Arizona families left scrambling after Medicaid drops two autism therapy providers from coverage

PHOENIX — Arizona families with children on the autism spectrum rallied at the State Capitol Thursday to protest the two largest providers of applied behavioral analysis therapy being dropped by the state’s Medicaid program known as AHCCCS.

The providers are Action Behavior Centers (ABC) and Centria Autism. Around 1,000 Arizona families on AHCCCS found out at the end of last year that they would need to find a new in-network ABA provider because coverage was ending in March.

ABA therapy not only helps diagnose a child with autism, but early intervention therapies can help a nonverbal child learn how to speak, correct temper tantrums and help with potty training.

Lawsuits filed after Medicaid drops autism therapy providers

There are currently two lawsuits in the works to try and reverse the move.

The first one, filed in December, is Centria and families of children with autism vs. health insurance company Mercy Care, AHCCCS and the Arizona Department of Economic Security. The plaintiffs sued over the contract termination and ABA access denials.

A second lawsuit was filed in February on behalf of more families who lost coverage and is against AHCCCS, Mercy Care and Arizona Complete Health, another health insurer.

Both lawsuits are asking AHCCCS to reverse the decision and compel the insurance companies to work with AHCCCS to keep Centria and ABC in-network.

How parents feel about losing coverage for kids’ ABA therapy

Parents who spoke at Thursday’s rally said other in-network providers of ABA therapy don’t meet the same standard of care, are far away or have waitlists of up to a year.

“In at least one case, an Arizona mom opted to cancel her own insurance policy in order to afford the $600 a month it will cost to continue ABA therapy for her son,” Jonna Lang, a family advocate for parents of children on the autism spectrum, said.

Lang emphasized that families are panicking to find a new in-network provider of ABA therapy.

“Being placed on a waitlist for another center will not just be inconvenient, it will cause regression and undo years of progress and hard work,” former Centria behavioral health technician Cassie Majors said.

Majors is also the mother of a child on the autism spectrum.

Elizabeth Galviz has three sons on the autism spectrum, two of whom were non-verbal until they started ABA therapy.

“He went from silence, to expressing feeling and even memorizing our phone numbers and address,” Galviz said.

Galviz has spent months calling and looking for alternative providers to no avail. ABA therapy has helped her kids learn how to speak, quell violent outbursts and give them the tools they need to learn and grow their skills.

“This is not optional care; this is not a luxury. This is the difference between a child thriving and disappearing back into silence,” Galviz said.

AHCCCS told KTAR News in a statement that it is committed to ensuring that members receive access to medically necessary services consistent with federal and state requirements.

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