Expansion of FEHBP-covered autism treatments draws praise as initial step

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A major federal employee union commended the Office of Personnel Management for allowing insurance coverage for certain autism treatments but said the agency must do more to help federal workers with autistic children, according to a statement.

The American Federation of Government Employees lauded OPM’s decision to consider applied behavior analysis a medical treatment rather than an educational intervention, allowing the procedure to be covered by the Federal Employees Health Benefits Program starting in 2013. Until now, the distinction has prevented FEHBP plans from covering a “clinically proven” method for treating autism. OPM’s move gives participating plans the ability to cover ABA treatments but does not require it, according to the union.

AFGE National President J. David Cox said the policy change was a good start but anything short of a mandate from OPM demanding full coverage of the autism treatments is cutting federal workers short.

“Parents should not have to worry if vital services will be covered by their insurance plan,” Cox said in a statement.

According to Autism Speaks, an advocacy organization, FEHBP will have 67 plans in 22 states with some form of coverage of ABA treatments. Autism Speaks addedthat coverage would remain unavailable in many areas with a federal government presence, including Washington, Maryland and Northern Virginia.

In a column published on Dec. 4, Washington Post columnist Joe Davidson said many federal workers living in out of coverage areas were disappointed with OPM’s decision. Krystal Wick, an employee with the Veterans Affairs Department in Milwaukee, told Davidson the lack of mandated coverage for ABA was making the FEHBP “substandard” to benefit plans given to workers in the private sector and local governments.

“The least that OPM could do is provide at least one option for [the autism] coverage to every federal employee in all geographical areas regardless of the employee paid premium price,” Wick told Davidson.
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