Missouri

Missouri Autism News:

Autism Speaks Joins the Missouri Autism Community In Applauding State Senate Members for Passing Autism Insurance Legislation

Missouri Senate Bill 167 Passes on Senate Floor

NEW YORK, NY (April 23, 2009) -- Autism Speaks today joined Missouri families and other autism advocacy organizations in applauding the members of the State Senate for passing Assembly Bill 167, which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies. The bill now heads to the State House for further action.

The Missouri Senate bill requires insurers to cover up to $55,000 annually for a child with autism under the age of 15 specifically for Applied Behavior Analysis (ABA) therapy.  ABA is recognized as an effective, evidence-based treatment for children with autism. SB 167 was sponsored in the State Senate by Senator Scott B. Rupp (R-2).

“Autism Speaks applauds the members of the Missouri State Senate for their passing Senate Bill 167 and extending a helping hand to families that have been financially devastated by the lack of insurance coverage for necessary autism therapies,” said Elizabeth Emken, Autism Speaks Vice President of Government Relations. “We now call on the members of the state House to follow suit and pass their bill, House Bill 357 as well, allowing Missouri to join the ranks of states that have recognized the unfair and unreasonable burden being imposed on families of children with autism”... Read more and post a comment

Summary of MIssouri Autism Insurance Reform Bills:

Senate Bill 167 - Sponsored by State Senator Scott B. Rupp (R-2)

• Requires private health insurance companies to provide coverage for the diagnosis and treatment of  autism spectrum disorder
  
  
• Coverage of treatments will be provided  when prescribed, provided, or ordered for an individual diagnosed with autism by a licensed physician or a licensed psychologist who determines the care to be medically necessary
  
  
• The bill provides coverage for individuals under the age of 18
  
  
• The bill includes coverage of the following treatments: Diagnosis, Habilitative or rehabilitative care, Pharmacy care, Psychiatric care, Psychological care, Therapeutic care, Applied Behavior Analysis (ABA)
  
  
• Coverage for ABA will only be provided until age 15 and will be subject to a maximum benefit of $55,000 per year
  
  
• The bill applies only to fully-funded health plans governed by state and all health plans for state employees
  
  
• If passed, this bill will go into effect in August 2009

House Bill 357 - Sponsored by State Representative Dwight Scharnhorst (R-93)

• Requires private health insurance companies to provide coverage for the diagnosis and treatment of  autism spectrum disorder
• Coverage of treatments will be provided  when prescribed, provided, or ordered for an individual diagnosed with autism by a licensed physician or a licensed psychologist who determines the care to be medically necessary
  
  
• The bill defines "medically necessary" as any care, treatment, intervention, service, or item that is prescribed, provided, or ordered by a licensed physician or a licenses psychologist that will, or is reasonably expected to
  • prevent the onset of an illness, condition, injury, or disability;
  • reduce or ameliorate the physical, mental, or developmental effects of an illness, condition, injury, or disability; or
  • assist to achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the individual and the functional capacities that are appropriate for individuals of the same age
    
    
• The bill provides coverage for individuals under the age of 21
  
  
• The bill includes coverage of the following treatments: Diagnosis, Habilitative or rehabilitative care, Pharmacy care, Psychiatric care, Psychological care, Therapeutic care, Applied Behavior Analysis (ABA)
  
  
• Coverage for ABA is subject to a maximum benefit of $72,000 per year for individuals under age 11 and $36,000 per year for individuals between age 11 and 21 
  
  
• The bill applies only to fully-funded health plans governed by state and all health plans for state employees
  
  
• If passed, this bill will go into effect in August 2009