Ohio

Ohio Autism News:

Autism Insurance Reform Bill Reintroduced in House of Representatives

COLUMBUS, OH (November 15, 2011) -- An autism insurance reform bill (HB 376) was introduced today in the Ohio House of Representatives by Reps. Ted Celeste and Nancy Garland. Read more...

Autism Speaks Announces Results of Independent Actuarial Analysis Of Amended House Bill 8

Legislation Requiring Health Plans to Cover Autism Treatment Would Have Minimal Effect on Health Insurance Premiums

NEW YORK, NY (October 8, 2010) – Autism Speaks, the nation’s largest autism science and advocacy organization, announced today that the impact of Amended House Bill 8 on health insurance premiums in Ohio is projected to be a mere one-half of one-percent (0.51% or $1.57 per member per month.) This projection is the result of an independent actuarial analysis prepared by Oliver Wyman, one of the largest actuarial practices in North America... Read more

> Read the full cost analysis 

Summary of Ohio 2010 Autism Insurance Reform Bill (A new bill will need to be introduced in the 2011 legislative session):

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