PORTLAND, Ore. (AP) — In the wake of a court ruling, Oregon will begin drafting a bulletin to clarify that coverage for Applied Behavior Analysis therapy for autistic children should be required of all insurers.
In a statement issued Thursday, the Oregon Insurance Division said insurers cannot broadly deny payment for ABA therapy. The treatment can cost up to $50,000 a year.
But the division also said there are limited circumstances in which denial of coverage for ABA therapy may be reasonable, if the therapy is not medically necessary or appropriate.
Earlier this month, a federal judge in Portland found that Providence Health Plan violated state and federal laws in its denial of ABA.
Last year, the Oregon Legislature passed a bill requiring insurers to pay for ABA starting in 2016.