Minnesota

Minnesota Autism News:

December 19 Update

'Blue Cross change concerns patient advocates for autistic children:' St. Paul Pioneer-Press

"Blue Cross and Blue Shield of Minnesota will begin dropping coverage in most cases for a costly therapy for autistic children as early as Jan. 1 - a change that has patient advocates worried about losing coverage through a key state program, too."  Read more here.

Autism Speaks Endorses Minnesota Autism Insurance Reform Bill

House File 204 Would End Health Care Discrimination Against Children with Autism by Requiring Coverage of Diagnosis and Treatment

NEW YORK, NY (January 27, 2011) – Autism Speaks, the nation’s largest autism advocacy organization, today announced its support for House File 204, the autism insurance reform bill. The legislation would require private health insurance companies to cover the diagnosis, testing, and treatment of autism spectrum disorder (ASD).

Sponsored in the Minnesota State House by State Representative Kim Norton (District 29B), HF 204 includes coverage of behavioral health treatments, such as Applied Behavior Analysis (ABA), an evidence-based, medically-necessary autism therapy, for individuals with autism. HF 204 has been referred to the House Health and Human Services Reform Committee.

“We applaud and thank Senator Norton for her leadership again this year on this issue of critical concern to thousands of Minnesota families,” said Peter Bell, Autism Speaks executive vice president for programs and services. “Autism Speaks joins Minnesota’s autism community in calling on the legislature to pass HF 204 and join the growing number of states that have ended healthcare discrimination against children with autism.”

Many states do not require private insurance companies to cover even essential autism treatments and services. In the absence of coverage, families often pay as much as they can out-of-pocket for services that can cost upwards of $50,000 per year. In the process, many risk their homes and the educations of their unaffected children – essentially mortgaging their entire futures.

To date, twenty-three states – Arizona, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, Vermont, and Wisconsin – have enacted autism insurance reform legislation. Several other state legislatures will introduce similar legislation during the current 2011 session.

Autism Insurance Reform Bill Introduced in Minnesota State Legislature; Hearing to Be Held on Wednesday Feb. 4! (February 4, 2009) 

Summary of Minnesota 2011 Autsim Insurance Reform Bills:

House File 204 - Sponsored by State Representative Kim Norton (District 29B)

Would require health insurance companies to provide coverage of the  diagnosis, evaluation and medically necessary care of autism spectrum disorders


• A health care plan may not  refuse to renew or reissue, or otherwise terminate or restrict coverage of an individual solely because the individual is diagnosed with an autism spectrum disorder
  
  
• The bill has no cap on age
  
  
• The bill has no annual benefit dollar limit
  
  
• Coverage must be in accordance with a treatment plan prescribed by the insured's treating physician or mental health provider
  
  
• Under this bill, treatment that requires coverage includes, but is not limited to, the following:
  • Evaluation and assessment services
  • Applied Behavior Analysis (ABA)
  • Behavior services, instruction, and management
  • Speech therapy
  • Occupational therapy
  • Physical therapy
  • Medications
  • Pharmacy care
    
    
• 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 passed, this bill will go into effect on August 1, 2011

Information Regarding Previous Lawsuits Against BCBS in Minnesota:

One lawsuit was brought against Blue Cross Blue Sheild of Minnesota by the State Attorney General.  The settlement agreement for the case reads:

• WHEREAS, the Attorney General and Blue Cross and Blue Shield of Minnesota desire to promote health and agree that research, treatment and coverage for those in need of mental health, chemical dependency, eating disorder and autism treatment and services needs to and can be advanced throughout the State of Minnesota;

• WHEREAS, the Attorney General and Blue Cross and Blue Shield of Minnesota agree that this Settlement Agreement and Consent Order is intended to provide a working model for the advancement of the provision of health care treatment and services in Minnesota;

• Read Full Settlement Agreement 

As a result of the court settlement, Blue Cross Blue Shield of Minnesota issued the following policy statement:

• Pervasive Developmental Disorders: Identification, Evaluation, and Treatment