Taking a break from election results . . .
Tonight ABC-7 has a very interesting story featuring my good friend Feda Almaliti, who successfully took on her insurance company to pay for treatment for her son with severe autism. Kaiser told Feda that her son’s issues were purely educational, and told her to go to her local school district to get them to provide the intensive behavioral treatment he needs.
After several frustrating years and lots of hard work, Feda won an independent medical review of her son’s case and was awarded comprehensive behavioral treatment at Kaiser’s expense. While her case does not set a legal precedent, I think it exposes a huge issue in special education and a real opportunity for school districts to join with parents to argue that health insurance companies should pay their fair share of the sometimes very high cost of treating autism spectrum disorders–which are both medical and educational in nature. It’s almost laughable (if it didn’t make me want to scream) to hear a Kaiser executive say in Part II of the piece that “schools have traditionally said they are responsible for these kinds of interventions.” Oh, really? That would be news to the California School Boards Association. (It’s also interesting to listen to the raw interview with Sharon Levine, the Associate Director of Kaiser Permanente.)