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| Funding ABA: The Intersection of Law and Applied Behavior Analysis in Evidence-Based Autism Treatment - The Workshop! |
| Friday, January 18, 2019 |
| 9:30 AM–12:20 PM |
| Grand Ballroom A-C |
| Area: AUT; Domain: Service Delivery |
| CE Instructor: Julie Kornack, Ph.D. |
| JULIE KORNACK (Center for Autism and Related Disorders) |
 Julie Kornack is the director of public policy for the Center for Autism and Related Disorders. Her work includes identifying, developing, and supporting state and federal initiatives that increase access to services and supports for people with disabilities, as well as analyzing the impact of federal and state legislative and regulatory developments on access to mental health services. She is co-author of A Response to Papatola and Lustig’s Paper on Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis in the Treatment of Individuals on the Autism Spectrum, published in Behavior Analysis in Practice, and is the author of The History, Pitfalls, and Promise of Licensure in the Field of Behavior Analysis, published in Handbook of Treatments for Autism Spectrum Disorder. Her analysis of the economics of autism treatment was published in the Handbook of Early Intervention for Autism Spectrum Disorders: Research, Policy, and Practice, and she was an editor of Evidence-Based Treatment for Children with Autism: The CARD Model. She co-founded and serves on the board of directors of the National Coalition for Access to Autism Services, as well as several state and national advisory committees and task forces. |
| Description: With applied behavior analysis (ABA) joining the mainstream of medically necessary treatments, insurers and managed care organizations have moved to introduce policies intended to influence treatment decisions – critical decisions about how many hours of ABA are medically necessary, which locations are allowable, and who must participate in treatment. Arbitrary policies that constrain behavior analysts from designing and implementing the most effective treatment plan are often indicative of an overreach by the funding source. Behavior analysts are in a position to shape funding practices by understanding the laws and regulations that underpin patient rights in the determination and funding of medically necessary treatment. This workshop will teach participants how to challenge improper payer policies, stand by their clinical recommendations, and ensure that behavior analysts – not funding sources – set the standard of care for ABA. Participants will learn the variables that should and should not contribute to their determination of medically necessary ABA and how to appeal an insurance carrier’s decision to ABA. During the workshop, participants will have the opportunity to complete an actual appeal of an insurance carrier’s denial.Workshop participants will receive an exclusive toolkit via their ABAI portal at the conclusion of the conference. |
| Learning Objectives: At the conclusion of the workshop, participants will be able to: (1) discuss the variables that should contribute to determinations of medical necessity; (2) recognize the difference between educational and medically necessary ABA; (3) recognize improper limitations and discriminatory practices of funding sources; (4) protect patient rights to medically necessary treatment; (5) discuss the difference between standard of care and best practices; (6) appeal an insurance decision to deny or only partially authorize ABA. |
| Activities: Pending. |
| Audience: Board certified behavior analysts; licensed psychologists; graduate students. |
| Content Area: Practice |
| Instruction Level: Intermediate |