism learn basic skills to live and to cope.
Children who currently have an order for ABA therapy and a treatment plan may start receiving therapy now with prior authorization. Children who do not have an order in place should start the process with their doctor and collect the information required to submit a request for services.
This benefit is the result of a legal settlement approved by U.S. District Court Judge Richard A. Jones. This lawsuit was between a local advocacy group and the state.
In July 2012, the state settled another lawsuit for ABA coverage under the Uniform Medical Plan for state employees and some school districts and local governments only. This settlement was called Shayan’s Settlement after one of the plaintiffs.
For more information visit or learn how to start the the approval process visit Washington State Health Care Authority.
You can also email ABA@hca.wa.gov to ask questions about the benefit or finding therapy.