Maine

Maine Autism News:

Autism Speaks Endorses Maine Autism Insurance Reform Bill

LD 1198 Would End Health Care Discrimination Against Children with Autism by Requiring Coverage of Diagnosis and Treatment

Augusta, ME (March 28, 2009) – Autism Speaks, the nation’s largest autism advocacy organization, today announced its support for LD 1198 (SP 446), the autism insurance reform bill. The legislation would require private health insurance companies to cover the screening, diagnosis, testing and treatment of autism spectrum disorder (ASD) for individuals up to the age of 21.  The maximum benefit would be $36,000 per year.

Sponsored in the Maine State Senate by State Senator Peter Bowman (D-1), LD 1198 includes coverage of Applied Behavior Analysis (ABA), an evidence-based, medically-necessary autism therapy. 

“We applaud and thank Senator Bowman for his leadership on this issue of critical concern to thousands of Maine families,” said Elizabeth Emken, Autism Speaks Vice President of Government Relations. “Autism Speaks joins Maine’s autism community in calling on the legislature to pass LD 1198 and join the growing number of states that have ended healthcare discrimination against children with autism”... Read more 

Summary of Autism Insurance Reform Bill:

LD 1198 - Sponsored by State Senator Peter Bowman

• Requires private health insurance companies to provide coverage for the diagnosis and treatment of  autism spectrum disorder
  
  
• Coverage will be provided to individuals under the age of 21
  
  
• Coverage under this bill is subject to an inflation adjusted maximum benefit of $36,000 annually
  
  
• Small businesses (employers with 50 or fewer employees) may "opt out" of providing this coverage
  
  
• 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
  
  
• The bill includes coverage of the following treatments: Diagnosis, Habilitative or rehabilitative care, Pharmacy care, Psychiatric care, Psychological care, Therapeutic care, Applied Behavior Analysis (ABA)
  
  
• The bill applies only to fully-funded group health plans governed by state law