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New state regulations require minimum coverages
BALTIMORE (March 10, 2014) --A Marylandagency has directed many of the state's private health plans to start covering treatments for individualswith autism through age 18.The Maryland Insurance Administration(MIA) finalized regulations that willrequire insurers to cover at least 25 hours a week of habilitative care for children with autism aged 18 months through 5 years, and a minimum of 10 hours a week of therapy for ages 6 though 18.
The new regulations culminate years of work by the MIAto clarify how Maryland's habilitative care law applied to autism treatment. Rather than enact autism insurance reform legislation, the Maryland Legislature in 2012 directed the state agency to undertake the review and implement new regulations.
Autism Speaks worked closely with Pathfinders for Autism and other Maryland advocates to help shape the new regulations to require the best coverage.
Still remaining to be completed is the enactment of a newlicensing statute to regulate ABA providers. Bills have been introduced in the House by Delegate Kirill Reznik(HB.150) and in the Senate by Senator Katherine Klausmeier (SB.694).
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Measure moves to House
HONOLULU (March 7, 2014) -- The Hawai'i Senate voted 24-1 for SB.2054, an autism insurance reform bill, and sent the measure to the House. The first hearing is scheduled Wednesday before the House Health Committee.
Introduced by Senators Josh Green,Suzanne Chun Oakland and Russell Ruderman, the bill would require state-regulated health plans to coverthe screening, diagnosis and evidence-based treatment of autism up to age 21, including up to $50,000 for behavioral therapy. Lifetime benefits for behavioral health therapy, such as applied behavior analysis (ABA), would be capped at $300,000.
The bill is similar to a measure that passed both houses of the Legislature last year, but then failed to clear conference committee. In addition to Autism Speaks, the measure is supported by the Hawaii Medical Association, the Hawaii Disability Rights Center, and other groups.Opposition has been raised from theHawaii Medical Service Association and Hawaii Association of Health Plans.
In addition to behavioral health ABA treatment, the bill would require coverage for autism-related psychiatric, psychological, pharmaceutical and therapeutic care, such as speech, occupational and physical therapy.
Hawaii is one of 16remaining states yet to require state-regulated health plans to cover essential autism treatments and services.