Michigan to Hold Hearing on Autism Insurance Legislation

Michigan State Rep. Kathy Angerer, a Democrat from Dundee who chairs the House Health Policy Committee, has filed two bills that would require health insurance companies to cover diagnosis and treatment for autism spectrum disorders. Angerer's House panel is scheduled to hold a hearing on the measures, Dec. 13 at 9 a.m. in Room 519 of the House Office Building in Lansing. Thanks to the bloggers at Autism Insurance in Michigan for passing along word of this hearing and links to the legislation.

The wording of the legislation is below; what's interesting to note is the specific items covered—speech, OT, ABA, PT and early intervention services. The bill does not mention age restrictions as in states like South Carolina and Texas.

"More and more children across our state are being diagnosed with autism, leaving an increasing number of Michigan families struggling to keep up with the high costs of treatment," Angerer said in a statement. "Proper screening and treatment of autism is crucial to a child's development, and experts agree that early diagnosis and treatment is vital to increasing the chances that a child will reach their full potential. Excluding autism from coverage is not only arbitrary and unfair – it sets back efforts to understand and treat this disorder, which threatens to increase health care costs for everyone down the road."

Angerer is the lead sponsor of two house bills, No. 5529 and No. 5527, each of which calls for coverage of autism-related services. The bills have parallel Senate versions (Nos. 784 and 785) sponsored by Sen. Tupac Hunter, a Detroit Democrat (again, noted by Autism Insurance in Michigan.)

Language in the Michigan Bills

Here's specifics on what the House bills cover. Bill No. 5529 states that authorized hospitals, medical facilities, health maintenance plans:

shall provide coverage for the treatment of autism spectrum disorder, including, but not limited to, coverage for therapeutic evaluations and interventions, speech therapy, intensive early intervention, applied behavioral analysis, and Lovaas behavioral therapy.

Coverage for autism spectrum disorder under this section is subject to the same terms and conditions that the insurer or health maintenance organization applies to the treatment of other disorders. However, an insurer or health maintenance organization may confirm a diagnosis or review the appropriateness of a specific treatment plan in order to insure that coverage under this section is limited to diagnostic and treatment services.

As used in this section, "autism spectrum disorder" means a neurobiological condition that includes autism Asperger Syndrome and Rett's Syndrome.

The other bill, No. 5527 has the exact same wording regarding coverage of services, and what autism means, except it applies to "a health care corporation group or nongroup"; in other words, other kinds of health insurance organizations and health care organizations.

Also see in Autism Bulletin archives:

* Past coverage of health insurance

Also, an updated version of the Autism Insurance Map is below (e-mail subscribers, click here if you have trouble seeing it):