Missouri

Missouri Autism News:

Autism Speaks Joins the Missouri Autism Community In Applauding State House Members For Passing Autism Insurance Legislation

NEW YORK, NY (February 19, 2010) -- Autism Speaks yesterday joined Missouri families and other autism advocacy organizations in applauding the members of the State House for their passage of House Bill 1311, which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies, such as applied behavior analysis. HB 1311, was combined with a similar bill, HB 1341, and passed on the House floor by a vote of 135 yes to 18 no. The bill now goes to the State Senate for consideration.

The final bill includes a $36,000 annual cap on applied behavioral analysis (ABA) for children with autism spectrum disorders (ASD) up to age 18 with no limits on the number of visits to an ASD service provider. Insurance coverage for non ABA related therapies does not have any age limits or monetary caps placed on it under the passed House bill.

HB 1311 was sponsored in the State House by Representative Dwight Scharnhorst. HB 1341 was sponsored by Representative Jason Grill. A companion bill, SB 618, sponsored by Senator Scott Rupp, passed its second reading and was perfected in the Senate earlier this month.

“Autism Speaks applauds the members of the Missouri House for their passing of House Bill 1311 thereby extending a helping hand to families that have 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. “We now call on the members of the Senate to follow suit and pass this bill through its third reading 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

Featured Missouri Headlines:

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:

Senate Bill 618 - Sponsored by State Senator Scott B. Rupp (R-2)

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
  
  
• SB 618 requires coverage for individuals under the age of 21
  
  
• HB 1311 requires coverage of ABA for individuals under the age of 18
  
  
• 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
  
  
• SB 618 requires coverage for applied behavior analysis (ABA) therapy is subject to a maximum benefit of $55,000 per year
  
  
• HB 1311 requires coverage for applied behavior analusis (ABA) therapy is subject to a maximum benefit of $36,000 per year
  
  
• 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
    
    
• HB 1311 contains an opt-out/waiver from offering ASD coverage if the employer demonstrates by actual experience over any consecutive 12-month period that the cost of providing coverage has resulted in a 2.5% increase in the health plan premiums
  
   
• 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
  
  
• If enacted, this bill would take effect on August 28, 2010