Lawmakers seek passage of autism treatment bill

Newsday.com
Lawmakers seek passage of autism treatment bill
BY JAMES T. MADORE

[email protected]

10:13 PM EDT, June 2, 2009

ALBANY - Lawmakers here and in Washington Tuesday urged passage of bills requiring health insurers to pay for autism treatment and therapy for children and young adults.

A bipartisan coalition of state senators and Assembly members touted legislation from Sen. Charles Fuschillo (R-Merrick) and Assemb. Harvey Weisenberg (D-Long Beach) to have insurers cover up to $36,000 per year in autism-related care. The benefit would increase based on the inflation rate.

Meanwhile, in Washington, U.S. Sen. Kirsten Gillibrand announced plans to introduce a bill that would help military families with autistic children. She said, "They often aren't in one place for very long and that complicates health care."

In Albany, the state lawmakers criticized insurance companies that don't reimburse for treatments, leading parents to mortgage homes and drain bank accounts to pay the bills. Autism therapy can run from $20,000 to $50,000 annually.

"Parents face financial ruin or stop getting treatments for their child; that has to stop," Fuschillo said.

Autism is a neurobiological disorder affecting communication skills. The causes are in dispute and there is no cure.

One in every 150 children is afflicted, according to the advocacy group Autism Speaks. On Long Island, that amounts to 4,486 children out of a total of 672,595.

The bill in Albany would cover Applied Behavior Analysis, a treatment endorsed by the American Academy of Pediatrics and the U.S. Surgeon General. Reimbursement also would be provided for speech, occupational and physical therapies; medication; counseling; and psychiatric and psychological care.

Weisenberg said, "Ninety-percent of the families with an autistic child end in divorce. . . . We need to provide the resources so that there is less stress on these families."

Similar measures have been adopted in nine states, including Illinois, Texas and Florida.

America's Health Insurance Plans, a trade group representing companies that insure more than 200 million people, opposes the New York bill and others.

Spokeswoman Susan Pisano said additional coverage requirements would drive up premiums. She said hard-pressed employers are dropping coverage for employees because of the recession.

"They don't want to pay more for health care. . . . New mandates increase costs," Pisano said.

Some insurers have balked at paying for Applied Behavior Analysis because it has been classified as an "educational" rather than "health" treatment by the pediatrics academy.

Fuschillo and Weisenberg were cautiously optimistic that the legislation would be adopted before lawmakers end their regular session on June 22.

Copyright © 2009, Newsday Inc.

Re: Lawmakers seek passage of autism treatment bill

Thanks for posting this Liza, I was just saying this is one of the reasons I want my BCBA.

I see first hand how costly therapy is, insurance must start paying!

Re: Lawmakers seek passage of autism treatment bill

EI submitted their claim with our insurance to see if they would cover anything. We just got a letter than NOTHING would be covered. EI is "free" but not really since it comes from tax money. This is a huge burden on counties. I wish insurance would step up to the plate and do their job instead of saying that there is no cure so we don't need to pay anything. Easy way out for them. They are neglecting the fact that kids DO benefit from ABA, therapies, etc... to make those kids try to integrate in society.

It's so ridiculous! To the point that if an autism specialist Dr writes a script, it won't be reimbursed for insurance but if a regular Dr writes the same script it would be covered. It's like you have to hide that your kid has autism to get certain blood test covered. This is insane!!!