Funding Information for HOPE Reach Services

 

Ryan's Law

Under Ryan’s Law, certain South Carolina insurance companies must cover Applied Behavior Analysis services.

When did Ryan’s Law go into effect? 
It covers from the first renewal date of the insurance policy after July 1, 2008.

What insurance policies fall under the mandate of Ryan’s Law?
At this time, coverage is clear for two types of policies:

  1. Policies for South Carolina state employees, and
  2. Group policies with more than 50 employees that are written in South Carolina and are not “self-insured” policies.

It is worth pursuing coverage with any insurance company because clarification of Ryan’s Law is still progressing.

Medicaid, BabyNet and PDD Waiver Funding

South Carolina's Medicaid program has some of the lowest reimbursement rates for ABA line therapists in the country. The rates do not come close to covering the actual cost for services. Due to these unsustainable rates, HOPE Reach is not accepting any new clients whose only funding is Medicaid, PDD Waiver, BabyNet or TEFRA. 

The situation for children and families impacted by autism in South Carolina is dire. Every day, more families are left waiting for services. Twenty (20) percent of SC ABA providers have gone out of business during the last eighteen months, with even more struggling to stay afloat due to the inadequate reimbursement for line therapy. Without a significant rate increase, access to ABA therapy will not improve.  

Project HOPE Foundation continues to actively advocate on this issue.  We encourage all families affected by this situation to contact the SC Department of Health and Human Services (which administers our state's Medicaid program), our governor, and their state legislators.   Click here to search for your legislators and send them a message asking for the reimbursement rate for ABA line therapists to be raised to a sustainable level.