An agreement reached between the Mississippi Insurance Department and three major Mississippi insurance providers will result in lifting the age cap for coverage for Applied Behavior Analysis (ABA), a leading treatment for individuals diagnosed with autism and other developmental disorders, State leaders and ABA therapy advocates announced today.
State law currently mandates coverage for ABA therapy extend through age 8. Miss. Code Section § 83-9-26. The law includes a safe harbor for coverage, pursuant to an ongoing treatment plan, beyond age 8 if medical necessity is determined to exist. BlueCross BlueShield of Mississippi, UnitedHealthcare of Mississippi, and Magnolia Health voluntarily agreed on Tuesday to lift the age cap.
“It is fitting that we make this announcement today as we observe ABA Capitol Day,” Commissioner Chaney said. “We are grateful for the commitment BCBSMS, United, and Magnolia have made to helping some of our most vulnerable citizens who may not otherwise have access to treatment.”
More than a dozen entities—including the Mississippi Autism Board, which licenses ABA therapists, and the Behavior Analysis Association of Mississippi (BAAMS)—gathered in the Mississippi Capitol today to advocate for a better understanding and access to ABA therapy.
ABA is a process involving the systematic application of interventions, such as positive reinforcement, based upon the principles of learning theory to improve socially significant behaviors among individuals diagnosed with autism or other developmental disorders. Studies have demonstrated many children with autism experience significant improvements in learning, reasoning, communication, and adaptability when they participate in high-quality ABA programs.
Secretary of State Delbert Hosemann agreed with Commissioner Chaney.
“Quality treatment will now be more accessible to those who need it the most. Parents and caretakers of individuals diagnosed with autism and other developmental disorders will now be covered beyond age 8,” Secretary Hosemann said. “This is an example of our leading healthcare providers voluntarily meeting the changing healthcare needs of our children, and Mike and I sincerely appreciate their efforts.”
Watch the press conference here:
The Insurance Department also unveiled two new resources for individuals diagnosed with, and caretakers of individuals diagnosed with, autism. An Autism Hotline (1-833-488-6472) and Autism Insurance Resources website (http://www.mid.ms.gov/autism) are now live, and are designed to help consumers with any issues related to claiming health insurance benefits for screening, diagnosis, and treatment.
“In my work, I visit with parents and children trying to navigate the complicated insurance system every day,” said Mississippi Autism Board Chairman Dr. Jim Moore, who is Director of Autism Solutions at Canopy Children’s Solutions in Jackson. “We are grateful for Commissioner Chaney’s leadership in aggregating resources to make finding critical information easier for those who need it. We also wish to thank Commissioner Chaney and Secretary Hosemann for leading the negotiations to see restrictive age caps removed by the major insurers of Mississippi. Today is a victory for the children of Mississippi with autism and their families!”
“Access to ABA therapy has made a difference in the lives of so many of my clients. We want to spread the word, and these new resources help us accomplish that,” said BAAMS President Dr. Dannell Roberts, a licensed psychologist and Program Director at Will’s Way, a behavioral clinic in Hattiesburg.
Resources on the new website include:
- An autism FAQ and glossary of common insurance terms;
- A step-by-step guide to the health insurance claim/reimbursement process;
- A link to a list of Mississippi licensed applied behavioral analysis (“ABA”) therapy providers;
- A list of providers currently in-network;
- A link to the M-CHAT autism spectrum disorder screening tool;
- Claim filing and credentialing procedures, among other resources; and
- A step-by-step guide to the Mississippi Insurance Department’s formal complaint process.
Additionally, the State has seen recent progress in training and development opportunities for new ABA therapists in the State.
“The age cap lift and these new resources come at the same time our community college system, led by Holmes Community College, will begin offering an online ABA course in March,” Secretary Hosemann said. “This program is the first of its kind and will help increase the number of qualified autism workers in the State.”
More than 30 students have signed up to take the Holmes’ ABA course. For more information on the course, visit http://www.holmescc.edu/news/2017/120717_RBT.aspx.
Secretary of State Delbert Hosemann Press Release