|An Attorney and a BCBA Walked Into a Symposium: Clinical Best Practices and the Law|
|Sunday, May 29, 2022|
|12:00 PM–12:50 PM |
|Meeting Level 2; Room 254A|
|Area: AUT; Domain: Service Delivery|
|Chair: Amanda Kelly (Behaviorbabe)|
|Discussant: Daniel Unumb (Autism Legal Resource Center (ALRC); National Autism Law Center)|
|CE Instructor: William Courtney, Ph.D.|
In this symposium we will explore the relevant laws and implications on best practices in medically necessary ABA. We will also discuss clinical decision making that is in accordance with the law. We will also identify strategies for coordinating care with diagnosticians, and the importance of integrating the information garnered in the diagnostic report. Lastly, we have identified the need for data around authorizations and operations that will help with advocacy and public policy analysis.
|Instruction Level: Basic|
|Keyword(s): Insurance, Law, Medical Necessity|
|Target Audience: |
This information is relevant for all levels, no prerequisite knowledge necessary.
|Learning Objectives: 1. Identify two ways to use legal information to justify medical necessity. 2. Implement strategies for coordinating care with diagnosticians. 3. Describe key data points as related to areas of medical necessity|
The Many Hats BCBAs Wear While Navigating Medical Necessity
|William Courtney (Autism Legal Resource Center; BrightKyte; OneHorizon Health), HANNAH STAUFFER (Kadiant)|
A BCBA has a pivotal role in providing medically necessary care to individuals with autism. The BCBA has to advocate for the appropriate intensity of services and succinctly justify the medical necessity of care. The BCBA also has to coordinate services with other professionals providing care. One key area of coordination is with the diagnostician. In this symposium we will discuss strategies for coordination and the necessity for integrating the diagnostic report. We will also explore strategies for navigating potential pitfalls around medical necessity.
A BCBA, an Attorney, and a Statistician Walk into a Symposium…
|DANIEL UNUMB (Autism Legal Resource Center; National Autism Law Center)|
In this symposium we will explore the relevant laws governing delivery and coverage of ABA services and their implications on best practices. We will discuss integrating clinical decision making with legal analysis to improve ensure access to medically necessary care. We will also discuss processes for capturing and analyzing insurance authorization outcomes data as a tool for improving care and practice operations and enhancing public policy advocacy and regulatory enforcement.