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2015 September

The Fight for Medicaid Coverage of Evidence-Based Behavioral Treatments for Autism

By Betsy Havens, Miriam Harmatz & Monica Vigues-Pitan

Advocates in Florida achieved in federal court a victory that required the state’s Medicaid agency to cover a particular therapy for children with autism. The therapy, applied behavior analysis, was found not to be experimental even though it had not met the “gold standard” of medical tests—large-scale randomized, double-blinded, controlled trials. The injunction requiring Florida’s Medicaid agency to cover the therapy applied statewide even though the plaintiffs were not part of a class action.

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