States mandating autism insurance coverage
Given that most states seem to be moving towards covering autism, this argument does not carry as much weight as it formerly did.The purpose of health insurance is to help spread the risk and cost of ailments across broader populations so that the burden of medical expenses does not fall entirely upon individual families. I am hopeful that was can get this legislation moving and join the rest of the country instead of being the last one to act.Autism Speaks, an autism advocacy organization, has outlined eight arguments in support of private insurance coverage of autism-related services in the document Arguments in Support of Private Insurance Coverage of Autism-Related Services.The document describes ABA and other treatment options.The law applies to policies that disability insurers, hospital and medical service corporations, health care service organizations, and blanket disability insurers issue or renew on or after June 30, 2009, but it does not apply to a policy issued to a small employer (employs two to 50 employees).It also does not apply to individual health insurance, long term care insurance, life insurance, annuities, and limited benefit coverage.s most recent Diagnostic and Statistical Manual of Mental Disorders.Nine other states include autism in their laws mandating coverage for mental illness (California, Illinois, Iowa, Kansas, Maine, Montana, New Hampshire, New Jersey, and Virginia).The laws most recently enacted (Arizona, Florida, Louisiana, Pennsylvania, and South Carolina) generally require coverage for Applied Behavioral Analysis services, establish benefit maximums, and do not apply to individual health insurance policies or policies issued to small employers (50 or fewer employees).
It requires the state group insurance program and certain group health insurance policies and HMO plans issued or renewed on or after April 1, 2009 to provide coverage to an “eligible individual” for (1) well-baby and well-child screening for diagnosing autism spectrum disorder and (2) treatment of autism spectrum disorder through (a) speech, occupational, and physical therapy and (b) Applied Behavior Analysis services provided by a state-certified behavior analyst or a person licensed by the state to provide psychological, psychotherapy, clinical, or counseling services.
We want to be very, very careful to ensure there Connor, Co-Chair of the Insurance and Real Estate Committee, indicated that the committee was “very cognizant of the fact that some of these mandates are very costly, so we tried to incorporate what was already in place in the plans, but, at the same time, draw a very defined line of what was medical and what is educational.” The House passed the bill on a 144-to-0 vote.
On May 7, 2008, the Senate placed the substitute bill on the consent calendar without discussion and passed it (36-to-0 vote).
Of these, eight require coverage for behavioral treatment services for the treatment of autism (Arizona, Florida, Indiana, Kentucky, Louisiana, Pennsylvania, South Carolina, and Texas) and five require other coverage related to autism (Colorado, Georgia, Maryland, New York, and Tennessee).
We provide a description of these 13 laws below and enclose a copy of each.