ASAN Resources on Coverage for Autism-Related Services

The Autistic Self Advocacy Network is in the process of developing a series of resources for autistic people, our families, providers, and health plans on coverage for autism-related services. These services can include developmental approaches regarding social communication, sensory integration, emotional regulation, and adaptive skills.

Until now, much advocacy for coverage of “autism interventions” has focused on purely behavioral approaches, like Applied Behavioral Analysis (ABA). These interventions can be inappropriate or even harmful, and exclusive focus on coverage for behavioral interventions can result in limited access to evidence-based and emerging models that focus on improving relationships, communication skills, and development of skills that are meaningful to individuals’ quality of life. Our whitepaper on this topic entitled First-Hand Perspectives on Behavioral Interventions for Autistic People and People with other Developmental Disabilities, is available here.

Fortunately, laws governing health coverage permit access to a wide range of interventions. These laws vary by state and by source of coverage – for example, Medicaid or private health insurance.

Guide to Medicaid Coverage for Individuals

ASAN’s new guide to Medicaid coverage explains the evidence base for promising developmental interventions and provides instruction on how to advocate for coverage for these interventions. It is the first of several upcoming publications about health coverage for developmental interventions.

Guide for Medicaid Plan Administrators

ASAN’s resource for Medicaid Plan Administrators will help plan administrators develop and expand coverage for autism services such as communication supports, occupational therapy, and speech therapy. The resource provides an overview of all federal laws and regulations that address what services Medicaid providers are required to fund and why. It also includes model plan language, which provides an effective example of a health care plan that would cover a wide range of effective therapies for autism spectrum disorders.

Guide for Private Health Plan Policy Holders

ASAN’s resource for Private Health Plan Policy Holders will help individuals and families access coverage for autism services such as communication supports, occupational therapy, and speech therapy. The resource provides an overview of all federal laws and regulations that address what services private insurance providers are required to fund and why.

 Guide for Private Health Plan Administrators

ASAN’s resource for Private Health Plan Administrators will help plan administrators develop and expand coverage for autism services such as communication supports, occupational therapy, and speech therapy. The resource providesan overview of effective and emerging interventions, explanation of applicable federal laws governing private health plan coverage, and considerations for developing meaningful coverage standards and quality controls. It also includes model plan language, which provides an effective example of a health care plan that would cover a wide range of effective therapies for autism spectrum disorders.

For more information, contact Samantha Crane, scrane@autisticadvocacy.org.

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