Summary of Autism Insurance Reform Bills in Washington
- 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 $50,000 annually
- 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 calls for the State Department of Health to adopt rules establishing standards for qualified autism service providers. After the adoption of these rules, payments will only be made to providers that meet these standards
- The bill defines "medically necessary" as any care, treatment, intervention, service, or item that is prescribed, provided, or ordered by a licensed physician or a licenses psychologist that will, or is reasonably expected to
- prevent the onset of an illness, condition, injury, or disability;
- reduce or ameliorate the physical, mental, or developmental effects of an illness, condition, injury, or disability; or
- assist to achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the individual and the functional capacities that are appropriate for individuals of the same age
- The bill applies only to fully-funded group health plans governed by state law and to state health plans offered to public employees
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Washington News
URGENT: Contact Washington State Legislators on Behalf of Shayan's Law
The hearing for Shayan's Law (SB 5203) before the Health and Long Term Care Committee on Wednesday, January 28th, was a great success! Our proponents of the bill presented a solid case with great testimony. Thanks again to all who came! Shayan's Law is so important to thousands of families across Washington, as it would require insurance companies to provide coverage of up to $50,000 per year for autism treatments and therapies.
We need your help today to reach out to Senator Karen Keiser, the chair of the Senate Health and Long-Term Care Committee, to call for a vote on Shayan's Law.
We also need your help today to reachout to House Representative Eileen Cody, the Chair of the House Health Care & Wellness Committee, which has yet to schedule a hearing for Shayan's Law.
Both of these Committee chairs need to hear from as many people as possible from the state of Washington. There is national momentum in over 30 states on the issue of autism insurance reform. They need to be made aware that Washington's families who are dealing with the financial challenges of autism cannot afford to wait another day for treatment. The time for change is NOW!
HOW CAN YOU HELP?
1. CALL AND EMAIL THE CHAIR OF THE SENATE COMMITTEE, Senator Karen Keiser, today and continue to call her for the next 48 hours. Ask her to please schedule a vote on Shayan's Law in an executive session! Share your personal stories and convey the following message: Autism is a treatable medical condition. Insurance should cover the treatment. Be polite and persistent. Ask her to please schedule the bill for an executive session vote so that it can continue through the legislative process! Keep dialing until you get through!
Call Senator Karen Keiser - (360) 786-7664
Send an Email to Senator Karen Keiser HERE!
2. CALL AND EMAIL THE CHAIR OF THE HOUSE COMMITTEE, Representative Eileen Cody, today and continue to call her for the next 48 hours. Ask her to schedule a hearing for Shayan's Law! Share your personal stories and convey the following message: Autism is a treatable medical condition. Insurance should cover the treatment. Be polite and persistent. Ask her to please schedule the bill for an executive session vote so that it can continue through the legislative process! Keep dialing until you get through!
Call Representative Eileen Cody - (360) 786-7978
Send an Email to Representative Elieen Cody HERE!
Autism Insurance Bill Introduced in Washington State
Olympia, WA (January 19, 2009) – Last week, an autism insurance reform bill has been introduced in the Washington State legislature. House Bill 1210, sponsored by State Representative Brendan Williams (D-22), and Senate Bill 5203, sponsored by State Senator Steve Hobbs (D-44), or "Shayan's Law" will require private healthcare policies to provide coverage of the diagnosis and treatment of autism spectrum disorders. Shayan's Law will cover applied behavior analysis (ABA) and other medically necessary, evidence-based treatments prescribed by an insured's treating physician or psychologist. Coverage for autism treatments and therapies shall be subject to a maximum benefit of $50,000 annually through age 21.
There are currently eight states that have passed similar bills. Shayan's Law has been referred to the House Health Care & Wellness Committee and to the Senate Health & Long-Term Care Committee. Both bills are awaiting a hearing.
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