The Autism Society of Greater Phoenix Insurance Committee was formed in 2008 to work on the passage of Steven’s Law. We believe autism is treatable and that research supports the efficacy of intense Applied Behavioral Analysis to treat autism. This treatment is recognized by American Academy of Pediatrics and the U.S. Surgeon General. We believe that the earlier the treatment the greater the lifetime impact on the child. As a major stakeholder, we believe that Arizona families should be allowed to participate in the free market system and purchase insurance that covers autism. Autism Society of Greater Phoenix partnered with other stakeholders to ensure the passage of Steven’s law. Steven’s Law provides for medical treatment and care for children with autism including applied behavioral analysis, occupational therapy and speech therapy. Before 2009 parents in Arizona were unable to access their insurance to pay for autism treatment and had to rely solely on state and federal service and children with Aspergers were unable to access any medical treatment through the state or federal services.

The current mission of our committee is to educate parents and professionals on how to access insurance coverage for services for autism treatment. Currently only 200 children are receiving ABA therapy paid for through Steven’s Law. Our goal is to ensure that all families that qualify for this coverage know it, understand it and access it for their children. We also want to ensure that there are enough providers to provide quality programs and competition to give our families choice of providers within the network. Our second goal, it to help parents with self funded plans to understand their plan, get services paid for by the plan if possible, and educate employers to add autism insurance benefits. We work with and are members of the Autism Insurance Work Group in partnership with other stakeholders. We speak locally and nationally on insurance issues. We have designed a CD with information for parents on insurance including a PowerPoint on how to understand and read insurance policies, how to appeal and resources available to assist parents in accessing insurance. We currently are designing a webinar for parents in Arizona to access to ensure they are have the latest and best knowledge on using Steven’s Law. Catina Hoffman and Cynthia Macluskie are o-chairs of the Autism Society Insurance Committee.

Insurance Resource Files

Accessing Insurance Coverage Slides

2. EPSDT Service, Policy 430

3. AHCCCS Hearing Notebook

4. How Private Health Coverage Works-Primer 2008

5. Who Pays For What-National

6. Appeals Flow Chart for AHCCCS-ALTCS Service Denials

7. How to get services when your Private plan tells you no

8. How to make yor insurance work for you

9. How to get the services you need when AHCCCS tells you no

10. Managing Dual Insurance Coverage

12. Time and Grievance

13. List of AHCCCS-ALTCS Health Plans

(Click on the CPT Code/Relative Value Search to: Begin Search. It allows you to key in what Medicare considers reasonable and customary for a given procedure code in a given area, — it is very often higher than what the insurance system pays)

How to Appeal A Health Insurance Appeal