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TRAINWV

Rebecka Campbell and Emily Morris. TRAINWV. Summary of Legislation. Final draft signed on April 2 nd , 2012 Applies to state mandated plans PEIA CHIP BCBS Does not include… Self-funded plans Medicaid/ M edicare Small businesses. Coverage for ABA Services.

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TRAINWV

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  1. Rebecka Campbell and Emily Morris TRAINWV

  2. Summary of Legislation • Final draft signed on April 2nd, 2012 • Applies to state mandated plans • PEIA • CHIP • BCBS • Does not include… • Self-funded plans • Medicaid/Medicare • Small businesses

  3. Coverage for ABA Services • Annual Maximum Benefit $30,000 • First 3 years of services • Reduced to $2,000 a month thereafter • Services must be provided by or supervised by BCBA • WWW.TRAINWV.ORG • WWW.BACB.COM

  4. How to Qualify • Treatments that are medically necessary • Prescribed by licensed physician or a licensed psychologist • Age limitations • 18 mos – 18 yrs • By age 8

  5. Continuation of Services • Progress reports • Condition is improving in response to treatment • Maximum improvement has not be attained • Anticipated improvement is attainable in a generally reasonable amount of time.

  6. TRAIN WV Training and Resources for Autism Insurance Navigation Our goal is to increase access to effective, empirically validated services to individuals with autism across the mountain state.

  7. TRAINWV: A Brief Background • Training and Resources for Autism Insurance Navigation • Grant funded project • identify implementation issues • Work with stakeholders to find solutions • Disseminate information • Run a demonstration and training facility

  8. Highlights Over the Past Year • Resources • WWW.TRAINWV.ORG • Connect with providers • Discussion board • Additional Resources • Slideshows • Copy of legislation • FAQ about autism insurance reform law

  9. Highlights Continued • Newsletter • Cover current issues • FAQ • Share provider information • Brochure • Find us on FB!

  10. Highlights Continued • Events • Stakeholders meeting • Collaborative event to identify implementation issues • Conferences • AUCD • ABAI • Annual Families Conference • University colloquia

  11. Highlights Continued • Raising Awareness • Light it up blue! • Walk A Mile in Our Shoes • Media • Public Access • WBOY • 4 part series • Major Projects (Current) • PEIA policy • Pediatrics packet • Provider database

  12. Lessons Learned • Limited coverage • Percent of eligible population • Limited resources • 4,300 children • 44 registered BCBAs • Limited education • Insurance plans that follow a medical model • Parents unaware of rights • Providers • Bill issues • Lack of connection with community

  13. Suggested Next Steps • MOTIVATE and EMPOWER • Change in self-funded policies • Continue to train and educate next generation of BCBAs • (# students) • Undergraduate course sequence • TRAIN as a platform for communication

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