Virginia

Virginia Autism News:

Autism Speaks Joins the Virginia Autism Community In Applauding State Senate Members For Passing Autism Insurance Legislation

Virginia Senate Passes SB 464 in Vote of 27 to 13

NEW YORK, NY (February 16, 2010) -- Autism Speaks today joined Virginia families and other autism advocacy organizations in applauding the members of the State Senate for their passage of Senate Bill 464, which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies, such as applied behavior analysis. The bill now goes to the House of Delegates for further consideration.

SB 464 was sponsored in the State Senate by Senator Janet Howell. A companion bill, HB 303, is being sponsored in the House by Delegate John O’Bannon III.

“Autism Speaks applauds the members of the Virginia Senate for their passing of Senate Bill 464 thereby extending a helping hand to families that have 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. “We now call on the members of the House of Delegates to follow suit and pass this bill as well, allowing Virginia to join the ranks of states that have recognized the unfair and unreasonable burden being imposed on families of children with autism.”

Featured Virginia Headlines:

Families Affected by Autism Call on Senate Committee to Advance Bill Ending Healthcare Discrimination Against Children With Autism (February 9, 2009)

Summary of Virginia Legislation:

House Bill 303 - Sponsored by Delegate John M. O'Bannon III

Senate Bill 464 - Sponsored by Senator Janet D. Howell

• SB 464: Would require health insurance companies to provide coverage of the diagnosis and treatment of autism spectrum disorders for individuals age 6 and younger (the bill does not preclude the extension of coverage for individuals age 7 and up)
  
  
• HB 303: Would require health insurance companies to provide coverage of the diagnosis and treatment of autism spectrum disorders for individuals age 9 and younger (the bill does not preclude the extension of coverage for individuals age 10 and up)
  
  
• 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:
  • 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
    
    
• SB 464: Coverage for Applied Behavior Analysis (ABA) is subject to an annual maximum of $35,000
  
   
• 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
  
  
• Employers with fewer than 50 employees are exempt from this bill
  
  
• 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
  
  
• The bill would apply to health insurance coverage offered to state employees beginning July 1, 2015
  
  
• If enacted, this bill would take effect on January 1, 2011