NEW YORK, NY (November 1, 2011) – Autism Speaks joined New York families today in applauding Governor Andrew Cuomo for signing into law one of the most comprehensive autism insurance reform measures in the nation, Assembly Bill 8512. This new law requires insurance companies to provide coverage of critical autism therapies for both children and adults, and makes New York the 29th state to enact autism insurance reform.
“We thank Governor Cuomo for taking on the fight for families struggling with autism,” said Bob Wright, co-founder of Autism Speaks. ”New York has now stood up to the plate as a leader, not only for its families dealing with autism, but for taxpayers throughout the state.”
A fiscal analysis conducted for Autism Speaks found the new law would save New York taxpayers $13 million over six years by reducing Medicaid, early intervention, special education and other costs. The savings result from insurance-funded treatments provided to children with autism at an early age, helping them to overcome developmental disabilities and require fewer public-funded services as they grow older.
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Washington State Clinicians Committee Recommends Covering ABA For Autism
SEA-TAC, Wash. – On June 17th, 2011, an independent panel of 9 practicing health care professionals who make coverage decisions for state-funded programs voted to cover Applied Behavior Analysis and Intensive Early Behavioral Interventions for treatment of autism. Using independent clinical evidence, the HTCC determines if certain procedures or technologies are safe, effective, and cost-effective.
The committee’s decisions are used to determine whether the procedures will be covered under public-funded health coverage in Medicaid, state employee health benefits, worker compensation or other state-purchased health care.
After hearing the public comments by Dr. Bryan King, Arzu Forough, Dr. Sara White and Dr. Ilene Schwartz, the panel had a lot of unanswered questions and comments, were perplexed as to the challenges in this particular review and were clearly divided and mixed at the end on what they were tasked with. But one thing was clear to them at the end, they couldn’t in good conscience vote against the insurance coverage.
- 7 of the 9 members voted there is insuffincient evidence that ABA is effective.
- The other 2 members felt there is some evidence ABA is more effective than other available modalities.
- ABA was recommended for coverage under certain conditions where evidence demonstrates benefit.
- Conditions will be ironed out in collaboration with Seattle Children’s Autism Center & UW Autism Center. The members want to make sure there’s adequate oversight to ensure efficacy and fidelity.
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Court finds Washington State Health Care Authority Violates Mental Health Parity Act
Blanket exclusion of service for autistic individuals ruled illegal.
Seattle, WA – On June 7, 2011, King County Superior Court Judge Susan J. Craighead entered an Order in D.F. et. al v. Washington State Health Care Authority, No. 10-2-294007 SEA, finding that the Washington State Health Care Authority violated the state’s Mental Health Parity Act when it excluded all coverage of Applied Behavioral Analysis therapy, a mental health treatment for individuals with autism. Judge Craighead concluded:
“[U]nder the Mental Health Parity Act [the Health Care Authority and the Public Employees Benefits Board] are required to cover medically necessary Applied Behavior Analysis therapy, as determined on an individualized basis, when provided by licensed providers.”
This is the first ruling on Washington State’s landmark Mental Health Parity Act since it was enacted in 2005. The Parity Act took full effect on July 1, 2010. As of that date, insurers cannot impose treatment limitations on mental health services, if they do not impose comparable limitations on treatment for medical and surgical care.
“This decision is a life-saver for many families who have a child with autism,” said Arzu Forough, a parent of two of the plaintiffs, and a representative of Autism Speaks, a national advocacy group for people with autism. “We urge the Health Care Authority to implement Judge Craighead’s decision immediately so that all children of public employees who have autism can get access to this essential therapy.”
Washington Supreme Court strikes DSHS rules that discriminate against disabled children
Seattle, WA, May 27, 2011 – Yesterday, the Washington State Supreme Court held that Washington’s Department of Social and Health Services must assess children’s needs for Medicaid personal care services individually, rather than based upon generic assumptions about children’s age and living situation. The Court struck down two state regulations that reduced children’s personal care hours based upon generic assumptions about their age and living situation, re-affirming the Court’s prior holding in Jenkins v. Department of Social and Health Services, that “[o]nce a person is assessed to require and receive a certain number of [Medicaid personal care] hours, the assessment cannot be reduced absent a specific showing that fewer hours are required.”
Plaintiff’s counsel believe that all of the more than 3,000 children who receive Medicaid personal care services in Washington state will benefit from this decision. “Samantha’s case was not unique,” said Ms. Hamburger. “All children who received MPC services since 2006 suffered a similar unfair reduction in their personal care benefits – many experienced even greater cuts than Samantha did.”
Blue Cross Blue Shield of Michigan Forced to Pay for Autism Care In Landmark Case
DETROIT, June 19 /PRNewswire/ — The family of an autistic child filed a motion in federal court today to confirm settlement of a class action against Blue Cross Blue Shield of Michigan. The family alleged in the suit that the insurer wrongfully refused to cover behavioral therapy for children with autism spectrum disorder (ASD), on the baseless ground that the care was “experimental.” complete story …
Video of Senate Health and Long-term Care Committee Hearing for Shayan’s Law.
FOX Feature on Autism Insurance
Parents press states for autism insurance lawsThe Associated Press 10/19/08
CHICAGO (AP) — In Washington state, Reza and Arzu Forough pay more than $1000 a week for behavior therapy for their 12-year-old autistic son. .
In Indiana, Sean and Michele Trivedi get the same type of therapy for their 11-year-old daughter. But they pay $3,000 a year and their health insurance covers the rest.
Two families. Two states. Big difference in out-of-pocket costs….
Representatives Springer and Goodman Visit Keeli’s Classroom
Following up on our story about Keeli and her impromptu speech at a district 45 legislative forum, Respresentatives Springer and Goodman visited her classroom recently.
More than a decade before they can vote, Keeli Burton and her first grade classmates at Rosa Parks Elementary School have already exercised their civic duty, asking state legislators to rally for autism insurance parity.
Read more at: Taking action against autism from the Redmond Reporter.
A place for Alex: Mom struggles to keep family together despite son’s severe autism
Young mom, boy on swing, little sister spying bugs in grass. It’s a picture so normal it barely snags a glance. The mother is Lacey Cairns, however, and normal is not in her vocabulary.
Lacey is a WAA member and the District Advocacy Leader for District 19.
Study:Autism costs strain family finances
Associated Press 11/30/2008:More than half a million U.S. children have autism with costly health care needs that often put an unprecedented financial strain on their families, national data show.
National survey shows impact of caring for a child with autism, three times more likely to have adverse financial strains than other chronic health care conditions.
Autism: Early Intervention
SeattlePI.com 11/17/ 2008
Seattle Post Intelligencer Endorses Autism Insurance Reform.
Very rarely does a Major Newspaper endorse a State Initiative.
The Money Squeeze: Economic crisis devastating for family with autistic son
SeattlePI.com 11/09/2008
From middle class to cash-strapped within months.
This article is about the economic realities facing families with autistic children, and it features WAA member Robert Ott and his son.
WHO SHOULD PAY FOR TREATING CHILDREN WITH AUTISM?
The News Tribune 10/12/08
In treating autism, the healthcare system isn’t fully functional
Los Angeles Times 7/06/08
Should insurance cover autism?
MSNBC, 6/12/08
Many states are debating measures to force insurance companies to help cover autism therapy. TODAY’s Natalie Morales talks to NBC’s chief medical editor, Dr. Nancy Snyderman.
Autistic and Uncovered
STLtoday.com, 4/14/08
An Autism Road Map
Seattle Times Editorial 1/29/08
Autism Help Scarce
Seattle Times, 1/21/08
Families Changed Microsoft’s View of Autism
SmartMoney.com, 5/8/07
Videos About A.I.R
http://www.youtube.com/watch?v=2uAVXcvEulQ
Governor Jim Doyle of Wisconsin appeals to the State Assembly.
http://www.youtube.com/watch?v=Q2C-Np_-ZqA
Actor Joe Montegna, father of a daughter with autism, appealing for passage of a Bill in Illinois.
Autism Insurance Sought in Florida
Parents of a 9 year old in Autism contributed to efforts in Florida towards statewide insurance coverage of autism treatments.
WAA Media Contact: Arzu Forough: Arzu@WashingtonAutismAdvocacy.org
