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 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 claims the state was violating federal law for not providing treatment for children diagnosed with autism.

Gail Kreiger manages the program’s medical benefits. She says the new benefit will apply to kids who are currently enrolled under the Apple Health for kids program.

Coverage will start in January, and will require pre-authorization from the state.

Kreiger says the first step is for the child to have been evaluated by a specialist.

“It helps them if I can go through the information that they have and look to see where this child is in regards to services rendered to date, what’s the last time the child was seen, was there an actual order written yet, and what I can do to help them put them in that pathway, because we need to make sure that we have a current evaluation and an order that was actually written for treatment," Kreiger says.

Once the agency gets that information, the child will get another assessment and a treatment plan.

Kreiger estimates about 9,000 children who are under 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.

Copyright 2012 KUOW