If you’ve tried to get your health insurer to pay for physical, occupational or speech and language therapy for your child with a disability, and had the service denied because it was not “rehabilitative” and therefore, not medically necessary, you are not alone. Many health insurers deny these therapies for children with physical or developmental disabilities. They state the child never obtained the skill in one or more of these areas, therefore, the therapies are not rehabilitative. Currently, individuals only receive these therapies when, for example, they were able to walk, hold a pencil, and talk, and then lost that ability due to illness or injury. The therapy is rehabilitative because it helps the person regain a skill they used to have.

However, children with disabilities may need habilitative therapies in order to reach developmental milestones. Many benefit from the help of a physical or occupational therapist, or speech and language pathologist to learn, for example, to walk, talk or hold small objects, like a spoon, so they can feed themselves.

It’s not a matter of rehabilitation – it’s about quality of life, and helping children with disabilities become as independent as possible.

In January 2009, Massachusetts State Senator Karen Spilka of the second Middlesex and Norfolk district presented Senate Bill # 70: An Act to Provide Habilitative Services to the Children of the Commonwealth, to the Massachusetts House and Senate. Additional supporters include Representatives David P. Linsky of 5th Middlesex, Tom Sannicandro of 7th Middlesex, and Benjamin Swan of 11th Hampden. The goal of this bill is to have health insurers cover medically necessary habilitative services for children younger than 19 years old.

Read the text of Senate Bill #70 at www.mass.gov/legis/bills/senate/186/st00pdf/st00070.pdf, and speak to your state legislators about what this legislation, if passed, might mean to your child and family. Find your state legislators and contact information at www.usa.gov/Contact/Elected.shtml.

More information about Senate Bill # 70 is available on the Family-to-Family Health Information Center Web site at www.massfamilyvoices.org.