Tuesday, January 16, 2018

Insurance companies to remove age limits on autism therapy.

Insurance Commissioner Mike Chaney and Secretary of State Hibbit Hosemann issued the following press release.

Insurance Department, Mississippi Autism Board Announce Major Advancements,
Resources Related to Insurance Coverage for ABA Therapy
Jackson, Miss.—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, 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,” Insurance Commissioner Mike 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.
“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 of State Delbert 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.”
The Insurance Department also unveiled two new resources for 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; and
·         A step-by-step guide to the Mississippi Insurance Department’s formal complaint process, among other resources.
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.
For more information about the Mississippi Autism Board, BAAMS, and ABA therapy, visit http://sos.ms.gov/autismboard/ or https://www.baams.org/.  For more information about insurance for autism-related services like ABA therapy, visit http://www.mid.ms.gov/autism.


Anonymous said...

Chaney doing work. He is as good a statewide official as we have. Mike works hard and doesn’t seek the spotlight or the bully pulpit.

Plain ol' Catfish said...

But ol' Mike sure as heck loves his superfluous press releases.

Anonymous said...

Wish Mike would run for Lt. Gov in 2019, much better than the high hat partner he is sharing this press release with. Chaney is the best statewide official we have today, and Mike could actually lead the Senate, where Delbert would drag the Senate.

Anonymous said...

Both of them seek notoriety full time. So, the cap was removed or raised? The cap was 8 yrs of age. What is it now that these two fine public servants interceded and got it removed?

Anonymous said...

So very thankful for Mike Chaney's office. They are very quick, responsive, and helpful with problems.

Anonymous said...

To whoever wrote this self-promotion press release....keep it short. The first paragraph was enough to convey the message. You’re not writing a dissertation. Wasted words

Anonymous said...


The limit was previously 8. (Technically it still is... The age limit that these three insurance providers have voluntarily agreed to is 21. The statutory limit has not yet been raised as far as I know.) ABA therapy is fairly intensive, usually requiring around 2-6 hours of therapy per week for months or years at a time. This is prohibitively expensive for most families that have kids older than 8 and/or are not insured through approved insurance providers. The current rules focus on younger children because there are many studies that focus on the importance of early intervention. It's nice to see that people are realizing that it is medically necessary for some older kids with autism to receive this therapy after the age of 8.

Anonymous said...

Will Longwitz also deserves credit for making this possible. Thank you Will, Mike, and Delbert!!!

Hey! Over Here! Gimme Kredik! said...

How many grandstanding cheerleaders does it take to tell insurance companies that they're in violation of the Americans with Disabilities Act and federal age discrimination laws?

It's not as if this took sixteen pots of coffee and five late nights around a negotiating table at Patel Inns and Suites.

Anonymous said...

Note to Mr. "We take pride in perfection", the job of insurance commissioner is more than inflating your pockets through body shop labor rates and crowing about Mr. Chaney being in bed with the insurance companies. I implore you to figure out how the health insurance companies greasing of palms helped them here.

Anonymous said...

Thank you, 11:36. Thank you, Commissioner Chaney.

Anonymous said...

@ 3:07. Don’t forget Tom Miles and Jay Hughes. Hughes even showed up to the PC and sent out pictures - but cropped out Hosemann since he is running against him.

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