Autism Insurance Resource Center Update

Phone:1-800-642-0249 or email: info@disabilityinfo.org

MassHealth Coverage for ABA Therapy Update

MassHealth is working with its managed care plans to add ABA coverage and anticipates that this will be in place by October 2015.  In the meantime, they are making ABA services available now to children under age 21 through a special process of MassHealth prior authorization. Eligible MassHealth members who do not have access to ABA through an Employer Sponsored plan or a Qualified Health Plan and that are seeking coverage for ABA should have their ABA provider contact MassHealth at 617-847-3786 to request prior authorization for ABA.  Note – this number is for providers only – members should contact MassHealth customer service at 1-800-841-2900 for assistance. The Autism Insurance Resource Center maintains a list of ABA providers which can be used to locate a provider. However, please note that most of these providers are not currently contracted with MassHealth and will need to enroll before getting authorization to provide ABA.  MassHealth has informed us that they are currently reviewing applications from several providers, and expect to be issuing the first set of approvals shortly. Co-Pays – For members that have access to ABA through an Employer Sponsored plan or a Qualified Health Plan, MassHealth will begin covering copays for ABA services through the Mass Behavioral Health Partnership (MBHP). Providers should call MBHP Customer Service at 1-800-495-0086 for authorization – they do not have to go through MassHealth credentialing to be paid for cost sharing. As more information becomes available we will be posting updates, distributing information, and providing support. If you have any specific questions or need further assistance, please email us at info@disabilityinfo.org  or contact us at 1-800-642-0249, or 774-455-4056

Amy K. Weinstock Director Autism Insurance Resource Center