Ohio

Ohio Autism News:

Ohio Families Rally At Capitol To Call For An End To Healthcare Discrimination Against Children With Autism

House Bill 8 Requires Insurance Companies to Provide Coverage of Medically Necessary, Evidence-Based Autism Services

COLUMBUS, OH (April 14, 2010) -- This morning Autism Speaks joined parents of children with autism and other advocates at a rally in support of several bills aimed at helping individuals affected by autism, including House Bill 8, which was passed by the House in December and is awaiting a hearing in the Senate. HB 8 would end insurers’ discriminatory policies that deny coverage of key treatments for children with autism. The rally included speeches by the leaders of the House Autism Legislative Caucus, other supportive state legislators, as well as members of the grassroots community.

Sponsored by Representative Ted Celeste and Representative Nancy Garland, HB 8 seeks to require private health insurance companies to provide coverage for the diagnosis and treatment of autism spectrum disorder. Coverage would be subject to an inflation adjusted maximum benefit of $36,000 annually. The bill includes coverage for Applied Behavior Analysis (ABA) therapy, the most widely accepted, evidence-based autism therapy.

“We thank Representatives Celeste and Garland and their House colleagues for passing House Bill 8 and join today with parents, legislators, and other advocacy organizations in calling on the Senate to pass this bill as well,” said Peter Bell, Autism Speaks executive vice president for programs & services. “Families are literally going broke trying to provide their children with the treatments they need and deserve. It is time for Ohio to join the growing number of states that have ended healthcare discrimination against children with autism.”

In many states, insurers explicitly exclude coverage of evidence-based, medically necessary autism therapies from policies, which places a significant financial burden on families seeking to provide their children with necessary treatment. Seventeen states – Arizona, Colorado, Connecticut, Florida, Illinois, Indiana, Kentucky, Louisiana, Maine, Montana, Nevada, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, and Wisconsin – have enacted similar autism insurance reform bills, while three more have been passed by state legislators and await enactment into law.

Autism Speaks Joins the Ohio Autism Community In Applauding State House Passage Of Autism Insurance Reform Legislation (December 8, 2009)

Autism Speaks Launches Radio Ad Campaign Urging Ohio Legislators To Include Autism Insurance Reform Measure In State Budget (June 10, 2009)

Autism Speaks Endorses Ohio Autism Insurance Reform Legislation (February 19, 2009)

Summary of Ohio Autism Insurance Reform Bill:

House Bill 8 - Sponsored by Representative Ted Celeste (D-24) and Representative Nancy Garland (D-20)

• 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
  
  
• In order to receive coverage, treatment must be provided by or overseen by a liscensed, certified, or registered provider
  
  
• The bill includes coverage of the following treatments: Diagnosis, Habilitative or rehabilitative care, Pharmacy care, Psychiatric care, Psychological care, Therapeutic care, counseling services, and Applied Behavior Analysis (ABA)
  
  
• Coverage will be subject to a maximum of $36,000 per year
  
  
• The bill defines "medically necessary" as a services that is based upon evidence; is prescribed, provided, or ordered by a health care professional licensed or certified under Ohio law to prescribe, provide or order autism-related services in accordance with accepted standards of practice; and will or is reasonably expected to do any of the following:
  • 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 applies only to fully-funded individual and group health plans and multi employer welfare arrangements governed by state law 
  
  
• The insurer can request to a review of treatment every six months
  
  
• If enacted, the bill will go into effect in January 2011