Maine

Maine Autism News:

Governor John Baldacci Signs Maine LD 1198 Into Law

Maine Becomes the Sixteenth State to Enact Autism Insurance Reform

NEW YORK, NY (April 13, 2010) -- Autism Speaks joined Maine families and other autism advocacy organizations in applauding Governor Steve Baldacci for signing the autism insurance reform bill, LD 1198, into law yesterday. Maine is the sixteenth state to enact legislation which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies.

LD 1198 was sponsored in the Senate by State Senator Peter Bowman. The law applies to individuals diagnosed with autism up to age five and requires coverage for ABA therapy up to $36,000 per year... more info to come!

Autism Speaks Endorses Maine Autism Insurance Reform Bill (March 28, 2009)

Summary of Autism Insurance Reform Bill:

LD 1198 - Sponsored by State Senator Peter Bowman

• Would require health insurance companies to provide coverage of the diagnosis and treatment of autism spectrum disorders for individuals age 5 and younger
  
  
• 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 bill, health insurance companies would be required to provide coverage of the following:
  • Habilitative or rehabilitative care - including applied behavior analysis or other professional or counseling services necessary to develop, maintain and restore the functioning of an individual to the extent possible
  • Psychiatric care
  • Psychological care
  • Therapeutic care - meaning services provided by certified speech, occupational, or physical therapist 
    
• Coverage for Applied Behavior Analysis (ABA) is subject to an annual maximum of $36,000, but the will be no limits on the number of visits to an ABA provider
  
  
• There will be no dollar or number of visit limitations on other covered treatments unrelated to ABA
  
  
• 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
  
  
• This bill will apply to plans issued or renewed on or after January 1, 2011.