Kentucky

Kentucky Autism News:

Governor Steve Beshear Signs Kentucky House Bill 159 Into Law

Kentucky Becomes the Seventeenth State to Enact Autism Insurance Reform

NEW YORK, NY (April 14, 2010) -- Autism Speaks joined Kentucky families and other autism advocacy organizations in applauding Governor Steve Beshear today for signing the autism insurance reform bill, House Bill 159, into law. Kentucky is the seventeenth state to enact legislation which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies.

The new law stipulates that coverage for individuals in the large group and state employee market between the ages of one and seven will be subject to a maximum annual benefit of $50,000 and that coverage for individuals between the ages of seven and twenty-one will be subject to a maximum monthly benefit of $1,000. Individuals in the small group and individual market will be subject to a maximum monthly benefit of $1,000 regardless of age. HB 159, which was passed unanimously in both the House and Senate, was sponsored in the House by Representative Jeff Greer and helped through the Senate by Senators Tom Buford, Julie Denton, Brandon Smith, and Robert Stivers.

"This is a great day for the thousands of Kentucky 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 Kentucky's legislators and Governor Beshear for having the courage to put families and their needs first."

“In signing this much needed legislation, I am happy to say that this administration and this General Assembly are helping these families cope with this developmental disability by removing some of the treatment cost barriers that have kept these young people from getting the care they need,” said Governor Beshear.

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. In addition to Kentucky, sixteen states – Arizona, Colorado, Connecticut, Florida, Illinois, Indiana, Kentucky, Louisiana, Maine, Montana, Nevada, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, and Wisconsin – have enacted autism insurance reform bills, while three more have been passed by state legislators and await enactment into law.

“Thanks to the dedication and courage of our state legislators and Governor, parents will now actually be able to receive a benefit for the premiums they pay every month to their insurance companies,” said Anne Gregory, Autism Speaks Kentucky Chapter Advocacy Chair and mother of a child with autism. “Families in Kentucky will no longer go broke trying to provide their children with the medically necessary, appropriate autism treatments they need and deserve.”

Top picture: Governor Steve Beshear signs HB 159 into law with Representative Jeff Greer; Anne Gregory, Autism Speaks Kentucky Chapter Advocacy Chair; Janet Pope, autism advocate; and other advocates

Middle picture: Anne Gregory, Autism Speaks Kentucky Chapter Advocacy Chair, speaks at the bill signing ceremony fo HB 159

Bottom picture: Janet Pope, autism advocate; Governor Steve Beshear; and Anne Gregory,  Autism Speaks Kentucky Chapter Advocacy Chair at the at the bill signing ceremony fo HB 159

Autism Speaks Joins the Kentucky Autism Community In Applauding All State Senate Members For Passing Autism Insurance Legislation (April 2, 2010)

Autism Speaks Joins the Kentucky Autism Community In Applauding All State House Members For Passing Autism Insurance Legislation (March 16, 2010)

Kentucky State Legislature Holds Joint Hearing on Autism Insurance Reform (August 25, 2009)

Summary of Kentucky Autism Insurance Reform Law:

Sponsored by State Representative Jeff Greer  

• Would require health insurance companies to provide coverage of the diagnosis and treatment of autism spectrum disorders
  
  
• The law stipulates that coverage for individuals between the ages of one and six will be subject to a maximum annual benefit of $50,000 and that coverage for individuals between the ages of seven and twenty-one will be subject to a maximum monthly benefit of $1,000.  SB 13 has no cap on age or annual/monthly benefit.
  
  
• 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
  
  
• Under this law, 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
    
    
• The law creates a licensing board for behavior analysts and requires licensure for BCBAs and BCaBAs
  
  
• The law 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 law 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 law would apply to state regulated health insurance plans that are delivered, executed, issued, amended, adjusted, or renewed within Kentucky, or outside of the state if insuring Kentucky residents