Anthem Blue Cross & Blue Shield Arbitration Award RE:  Applied Behavioral Analysis Therapy Coverage

November 20, 2007 An arbitration judge ordered Anthem Blue Cross and Blue Shield to reimburse a Colorado family for Applied Behavior Analysis (ABA) therapy provided to their four-year-old child diagnosed with autism. The ruling acknowledges that Anthems coverage for congenital defects or birth abnormalities exists only until a child reaches the age of five, and that over the age of five, ABA would be excluded from coverage as are other therapies for learning disorders, behavioral or personality disorders, developmental delays, stuttering, voice disorders, or rhythm disorders. Key aspects of the ruling include: ABA is not experimental; it is . . .