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August 20, 2014

New fischertechnik Partnership Brings STEM Learning Tools to Students with Special Needs and Autism - PRNewswire
SANBORN, N.Y., Aug. 19, 2014 /PRNewswire/ -- The fischertechnik Division of Studica recently partnered with Minnick Schools to bring some of the fischertechnik learning kits to students with learning disabilities, special needs, behavioral issues and autism.  Together they aim...

Down Syndrome Laws Stir Debate - DisabiltyScoop
A growing number of states are requiring that a Down syndrome diagnosis be accompanied by accurate information about the disorder, but not everyone is pleased by the new mandates.
August 19, 2014

Toyota of Naperville reminds customers about mobility options - PRNewswire

NAPERVILLE, Ill., Aug. 19, 2014 /PRNewswire-iReach/ -- Estimations made by the Centers for Disease Control in 2012 stated that one in five Americans, or approximately 53 million people, have some kind of disability. Physical disabilities that make it difficult for people to perform...



Mazda Racer Liam Dwyer Ready to Race Again - PRNewswire

IRVINE, Calif., Aug. 19, 2014 /PRNewswire/ -- When Hollywood scripts a racing movie, they tend to go overboard.  Having an injured U.S. Marine Staff Sergeant winning a professional race, in only his second start, just miles from where he grew up, on the third anniversary of his...



Tony Ferlenda named CEO at the National Fragile X Foundation - PRNewswire

WALNUT CREEK, Calif., Aug. 19, 2014 /PRNewswire-USNewswire/ -- The National Fragile X Foundation (NFXF), the world's leading advocacy organization for people affected by all Fragile X-associated Disorders, has named Tony Ferlenda as chief executive officer. He will begin on August 25,...



VIA Rail's New Accessible Cabin for Two Makes its Inaugural Trip from Vancouver on the Canadian - PRNewswire
MONTRÉAL, Aug. 19, 2014 /CNW Telbec/ - VIA Rail Canada (viarail.ca) is proud to announce that the Canadian leaving Vancouver tonight will include, for the very first time, a newly renovated Park car featuring an accessible cabin designed for people with disabilities. This new cabin...

New Sites Added To Autism Treatment Network - DisabiltyScoop
Two more medical centers will soon join a national network designed to provide a one-stop shop for autism care.

Plan For Special Education Substitutes Draws Concerns - DisabiltyScoop
With too few teachers on staff as the school year kicks off, one school district may rely on long-term substitutes for many special education classes.

Albert Pujols "Pinch Hits" To Support 20th Anniversary Of The Toys"R"Us Toy Guide For Differently-Abled Kids® - PRNewswire

WAYNE, N.J., Aug. 19, 2014 /PRNewswire/ -- Toys"R"Us® today announced the release of its 20th Anniversary edition of the Toys"R"Us Toy Guide for Differently-Abled Kids®, an easy-to-use toy selection resource for those who know, love and shop for children with special needs....



Developmental Disorders More Common Than A Decade Ago - DisabiltyScoop
The number of children with disabilities is on the rise, largely due to growth in incidence of mental and developmental disorders, researchers say.
August 18, 2014

TV Series To Examine Life During Transition - DisabiltyScoop
A new show focusing on the experiences of five young adults with intellectual disabilities is coming to television.
August 16, 2014

Ice Bucket Donations Surpass $10 Million to The ALS Association - PRNewswire

WASHINGTON, Aug. 16, 2014 /PRNewswire-USNewswire/ -- Today, The ALS Association announced it has surpassed $10 million in "Ice Bucket" donations. Specifically, as of Saturday, August 16, 2014, The ALS Association has received $11.4 million in donations compared to $1.7 million during the...


August 15, 2014

Despite Pleas, Brothers With Disabilities Set To Lose Home - DisabiltyScoop
Three aging brothers with developmental disabilities who have been fighting to remain in the only home they have ever known will likely see it demolished in the next few weeks.

Advocates Cracking Down On Sheltered Workshops - DisabiltyScoop
A nationwide effort is underway to lodge federal complaints against sheltered workshops that are not fully complying with the law.

Oregon To Order Sweeping ABA Coverage - Autism Speaks - Advocasy

Successful litigation against insurers leads to state order

August 14, 2014

SALEM, OR (August 14, 2014) -- Acting in response to a string of successful lawsuits against the insurance industry, an Oregon state agency announced today that it would prepare a directive requiring all private health insurers to cover applied behavior analysis (ABA) for autism.

“Recent court decisions have brought clarity that coverage for ABA therapy should be required of all insurers,” said Insurance Commissioner Laura Cali. “After evaluating the latest ruling made in Oregon last week, we have determined there are limited circumstances in which denial of coverage for ABA therapy as a treatment for autism may be reasonable. We hope the bulletin will provide more certainty to Oregon families who seek this treatment.”

Cali was referring to last week's decision by U.S. District Court Judge Michael Simon striking down the use of a "developmental disability exclusion" by insurers to deny claims for ABA treatment for autism. The ruling came in a class action lawsuit brought by two families against Providence Health Plans.

Simon found that the disabilities exclusion violated federal and state mental health parity law.

In a previous case, McHenry v PacificSource Health Plans, the court struck down the insurer's claims that ABA was "experimental" and "educational," rather than medical, in nature. The health plan administered by theOregon Public Employees Benefits Board (PEBB)is currently beingsuedfor its refusal to cover ABA, while in neighboring Washington state a series of decisions in class action suits have run against insurers.

Last year, Gov. John Kitzhaber signed legislation requiring state-regulated health plans to cover ABA, but the requirement would not take effect until 2016.

The Oregon Insurance Division, which is part of the state Department of Consumer and Business Services,has the authority to issue bulletins to clarify requirements of insurance companies under the Oregon Insurance Code and other state and federal laws.

"This bulletin will explain that insurers cannot exclude coverage of ABA therapy for autism from their policies," the Insurance Division announced in a statement. "As with other types of medical services, insurers can make coverage decisions based on whether the therapy is deemed appropriate and medically necessary for an individual patient, but they cannot broadly deny payment for ABA therapy."

The statewill begin drafting the bulletin "immediately" and share the draft withconsumers, advocates, insurers, and other interested parties, for comment and feedback. The division also promised todevelop a "transparent and consistent approach" for resolving current and future consumer complaints and enforcing the bulletin.

The Insurance Division has drawn fire in the mediafor purportedly maintaining a cozy relationship withthe state's insurance industry.As reported by The Oregonian, adraft memo analyzing the 2013 autism insurance reform bill was shared with a lobbyist for Regence Blue Cross Blue Shield while the bill was still before the Legislature.

Cali took over as director shortly after the episode and told The Oregonian she was making improved autism insurance coverage a priority for the Insurance Division.

August 14, 2014

Increasingly, Parents Push For Inclusive Playgrounds - DisabiltyScoop
With local governments tight on funds, families are stepping up to ensure that community playgrounds offer a fun space for all children no matter their abilities.

‘Love Hormone' Not Responsible For Autism, Study Finds - DisabiltyScoop
While some children with autism may benefit from taking oxytocin, low levels of the so-called "love hormone" do not appear responsible for causing the developmental disorder, researchers say.
August 13, 2014

Sedgwick SVP Denise Fleury receives 2014 DMEC Partnership Award - PRNewswire

MEMPHIS, Tenn., Aug. 13, 2014 /PRNewswire/ -- Sedgwick, the leader in technology-enabled claims and productivity management solutions, announced that Denise Fleury, senior vice president of disability and absence management, received the 2014 Partnership Award from the...



Rethink Announces New Tool to Help Teachers Support Students with Behavioral Challenges - PRNewswire
NEW YORK, Aug. 13, 2014 /PRNewswire/ -- School districts across the country are beginning to adopt a new tool that will make it easier for educators to help students overcome behavioral challenges -- an impediment to academic progress for students. Rethink, an education technology...

Federal Judge Removes Key Roadblock To ABA Insurance Coverage - Autism Speaks - Advocasy

In Oregon class action suit, judge rejects 'developmental disability exclusion' widely used to deny claims

August 13, 2014

PORTLAND, OR (August 13, 2014) -- A "developmental disabilityexclusion" widely used by insurers to deny claims for applied behavior analysis (ABA) therapy for autism has been rejected in Oregon by a federal judge as a violation of federal and state mental health parity law.

Ruling in a class action lawsuit brought against Oregon's Providence Health Plan, U.S. District Court Judge Michael Simon ruled that "an insurer cannot provide coverage for a service for one child and deny coverage for the same service for another child solely because the second child suffers from a developmental disability."

The complaint, A.F. and A.P. v Providence Health Plan,was brought by two families raising children with autism and was certified as aclass action covering all Providence policyholders earlier this year.

Simon ruled that the blanket exclusionviolated the federal 2008 Wellstone Domenici Mental Health Parity and Addiction Equity Act, Oregon's Mental Health Parity Act and a 2007 Oregon statute regarding medical coverage for autism. According to the decision, "Providence cannot simultaneously purport to cover autism and yet deny coverage for medically necessary ABA therapy through its Developmental Disability Exclusion consistent with the Oregon Mental Health Parity Act."

Simon also made clear he considers ABA to be medical treatment, as opposed to a service provided by schools.

"The case is significant in holding that developmental disabilities exclusions are prohibited as'separate treatment limitations' applicable only with respect to mental health benefits," said Dan Unumb, executive director of the Autism Speaks Legal Resource Center. "The case is also useful in its discussion of othertreatment limitations, such as 'experimental' exclusions and 'medical necessity' exclusions that are often more restrictivelyapplied to exclude ABA coverage for autism.

"Finally, it is important just for making clear that coverage of ABA treatment for autism is a benefit with respect to a service for a mental health condition covered under mental health parity," he said. "Even if autism or related treatment may also be characterized as “developmental,”this does not in any way remove thiscondition from the protections of the mental health parity act."

In the course of the litigation, questions arose over the enforcement practices of the Oregon Insurance Division. External review boards over the course of several years ordered private insurers more than 20 times to cover autism treatment, but the state agency failed to enforce compliance, as reported by Willamette Week.

The report cited efforts by Paul Terdal, an Autism Speaks volunteer advocate, to improve the state's enforcement efforts.

Last updated : August 20, 2014 - 05:43:27
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