States mandating autism insurance coverage
In the 2008 February Session, the Insurance and Real Estate Committee introduced Raised Bill 5696, An Act Requiring Insurance Coverage For Autism Spectrum Disorder Therapies.As raised, the bill required individual and group health insurance policies delivered, issued, renewed, amended, or continued in Connecticut on or after January 1, 2009 to provide coverage for the treatment of pervasive developmental disorders (also known as autism spectrum disorders), including psychiatric, psychological, therapeutic, and habilitative care based on the principles of Applied Behavioral Analysis, which is sometimes referred to as “in-home behavioral support.”s March 6, 2008 public hearing, where numerous people spoke in favor of the bill, including legislators, health care professionals, and parents of autistic children.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.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.
The law specifically excludes from this coverage requirement (1) mental retardation; (2) learning, motor skills, communication, and caffeine-related disorders; (3) relational problems; and (4) additional conditions not otherwise defined as mental disorders in the DSM-IV-TR (CGS 38a-488a and 38a-514). Insurance must cover medically necessary early intervention services for a child from birth until age three that are part of an individualized family service plan.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.It defines “behavioral therapy” as interactive therapies derived from evidence-based research, including Applied Behavior Analysis, which includes discrete trial training, pivotal response training, intensive intervention programs, and early intensive behavioral intervention.s governor signed Senate Bill 2654 into law on May 20, 2008.
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.
The minutes do not reflect any discussion explaining the change from the raised bill to the substitute bill.