Missouri

Missouri Autism News:

Autism Speaks Applauds Missouri Governor Nixon for Enacting Autism Insurance Reform Bill

Missouri Becomes the 21st State to End Autism Insurance Discrimination

NEW YORK, NY (June 11, 2010) -- Autism Speaks joined Missouri families, the Missouri Autism Coalition, and other autism organizations yesterday in applauding Governor Jay Nixon for signing into law House Bill 1311, which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies, including behavioral health treatment such as applied behavior analysis. Governor Nixon signed the bill into law yesterday in Jefferson City, beginning a multi-city signing tour scheduled for several cities around the state.

The final version of HB 1311 includes coverage for applied behavior analysis (ABA) for children with autism spectrum disorders (ASD) up to $40,000 per year, or more if medically necessary, through age 18. Insurance coverage for non-ABA therapies is not subject to age limits or monetary caps. Insurers cannot impose visit limits on any coverage under the new law, other than the dollar cap on ABA.

"This is a great day for the thousands of Missouri families that had been financially devastated by the lack of insurance coverage for necessary autism therapies," said Peter Bell, Autism Speaks executive vice president of programs and services. “Legislatures across the country are introducing and passing bills that put an end to the discriminatory practices by insurance companies against children with an autism diagnosis. We thank Missouri's legislators and Governor Nixon for having the courage to put families and their needs first."

HB 1311 was sponsored in the House by Representative Dwight Scharnhorst and combined with a bill (HB 1341) that was sponsored by Representative Jason Grill. A companion bill, SB 618, was originally introduced in the Senate and sponsored by Senator Scott Rupp.

In many states, insurers explicitly exclude coverage of these therapies from policies, which places a significant financial burden on families seeking to provide their children with necessary treatments. In addition to Missouri, twenty other states – Arizona, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Montana, Nevada, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, Vermont, and Wisconsin – have passed similar autism insurance reform bills. A bill in New Hampshire has been passed by the legislature and is awaiting the governor’s signature.

"This new law will make Missouri a national leader in the diagnosis and treatment of autism, and it will lift a tremendous burden from thousands of families across our state," said Governor Nixon. "With the bill I'm signing today, parents of children with autism - who have faithfully paid their insurance premiums - will finally get the coverage they are entitled to. The law will ensure that ABA therapy is covered and that families will not get kicked off their insurance plans or otherwise limited in their insurance options because they have a child with autism."

The local autism community, including parents, grandparents, advocates, and local organizations, was instrumental in getting HB 1311 passed into law. Throughout the process they met with legislators frequently, reached out to them via phone and email, and attended hearings at the state capitol.

"I am thrilled with the enactment of HB 1311 and the commencement of coverage of the diagnosis and treatment of autism in Missouri,” said Bill Bolster, father of a child with autism and Autism Speaks Missouri Chapter Advocacy Chair. “More importantly, the work that led to passage of HB 1311 over three years brought the autism community in Missouri together in a way that will last and grow in the future for the benefit of people and families touched by autism in Missouri."

Pictured above:

1 - Governor Nixon signs the autism insurance reform bill into law

2 - Advocates gather at the signing ceremony at the Children's Mercy Hospital in Kansas City

3 - Lorri Unumb, senior policy advisor and counsel for Autism Speaks, speaks at the the signing ceremony 

Missouri State Legislature Passes Autism Insurance Reform Legislation (May 12, 2010)

Autism Speaks Joins the Missouri Autism Community In Applauding State House Members For Passing Autism Insurance Legislation (February 19, 2010)

The Power of a Legislative Champion: SB 618 Passes Second Reading in MO Senate (February 4, 2010)

Autism Speaks Joins the Missouri Autism Community In Applauding State Senate Members for Passing Autism Insurance Legislation (April 23, 2009)

Summary of MIssouri Autism Insurance Reform Bills:

House Bill 1311 - Sponsored by State Representative Jason Grill and Representative Dwight Scharnhorst (R-93)

• Would require health insurance companies to provide coverage of the diagnosis and treatment of autism spectrum disorders
  
  
• Requires coverage of individuals with autism up to age 18
  
  
• Coverage for applied behavior analysis (ABA) will have a maximum benefit of up to $40,000 per year, or more if medically necessary
  
  
• Insurance coverage for non ABA related therapies does not have any age limits or monetary caps placed on it under under the passed House bill
  
  
• 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 in accordance with a treatment plan
  
  
• Under this bill, health insurance companies would be required to provide coverage of the following:
  • Diagnosis of an autism spectrum disorder - meaning medically necessary assessments, evaluations, including neuropsychological evaluations, genetic testing, or other testing to determine whether an individual has one or more autism spectrum disorders
  • Habilitative or rehabilitative care - meaning professional counseling, guidance, services, and treatment programs, including applied behavior analysis (ABA) and other behavioral health treatments, that are necessary to develop, maintain, and restore to the maximum possible extent an individuals functioning
  • Pharmacy care
  • Psychiatric care
  • Psychological care
  • Therapeutic care - meaning services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers
  • Assistive communications devices
    
    
• Requires the department director to grant a small employer
  (employer with 50 or fewer employees) who offers a group health plan a waiver from offering ASD coverage if the employer demonstrates by actual claims experience over any consecutive 12-month period that the cost of providing the coverage has resulted in at least a 2.5% increase in health plan premium costs to the employer over a calendar year
  
  
• The bill does not affect any obligation to provide services to an individual under an individualized family service plan, an individualized education program (IEP), or an individualized services plan
  
  
• The bill applies only to state regulated insurance plans. It does not apply to self-funded insurance plans, as these plans are regulated by the federal government under ERISA law
  
  
• The bill applies to state regulated plans written inside or outside the state 
  
  
• Coverage would begin for state regulated plans that are delivered, issued, continued, or renewed on or after January 1, 2011