December 2022

MHAIP Victory, Year End Fundraising


Please remember to donate to our annual fundraising drive. As we come to the end of 2022, we reflect on what a remarkable year it has been on so many fronts. We were involved in drafting The Appeals Playbook, which is a detailed document for autism providers describing steps they need for the appeal process. We presented at several national conferences and webinars, and helped with the implementation of regulations related to California’s model state parity legislation. We worked with Department of Labor’s EBSA to educate them on the challenges families experience in getting mental health benefits through self-funded plans. And we continued our tireless work with families, supporting them with individual complaints.  Below is an example where helping one family helped all who came afterwards. 


MHAIP recently had the pleasure of assisting a Texas family that was trying to obtain ABA, applied behavior analysis therapy. Their seven year-old daughter, Dylan, had been diagnosed with autistic spectrum disorder, as well as intellectual giftedness, a concept known as twice exceptional.  The family had changed insurance plans over the summer, where Dylan had been receiving approximately 12 hours a week of ABA therapy in a private school setting that had experience in working with those that are twice exceptional. She needed the treatment to help with behaviors related to autism which occurred in the classroom, and also for social facilitation with peers. When they started with the new insurance carrier, the ABA provider was explicitly told that she could not deliver services in the school setting, and she was required to sign a written attestation to that effect. When we got involved, no denial letter had been issued for this part of the request. We had to submit an addendum to the service request, and formally request hours in the school setting. The insurance carrier alleged that Dylan did not need all the hours requested, but only denied the hours that were requested in the school setting. We mounted an appeal, describing that the provider had to sign the attestation, and that the Texas autism mandate required that autism services such as ABA therapy, prescribed by the primary care provider, be provided according to the treatment plan. Dylan’s pediatrician provided a letter of support, as did other specialists involved in her care, emphasizing her need for services in the school setting. The plan continued to uphold their denial. We took the case to the Texas Department of Insurance and asserted that Dylan’s rights under the Federal parity act were being violated, as those with medical conditions are not barred from receiving treatment in a school setting, so long as it is medically necessary. The state of Texas agreed with us, and not only overturned the case, but got the carrier to acknowledge that “any request for school-based services should be reviewed for medical necessity in totality and not to be excluded based on place-of-service. [The insurance company] has re-educated its autism staff and medical directors and apologizes for any inconvenience it may have caused.”

Dylan’s mother shares her experiences: 


“I cannot express what a gift it was to our family to work with MHAIP and Karen Fessel. We knew that what our insurance company was doing was wrong and that our daughter would suffer for it, but we felt totally helpless to do anything about it. As parents of a special needs child, we are not strangers to this feeling, but we never let it stop us. We all fight for our kids. Before learning about MHAIP, we were not equipped for the fight with our insurance company, but then we met Karen! From our first conversation she restored our hope. Karen was extremely competent and attentive and we were encouraged that she was a part of our team in getting what our daughter was entitled to from our insurance company. Both ourselves and our ABA provider were impressed by how Karen knew the details of our experience so completely, it was as if she was living it with us. At one point in the process I tried to help by reaching out to local resources, only to find out that Karen had already been in contact with them! Fighting a huge player in an unfair system is incredibly daunting, but she is so good at it and it is extremely satisfying to experience a win for our daughter and hopefully a win that can create change for others. I know I sound a bit hyperbolic, but MHAIP truly was nothing short of heroic in this fight for our daughter. We are deeply thankful."

MHAIP wishes you a happy holiday season and a wonderful 2023. Thank you to all who donated on Giving Tuesday, and thank you in advance for your end of year donations.




Karen Fessel, Dr PH

Executive Director and Founder

Feda Fund Updates

Thank you to all who have given generously to the Feda and Mohammed Almaliti Memorial Fund to provide scholarships to clients who have needed appeals. 

Donate Now to the Feda Fund

We will need your continued financial support to be able to keep this wonderful program, which allows us to provide assistance to financially struggling families and keeps Feda and Mu’s memories alive in our hearts.  Thank you for your active support.

Donate Now to the Feda Fund

Donate Now to our General Fund

The General Fund supplements our sliding scale program, pays for educational seminars and workshops for families and professionals, helps with policy work and allows us to provide free advice to families needing help with insurance.

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Helping families, providers and facilities obtain medically necessary mental health and autism treatments through health insurance.
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