|Is That Legal? Empowering Behavior Analysts to Use Mental Health Parity Law to Preserve Best Practices in Applied Behavior Analysis|
|Sunday, May 29, 2022|
|6:00 PM–6:50 PM |
|Meeting Level 2; Room 258A|
|Area: AUT/DDA; Domain: Service Delivery|
|CE Instructor: Ashley Williams, Ph.D.|
|Chair: Julie Kornack (Center for Autism and Related Disorders)|
|ASHLEY WILLIAMS (LEARN/BCI)|
|HANNA C. RUE (LEARN Behavioral)|
|JUDITH URSITTI (Council of Autism Service Providers)|
With the proliferation of insurance funding for applied behavior analysis (ABA), behavior analysts increasingly encounter insurer guidelines and limits that hinder their efforts to implement treatment plans that reflect best practices. This panel seeks to empower behavior analysts to recognize and reject payor practices that violate the federal Mental Health Parity and Addiction Equity Act (MHPAEA). Many common insurer guidelines, such as location exclusions, caregiver participation requirements, and age and hour limits, violate MHPAEA. More recently, payors have been using Medically Unlikely Edits (MUEs) to impose improper hour limits on medically necessary ABA in violation of MHPAEA. Although access to ABA is protected by MHPAEA, enforcement of MHPAEA has been limited and inconsistent since MHPAEA was first enacted in 2010. Now, federal agencies are focused on rooting out payor guidelines and practices that violate MHPAEA. With growing scrutiny on payors, behavior analysts have an opportunity to highlight improper guidelines and increase access to ABA that reflects best practices, rather than ABA that is shaped by payor guidelines.
|Instruction Level: Intermediate|
|Target Audience: |
Participants should have experience designing and implementing treatment plans for insurance-funded applied behavior analysis.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) identify improper quantitative and nonquantitative treatment limitations; (2) understand the appropriate use of Medically Unlikely Edits (MUEs); and (3) recognize the difference between the role of the payor and the role of the behavior analyst in delivering ABA that reflects best practices.|
|Keyword(s): Mental health, MHPAEA, Patient rights|