Understanding Applied Behavior Analysis (ABA) Insurance Policies

Applied Behavior Analysis (ABA) therapy plays an important role in supporting individuals with autism and other developmental conditions. A Frontiers Journal study shows that early ABA interventions help improve the skills of children suffering from autism spectrum disorder.

As the demand for these services grows, so does the necessity for comprehensive insurance coverage. ABA insurance can help providers navigate complex insurance requirements. Understanding the intricacies of ABA insurance policies is crucial for providers aiming to navigate potential risks and liabilities effectively.

The Importance of Professional Liability Insurance

For ABA practitioners, professional liability insurance, also known as malpractice insurance, is crucial. Claims resulting from alleged mistakes, omissions, or careless actions during the provision of professional services are covered under this coverage.

As noted by Olson Duncan, ABA service providers usually work at their customers’ homes. Thus, they offer their services in an environment that is not under their control. This puts them at an increased risk of potential legal claims, making insurance a must for them.

This can be extremely helpful for companies with a team of ABA service providers to manage claims arising from their employees’ errors. For example, Indiana’s specialists received Medicaid payments of $101.8 million in 2020. This is a significant increase from $14.4 million in 2017. When the Office of Inspector General (OIG) did an audit, it was found that these payments did not comply with Federal and State requirements.

Indiana was asked to refund $39.4 million to the federal government. Since this was a collective error from multiple service providers, it didn’t cause much harm to individual companies or professionals. However, such claims against a particular business can lead to large settlement amounts. Insurance can help cover such costs and others associated with liability, misconduct, abuse, workers’ compensation, etc.

General Liability Coverage: A Necessity

Beyond professional liability, general liability insurance addresses claims related to bodily injury or property damage that might occur during ABA service delivery. Sessions of ABA treatment can take place in various locations, such as the clients’ homes, clinics, educational institutions, and public spaces. Each setting presents unique risks.

For instance, a therapist might accidentally damage property in a client’s home. Similarly, a client could sustain an injury during a session at a clinic. ABA insurance services that offer general liability coverage can help mitigate the financial burden off providers’ shoulders by covering such unforeseen incidents.

Some clinic employees might even be using traditional ABA services, which can lead to liability. As noted in an article by The 74, Ole Ivar Lovaas, who invented ABA therapy, had a different thought procedure in 1987. He said that those undergoing this therapy are people only in a physical sense and not in a psychological sense.

He didn’t even shy away from saying that this lack of humanity justified using severe treatment means like giving electric shocks. Additionally, he also said using slaps, withholding food, and other forms of physical punishment for treatment are justified. An ABA service provider with a similar belief can bring on large liability claims on a company, making investing in insurance a smart choice.

Non-Owned Auto Liability: Covering Employee Transportation

ABA therapists often travel to provide in-home or community-based services. When employees use their vehicles for work-related tasks, companies can be held liable for accidents during these times.

Non-owned auto liability insurance offers protection in such scenarios, covering legal fees and damages that might arise from accidents. Auto accident settlement amounts can vary based on numerous factors. However, these amounts can be very high and impact your company’s operations. According to Forbes, bodily injury during crashes can result in a settlement worth more than $20,000.

This coverage is secondary to the employee’s personal auto insurance but is vital for protecting the organization from potential lawsuits. It can be useful when the employee’s personal insurance cannot cover the entire settlement cost.

Addressing the Risk of Abuse or Molestation Claims

Given the vulnerable populations served, ABA providers must be vigilant about the potential for allegations of abuse or molestation. Even unfounded claims can have severe repercussions for a practice’s reputation and financial stability.

Insurance policies that include coverage for sexual misconduct, abuse, or molestation allegations are crucial. Such coverage typically encompasses defense costs and any settlements or judgments, offering a layer of protection against these serious accusations.

Claims for such cases can have severe repercussions for a company if its employees are proven guilty. This is because law enforcement is usually strict against such acts, which can result in a significantly high compensation amount. Consider the example of abuse of students at an autistic school, where they were shoved into padded rooms.

According to BBC, the prime minister’s spokesperson has said that this horrendous act should never happen again. In fact, the act can even lead to some profound changes in the legal regulations of how such schools should act.

Navigating the Credentialing Process with Insurers

ABA providers must undergo a credentialing process to receive reimbursements from health insurance companies. This process involves verifying their qualifications and competencies to ensure they meet insurer standards.

A foundational requirement during this process is proof of adequate professional liability insurance. Providers may face delays or denials in becoming credentialed without this coverage, hindering their ability to serve clients covered by insurance plans.

Beyond securing appropriate insurance coverage, ABA providers should implement proactive risk management strategies. This includes establishing comprehensive policies and procedures, conducting regular staff training, and maintaining clear documentation of all services provided. Engaging in these practices reduces the likelihood of claims and demonstrates a commitment to excellence and accountability.

Frequently Asked Questions

What factors influence providers’ ABA insurance coverage costs?

The size of the practice and the number of workers are some variables that affect the cost of ABA insurance. Besides, the coverage levels selected and the particular services provided can also influence the insurance cost. Insurers may also consider the provider’s claim history and service delivery locations.

Are independent ABA therapists required to carry insurance?

Independent ABA therapists should have general liability and professional liability insurance, although this isn’t often required by law. Many customers, educational institutions, and healthcare groups need confirmation of coverage before signing a contract with a provider. Additionally, insurance shields individual practitioners against monetary losses brought on by litigation or claims.

Does ABA insurance cover telehealth services?

Telehealth services are now covered by many insurance policies, particularly since remote therapy sessions have grown in popularity. Providers should check with their insurer to see if virtual sessions are covered by their insurance, as coverage terms might differ.

A key element of operational success for ABA service providers is comprehending and obtaining the appropriate insurance plans. Comprehensive coverage shields providers from possible risks and liabilities so they may concentrate on providing their patients with high-quality treatment. By practicing proactive risk management and being up to date on insurance needs, ABA providers may confidently negotiate the complexity of their industry.