Financial Compensation for Evaluation and Therapy of Children With Developmental Disabilities

Abstract

A developmental disability is defined as an abnormality beginning in fetal life or early childhood which precludes or significantly impedes normal physical and/or mental development. Included in this definition are mental retardation, cerebral palsy, and other neurologically handicapping conditions, deafness, speech disorders, blindness, mental illness, autism, and disorders of comprehension or effective use of language. Diagnosis and therapy of a developmental disability frequently require efforts of many disciplines (i.e., medicine, occupational and physical therapy, psychology, nursing, social service, speech pathology, and audiology). It is essential that appropriate financial compensation be provided by third-party payers for the services performed by all these disciplines. Non-physicians should receive compensation from thirdparty payers only if the diagnostic and theticapeuic measures are prescribed by a physician. The most effective care for developmentally disabled persons necessitates coordination, staffing, and follow-up efforts. Physicians must receive third-party compensation for these efforts as well as for counseling and visits to schools on behalf of these patients. Such activities are all appropriate extensoins of the physician's primary care role in the diagnosis and management of developmental disabilities in children.