Monday, February 29, 2016

ABA to be Covered under Federal Employee Health Benefits in 2017



Applied Behavior Analysis (ABA) – 

OPM (U.S. Office of Personnel Management) has encouraged FEHB ( Federal Employees Health Benefits) Program plans to offer ABA benefits for children with autism spectrum disorders since 2013. 
We have also emphasized the growing number of providers and research linking behavioral interventions with positive outcomes. We are pleased that in the past several years, the provision of ABA within FEHBhas expanded significantly, particularly among carriers with state and local service areas.
OPM has now determined that appropriate coverage of ABA treatment by all plans/options is necessary for the efficient and effective operation of FEHB’s individual choice insurance
model. 
Therefore, for the 2017 plan year, carriers may no longer exclude ABA for the
treatment of Autism Spectrum Disorder (ASD). We expect all carriers to offer clinically
appropriate and medically necessary treatment for children diagnosed with ASD. You may
provide coverage for ABA as a fully case managed benefit, a pre-authorized service, and/or
an in-network benefit only. We will allow an exception to cost neutrality for ABA when
included as a new service in your plan.

courtesy of Autism Speaks


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