Washington State To Cover Autism Therapy For Medicaid Kids

Oct 31, 2012

Low-income parents will soon have a way to get treatment for their children with autism. Starting in January, Washington state will cover applied behavior analysis (ABA) therapy for kids with Medicaid coverage. The new benefit is part of a legal settlement between the state and a local advocacy group for children with autism. 

In April, the group Washington Autism Alliance and Advocacy sued the state’s Health Care Authority.  The lawsuit claimed the state was violating federal law for not providing treatment for children diagnosed with autism.

Gail Kreiger manages medical benefits for the state's Apple Health for Kids program.   She said the new benefit will apply to kids who are currently enrolled.  Coverage will start in January and will require pre-authorization from the state. Kreiger said the first step is for the child to have been evaluated by a specialist. “We need to make sure that we have a current evaluation and an order that was actually written for treatment,” she said.

Once the agency gets that information, the child will get another assessment and a treatment plan.  The Health Care Authority has set up a web page for families who want to start the pre-authorization process.

Kreiger estimates about 9,000 children who are covered by the Apple Health program are diagnosed with an autism spectrum disorder. 

This is the state’s second settlement to extend ABA therapy.  In July, the agency made a similar agreement with state employees to include ABA therapy as part of its health coverage.