Ask a Business Lawyer. Get Business Law Questions Answered ASAP.
Good afternoon. I am Loren, a licensed attorney, and I look forward to assisting you.
Have they made a diagnosis which they can support?
Are you online with me?
My daughter was diagnosed with autism a couple of years ago because they were unfamiliar with Rett Syndrome. As of Febrary, genetic testing was done and a diagnosis of Rett Syndrome was confirmed and autism was removed. At that time her ABA therapy decided to keep the documentation of autism active;however, they unofficially changed her treatment plan to be geared toward Rett Syndrome without putting it on paper.
It is really only a problem if there is an intent to defraud. In other words, if there is any medical support, using current diagnostic standards and protocol for a finding of autism then it is not illegal or improper for the faciliry to include it in her treatment.
However, the autism diagnosis has been withdrawn then it is, potentially, a basis for insurance fraud to continue billing for treatment based upon the withdrawn diagnosis and the billing should be updated.
Did you have further questions? Have I answered your question?