Tuesday, January 20, 2009

Autism Insurance Legislation Updates

There's been a lot of activity around the country on the autism services and insurance legislation front. The chart and map below is an uploaded copy of a PDF assembled by Autism Speaks, a leading autism advocacy organization. It shows the status of insurance legislation as of December 17, 2008.

If you are receiving this by e-mail, you can find the chart by clicking here. Green states—Arizona, Florida, Illinois, Indiana, Louisiana, Pennsylvania, South Carolina and Texas—have passed laws that "require private insurance companies to cover autism services, including Applied Behavior Analysis (ABA)."

Red states—Michigan, New Jersey and Virginia—are considering bills endorsed by Autism Speaks that reform autism insurance coverage.

The map also shows other states—most, that is—which are in some fashion starting to work on an autism insurance bill.

There have been some updates since Autism Speaks published this chart. These include:

Washington State, where advocates today issued a press release on pending legislation. From the release:

Washington lawmakers are getting ready to consider two companions bills, HB1210 sponsored by State Representative Brendan Williams (D-22) and SB 5203 sponsored by State Senator Steve Hobbs (D-44), that will require health insurance plans to cover diagnosis and treatment for autism spectrum disorders, including services like Applied Behavior Analysis, for individuals up to age 21.

The bills, referred to as "Shayan’s Law," follow the recommendations of the Caring for Washington Individuals with Autism Task Force in their Executive report to the Governor (December 2007). The report lists health insurance coverage of autism-related treatments within Washington State as its number one priority recommendation.

The grassroots organization, “Washington Autism Advocacy”, made up of parent volunteers, has up to the minute information about the bills on its website www.washingtonautismadvocacy.org.

Both bills were introduced in the legislature the second week of January. Once passed, they will require private insurance companies to pay for diagnosis and evidence-based treatment of Autism Spectrum Disorders, including Applied Behavior Analysis. In addition, they will remove unreasonable visit caps that have left thousands of families facing autism uninsured or under insured. Autism is a neurological condition that affects 1 out of 150 children.

51 State Representatives and 29 State Senators, who recognize the debilitating impact the autism epidemic is having on children, families and schools, have signed on as cosponsors of Shayan’s Law.

Wisconsin, where autism advocates report: "Wisconsin's new Legislative session has begun and in it is this introduction of a Bill for Autism Insurance dated January 8th, 2009. It has been read for the first time and was referred to the committee on Health, Health Insurance, Privacy, Property Tax Relief, and Revenue on the same date." According to an analysis by the Wisconsin Legislative Reference Bureau:

This bill requires health insurance policies and self−insured governmental and school district health plans to cover the cost of treatment for an insured for autism, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified if the treatment is provided by a psychiatrist, a psychologist, a social worker who is certified or licensed to practice psychotherapy, a paraprofessional working under the supervision of any of those three types of providers, or a professional working under the supervision of an outpatient mental health clinic. The coverage requirement applies to both individual and group health insurance policies and plans, including defined network plans and cooperative sickness care associations; to health care
plans offered by the state to its employees, including a self−insured plan; and to self−insured health plans of counties, cities, towns, villages, and school districts. The requirement specifically does not apply to limited−scope benefit plans, medicare replacement or supplement policies, long−term care policies, or policies covering only certain specified diseases. The coverage may be subject to any limitations or exclusions or cost−sharing provisions that apply generally under the policy or plan.

Kansas, where advocates report:
Kate's Law was filed with the Kansas Legislature on January 12, 2009 and assigned Senate Bill Number 12 (SB 12).

It has been referred to the Senate Financial Institutions and Insurance Committee (Senator Ruth Teichman, District 33, chair). Kate's Law must pass out of the Senate FI&I Committee before it can be considered by the body of the Senate. If it passes the Senate, then the process starts all over again on the House side.

Our first goal is to get an early hearing on the bill. To see how you can help, please check the KCAL website and your email regularly.

See the map below. (Thanks to the Washington-based autism advocates for sharing it). If you have updates or news to share about this issue, please don't hesitate to e-mail me or post a comment at the end of this blog post.

As 2009 State Initiatives12.17

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