Full Mental Health Parity passed in Washington state in 2005. It was phased in over 5 years and all state regulated plans renewing after 7/1/2010 are legally obligated to cover medically necessary treatments for individuals with a DSM diagnosis for life, with the same dollar cap as medical & surgical benefits. WA MHP is only applicable to plans regulated by WA state laws, fully funded plans and Public Employees Benefits.
Shayan's Law was brought forward because insurance companies have not been following the letter and spirit of this law for individuals with autism. This has prompted legal experts to look into this very closely. Based on the information available to us:
- Diagnosis and treatment should be covered if referrals (prescribed testing and treatment) came from a licensed physician or licensed psychologist.
- Treatment should be provided by a licensed therapist.
- Unlicensed providers (i.e. nationally certified behavior specialists and behavior therapy assistants) must become licensed through Washington State department of health.
Navigating this system can be difficult, for help with the process visit the WAA Insurance Portal.
We are awaiting the outcome of court cases testing Mental Health Parity and depending on the outcome have to be prepared to block any action that will limit protection under Mental Health Parity for those with autism. If you have any questions, concerns or comments, please post to the link above.
All my best,
Arzu Forough