Summary of Oklahoma Legislation
Nick's Law - This bill was not passed by the OK State legislature during the last session. The bill will need to be reintroduced in the next legislative session to be considered again.
Here is a summary of the bill that was introduced during the last legislative session, but not passed:
- Sponsored by State Senator Jay Paul Gumm (D-6)
- Requires any individual or group health plan to provide coverage for the screening, diagnosis, testing, and treatment of an autistic spectrum disorder
- Includes the State and Education Employees Group Health Insurance Plan
- Requires coverage of generally recognized services and treatments that are prescribed by the insured individual's treating physician in accordance with a treatment plan, including all therapies, treatments, diagnoses and testing, medicines, special diets, and supplements prescribed by a licensed physician
- Coverage will be provided for any eligible person under the age of 21
- Coverage for behavioral therapy will have a maximum benefit of $75,000 per year
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Oklahoma News
Autism Speaks Joins Oklahoma Families In Decrying Blue Cross and Blue Shield of Oklahoma Autism Coverage Announcement
NEW YORK, NY (January 12, 2009) -- Autism Speaks, the nation’s largest autism advocacy organization, today joined Oklahoma autism organizations and families in calling for the Oklahoma legislature to reintroduce critical autism insurance reform legislation, known as “Nick’s Law.” At the same time, the autism advocates criticized Blue Cross and Blue Shield of Oklahoma’s announcement that it would add an autism benefit to its group plans – but that it would continue to deny coverage of the most widely-accepted evidence-based autism therapy, Applied Behavior Analysis.
An actuarial report released last week by the Oklahoma legislature claimed that autism insurance reform would result in an increase to policyholders of at least 7.8 percent and potentially as high as almost 20 percent. These figures differ greatly from research conducted in association with other state insurance reform efforts due to the fact that they are based on the unlikely assumption that a child with autism would purchase his own individual private health insurance. Children with autism would almost exclusively be covered by group policies.
When the $151 to $356 increase reported in the actuarial analysis is compared to the $10,592 average annual family premium reported in the same 2006 MEPS survey data cited by the actuarial analysis, the potential increase equals 1.3 to 3.4 percent, far less than the 7.8 to 20 percent increase indicated.
“This announcement by Blue Cross and Blue Shield of Oklahoma is little more than a red herring, a savvy public relations move that actually does very little to help thousands of Oklahoma families who simply cannot afford to provide their children with necessary, evidence-based therapy,” said Elizabeth Emken, Autism Speaks vice president of government relations. “The solution for helping these families must come through legislative action. We call on the Oklahoma legislature to vote on and pass Nick’s Law and join the growing number of states that have ended healthcare discrimination against children with autism.”
Nick’s Law, which was introduced during the last legislative session by State Senator Jay Paul Gumm but not passed, would require insurers to cover the screening, diagnosis, testing and treatment of autism spectrum disorder (ASD) for individuals up to the age of 21. The maximum benefit would be $50,000 per year.
To date, eight states – Arizona, Florida, Louisiana, Illinois, Indiana, Pennsylvania, South Carolina and Texas -- have enacted autism insurance legislative reform that requires insurers to cover ABA therapies, which typically cost upward of $50,000 a year – a cost well beyond the means of most families.
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