Kentucky Autism News:
Kentucky State Legislature Holds Joint Hearing on Autism Insurance Reform
 Frankfort, KY (August 25, 2009) -- Today, the Joint Banking and Insurance Committee held a hearing on autism insurance reform at the Kentucky State Capital. The hearing was attended by dozens of families dressed in red. Members of the Committee listened intently and asked probing questions for an hour and a half. Speaker of the House Greg Stumbo, while not a member of the Committee, also attended and participated in the hearing.
Those who testified in support of autism insurance reform included: Lorri Unumb, Senior Policy Advisor and Counsel for Autism Speaks, Anne Gregory, Janet Pope, FEAT of KY, and Dr. Stacy Trinkle. Sen. Ray Jones, who introduced the autism insurance reform bill in 2009, also gave an impassioned plea in support of the legislation.
Following the hearing, Lorri Unumb and Bart Baldwin, a lobbyist for the Children’s Alliance who has volunteered his time for this effort, conducted a two-hour advocacy training session for parents and other interested parties.
Miss Kentucky, Mallory Ervin, attended the hearing and the advocacy training session; autism is her platform issue for the year.
Legislation for autism insurance reform was passed by the Senate Committee in 2009 and will be refilled for 2010 session by Rep. Scott Brinkman and Sen. Ray Jones.
Pictured above: Lorri Unumb, Autism Speaks Senior Policy Advisor and Counsel (left) and Mallory Ervin, Miss Kentucky (right)
Summary of Autism Insurance Reform Effort in Kentucky:
Senate Bill 13 - Sponsored by State Senator Ray S. Jones (D-31)
House Bill 159 - Sponsored by State Representative Jeff Greer (D-27)
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Would require health insurance companies to provide coverage of the diagnosis and treatment of autism spectrum disorders
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HB 159 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.
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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
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Under these bills, health insurance companies would be required to provide coverage of the following:
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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
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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
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Pharmacy care
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Psychiatric care
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Psychological care
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Therapeutic care - meaning services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers
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HB 159 creates a licensing board for behavior analysts and requires licensure for BCBAs and BCaBAs
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The bills do 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
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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
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The bills 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
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