Oregon

Oregon Autism News:

Autism Speaks Endorses Oregon Autism Insurance Reform Bill

HB 3000 Would End Health Care Discrimination Against Children
with Autism by Requiring Coverage of Diagnosis and Treatment

Salem, OR (March 31, 2009) – Autism Speaks, the nation’s largest autism advocacy organization, today announced its support for House Bill 3000, 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 Oregon State House by State Representative Peter Buckley (D-5), HB 3000 includes coverage of Applied Behavior Analysis (ABA), an evidence-based, medically-necessary autism therapy.

“We applaud and thank Representative Buckley for his leadership on this issue of critical concern to thousands of Oregon families,” said Elizabeth Emken, Autism Speaks Vice President of Government Relations. “Autism Speaks joins Oregon’s autism community in calling on the legislature to pass HB 3000 and join the growing number of states that have ended healthcare discrimination against children with autism.”... Read more 

Summary of the Autism Insurance Reform Bill:

House Bill 3000 - Sponsored by State Representative Peter Buckley (D-5)

• 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
  
  
• Coverage of treatments will be provided  when prescribed, provided, or ordered for an individual diagnosed with autism by a psychologist , a psychiatrist, a psychiatric nurse practitioner, a licensed clinical social worker, or an autism service provider or a person, entity or group that works under the direction of an autism service provider who determines the care to be medically necessary
  
  
• The bill defines "medically necessary" as "in accordance with the definition of medical necessity that is specified in the policy, certificate or contract for the health benefit plan and that applies uniformly to all covered services under the health benefit plan"
  
  
• The bill includes coverage of the following treatments: prescription drugs, blood level tests, psychiatric services, psychological services, speech therapy, language therapy, occupational therapy, physical therapy, and Applied Behavior Analysis (ABA)
  
  
• The bill applies only to fully-funded health plans governed by state
  
  
• If passed, this bill will go into effect on July 1, 2011