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Title: A bill to provide for enhanced treatment, support, services, and research for individuals with autism spectrum disorders and their families.
Sponsor: Sen Durbin, Richard [IL] (introduced 4/2/2009)
Cosponsors (2)
Sen Casey, Robert P., Jr. [PA] - 4/2/2009
Sen Menendez, Robert [NJ] - 4/2/2009
Latest Major Action: 4/2/2009 Referred to Senate committee. Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
As read into the Congressional Record, April 2, 2009.
Title: A bill to provide for enhanced treatment, support, services, and research for individuals with autism spectrum disorders and their families.
4/2/2009 Referred to Senate committee. Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Yes
See bill, clause 12 for details
See bill, clause 12 for details
No
HR 2413
Title: A bill to provide for enhanced treatment, support, services, and research for individuals with autism spectrum disorders and their families.
yes-under rehabilitative care, behavioral intervention.
Must be diagnosed by age 8. Coverage through age 16.
$36,000 inflation adj annually and a maximum lifetime benefit of $200,00
licensed
55 psychiatrist, licensed psychologist, licensed clinical social worker, licensed behavioral
56 therapist, certified behavioral analyst, or other qualified professional as prescribed by a
57 licensed physician, licensed physician's assistant, or certified nurse practitioner.
Waiver-home and community based services for individuals with MR & DD, including autism.
not per se, inclusion is for behavioral supports consultation.
Hawaii
Not at this time
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Idaho
Not at this time
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Illinois
Public Law 095-1005
(Senate Bill 934 as Passed)
Serious mental illness, including pervasive developmental disorders and PTSD.
Limited parity.
45 inpatient day and 35 outpatient visit benefit for other mental health conditions. May be subject to 50 percent co-pay and lesser of annual limit of $10,000 or 25 percent of lifetime policy limit.
Indiana
Code §§ 27-13-7-14. 7 and 27-8-14. 2-4).
law- mandate
yes-behavioral treatment included if prescribed by physician with a treatment plan
none
Coverage may not be
less comprehensive and its cost
sharing shall be comparable to
physical illness coverage
Serious mental illness, including pervasive developmental disorders and autistic disorders.
law-mental health parity
Unclear-"medically necessary and clinically appropriate", but excludes developmental, educational and experimental treatments.
none
Autism coverage may not be
less comprehensive or cost
sharing less than comparable to
physical illness coverage.
Coverage shall include 30 days
of in-patient care for mental
illness and 52 visits for out-
patient care.
Serious mental illness, including Asperger’s Disorder, Intermittent explosive disorder, PTSD, Rett’s Disorder, and Tourette’s Disorder.
law-mental health parity
Coverage for diagnosis and treatment.
none
Minimum mandated benefit. 1 percent cost increase cap. 45 inpatient days and 45 outpatient visits annually. Minimum 30 inpatient days for other mental health and substance abuse disorders; not less than $7,500 lifetime benefit for outpatient care.
"An Act To Provide Reimbursement in the MaineCare Program for Board-certified Behavior Analysts"
Now LAW 2009
bill
related bill to reimbursement by MaineCare Program for BACB certificants.
NA
NA
YES--Specific topic of the bill.
NA
SC 24A,2749-C
law-mandated
No. Treatment & diagnosis of mental illnesses.
None
Coverage may not be less comprehensive than that for physical illness.
No.
N/A
Maine Home and Community Based Services Waiver: Support Waiver
support waiver Maine DHHS
Is not specified explicitly among approved services.
21 years or older
Different dollar amounts depending on service applied
No
N/A
Maryland
HB 274
SB 394
yes
21
$50,000
Yes
Md.Code Ann.§ 15-835
law-mental health parity
No. Coverage for habilitative OT, PT & speech
Up to 19
Not spec.
No
N/A
Massachusetts
Mar. 2009
Do not see bills at this time. Last listed is for 2008.
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Ch 175, Sect 47B
law-mental health parity
19
Medically necessary benefits; shall continue for adolescents in ongoing treatment beyond the adolescent's 19th birthday until the treatment plan is completed.
Dof 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
yes--medically necessary treatment from evidence based research
Under 18 yrs
$50,000/yr up to age 8, $20,000 ages 9 to 18.
yes-"licensed" by the BACB
Yes
33-22-706 (temporary)
CHECK THIS
Mental Health Parity
Serious mental illness, including autism. More limited group coverage for other mental health and substance use disorders.
Limited parity.
Maximum 20 inpatient days for other mental health disorders. Outpatient treatment fo other mental health disorders may be limited to $2,000 per year. Inpatient and outpatient substance use treatment is subject to $6,000 maximum in 12-months and lifetime maximum inpatient of $12,000. Allows exclusion of mental health for "barebones" policies (12 mo. pilot).
Licensing of behavior analysts. Research pilot program
An Act relating to autism; defining terms; providing for the licensing of certain persons; stating qualifications; providing for renewal; stating duties of licensee; prohibiting certain act; providing penalites; "etc.
Serious mental illness, includes autism and ADHD; substance abuse disorders.
law-neither mandate nor parity
Mandated minimum benefit for individual and small group plans of 20 inpatient days and 20 outpatient visits. Minimum 50 percent co-insurance required after first five outpatient visits, except for serious mental illness and substance abuse disorders
waiver for those diagnosed with MR or related AND require treatment or care of an intermediate care facility. Purpose of waiver is to provide services to remain in community.
Not specified. There is a "Special Family Habilitation" service to teach adaptive and social skills.
children through adults, although the waiver changes at age 21.
Covers advocacy and State & Federal legislation of issues of concern to the autism community, and acts as resource for state advocates seeking to submit insurance mandates (Model Mandate template on the website and Arguments for coverage of services). Tracking service of state autism insurance mandates.
Behavior analysis and public policy--topics of interest are competent delivery of behavior analytic services, autism services, and potential of behavior analysis as a licensed profession.
Advocates across the country are pushing for states to pass legislation requiring health insurance companies to cover autism treatment. With states hurting in this struggling economy, it’s been an uphill battle for many, but proposals in some states are moving forward.Here’s a look at recent legislative action on these autism insurance proposals:..."
Makes changes and includes additions to the statutes enacted last year regarding the licensure and regulation of behavior analysts. Last updated 2/13/2009
Provisions
· Establishes a separate account within the Board Fund (Fund) that must be used only for licensing and regulation of behavior analysts.
· Requires that any monies transferred into the Fund for licensing and regulation of psychologists must be used only for licensing and regulation of psychologists.
· Allows the Board to accept gifts, grants, or donations for deposit into the Fund for licensing and regulation of behavior analysts.
· Specifies that unprofessional conduct for a behavior analyst includes representing oneself as a psychologist.
· Delays until 2011 the requirement that behavior analysts be licensed to practice in Arizona.
· Allows the Board to issue a license to a certified or licensed behavior analyst from another state which has essentially the equivalent requirements as Arizona.
· Contains a conditional repeal from and after June 30, 2010.
· Exempts the Board from rule making requirements until September 26, 2011.
· Specifies that monies in the Fund are exempt from the lapsing of appropriations.
· Defines the term incompetent as a behavior analyst.
HB 273: Includes ABA. Status of service provider is an individual licensed under Title 14 or Title 18 of the Health Occupations Article or under the supervision of an individual licensed under Title 14 or Title 18 of the Health Occupations Article; or A Board Certified Behavior Analyst or a Board Certified Associate Behavior Analyst credentialed by the Behavior Analyst Certification Board.
SB 394: Includes ABA. Status of service provider is an individual licensed under Title 14 or Title 18 of the Health Occupations Article or under the supervision of an individual licensed under Title 14 or Title 18 of the Health Occupations Article; or A Board Certified Behavior Analyst or a Board Certified Associate Behavior Analyst credentialed by the Behavior Analyst Certification Board.
Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions
Sponsor:. Rupp. LR Number:. 0845S.02I. Fiscal Note:. 0845-02. Committee:. Small Business, Insurance and Industry. Last Action:. 2/17/2009 - Hearing Scheduled S Small Business, Insurance and Industry Committee. Journal Page:. Title:. Calendar Position:. Effective Date:. August 28, 2009. Full Bill Text. All Actions. List of 2009 Senate Bills.
Re: Provider of behavior analytic services
(1) The person who is supervising the direct implementer, who is certified as a board certified behavior analyst by the Behavior Analyst Certification Board; or
(2) The entity or group for whom such supervising person works or is associated.
Requires health carriers issuing or renewing a health plan to provide individuals younger than 21 years of age insurance coverage for the diagnosis and treatment of autism spectrum disorders Proposed Effective Date:. 08/28/2009. Co-Sponsor:. Schoemehl, Sue (100). etal.. LR Number:. 1030L.01I. Last Action:. 02/12/2009 -. Referred: Health Care Policy (H). HB357.
Re: Provider of behavior analytic services
To the extent any payments or reimbursements are being made for services rendered by a direct implementer for applied behavior analysis, such payments or reimbursements shall be made to either:
(1) The person who is supervising the direct implementer, who is certified as a board certified behavior analyst by the Behavior Analyst Certification Board; or
(2) The entity or group for whom such supervising person works or is associated.
SB 234: Includes ABA]. Re: service provider: "(ii) Applied behavior analysis covered under this section must be provided by an individual certified by the department of public health and human services as a qualified provider of behavior analysis.
"HELENA - A bill asking that the State of Montana require insurance companies to cover autism treatments has made it out of a Senate committee in Helena.
Senate Bill 234, otherwise known as 'Brandon's Bill,' passed out of the Business, Labor and Economic Affairs Committee on a 6-5 vote on Monday.
(...)
SB 234 is expected on the floor for second reading this week."
Coverage restricted to speech, occupational and physical therapy. Excludes services received from IDEA 2004 or other state educational services for children 3-22 years.
2/6/09 House Health and Government Affairs Committee introduced substitute removing ABA.
Current location: House Business & Industry Committee
OKLAHOMA HB 2027 legislation to license those with BACB certification
Floor Amendment/Floor substitute for HB 2027, House of Rep. OK, HB2027 FA3-A2 Steele 2/11/2009 7:59 pm, Steele, Sullivan and McDaniel "An Act relating to autism; defining terms; providing for the licensing of certain persons; stating qualifications; providing for renewal; stating duties of licensee; prohibiting certain act; providing penalites; "etc.
SUPPORT WITHDRAWN - UTAH SB 43. Includes ABA (Early intensive behavior therapy).
SB 43:Includes ABA, specifically notes "Early intensive behavior therapy", but also included habiliative and rehabilitative treatment. Does not specify deliver of services.
"ALT LAKE CITY (AP) -- The Senate has given initial approval to a bill that would require insurance companies to cover autism treatment for children younger than 17.
Senate Bill 43, known as Clay's Law, would require insurance companies to provide $50,000 in coverage for children younger than 9 and $25,000 in coverage for children 9 to 16...."
Senate's Move, House Panel's Inaction Anger Advocates
By Fredrick Kunkle
Washington Post Staff Writer
Thursday, February 12, 2009; Page B07
RICHMOND, Feb. 11 -- The Senate has effectively killed a bill that would have required insurers to cover autistic children,...The bill (HB 1588) quickly met resistance. The House Commerce and Labor Committee took no action on it...In the Senate (SB 1260) , Vogel sought compromise by limiting the mandated coverage to children younger than 12. Saslaw cut the age further, to 6 years old. But efforts at compromise failed..."
Autism spectrum disorder; mandated health insurance coverage therefor.
January 14, 2009
Prefiled September 24, 2008
A BILL to amend and reenact � 38.2-4319 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 38.2-3418.15, relating to health insurance coverage for autism spectrum disorder.
A BILL to amend and reenact � 38.2-4319 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 38.2-3418.15, relating to health insurance coverage for autism spectrum disorder.
WAHB 1210: Includes ABA. "The department of health will adopt rules establishing standards for qualified autism services providers. Once the rules are adopted, payment for the treatment of autism spectrum disorders covered under this section will be made only to autism service providers who
meet the standards."
Companion bill
SB 5203: Includes ABA. Same stipulation on establishing standards as HB 1210.
analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.
Summary of the Bill and Public Testimony to the Committee 1/28/09.
This group is advocating on behalf of,and tracking the legislation.
AB 15: Does NOT specifically refer to ABA as a treatment modality.
Introduced 1/3/2009
Specifies, "treatment is provided by a psychiatrist, a psychologist, a social worker who is certified or licensed to practice psychotherapy, a paraprofessional working under the supervision of any of those three types of providers, or a professional working under the supervision of an outpatient mental health clinic."
SB 3: Does NOT specifically refer to ABA in the original bill. (See Substitute Amendment for relevant changes).
This bill requires health insurance policies and self−insured governmental and school district health plans to cover the cost of treatment for an insured for autism, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified if the treatment is provided by a psychiatrist, a psychologist, a social worker who is certified or licensed to practice psychotherapy, a paraprofessional working under the supervision of any of those three types of providers, or a professional working under the supervision of an outpatient mental health clinic.
treatment for the mental health condition of autism spectrum disorder if the treatment is prescribed by a physician and provided by any of the following who are qualified to provide intensive level services or post-intensive-level services: (1) a psychiatrist; (2) a person who practices psychology;
(3) a social worker who is licensed or certified to practice psychotherapy; (4) a paraprofessional working under the supervision of a social worker who is licensed or certified to practice psychotherapy, a person who practices psychology, or a psychiatrist; (5) a professional working under the supervision of an outpatient mental health clinic; (6) a speech-language pathologist; or (7) an occupational therapist.
The substitute amendment defines additional terms, including “intensive-level services” and “post-intensive-level services.” “Intensive-level services” is defined as evidence-based behavioral therapy designed to help an individual with autism spectrum disorder overcome the social, behavioral,
and cognitive deficits associated with the disorder. “Post-intensive-level services” is defined as therapy that occurs after completing treatment with intensive-level services and that is designed to maximize and sustain gains made during treatment with intensive-level services or, for an individual who has not and will not receive intensive-level services, therapy that will improve the individual’s condition**. The Commissioner of Insurance is required, by rule, to further define “intensive-level services,” “postintensive-level services,” “paraprofessional,” and “qualified.” In addition, the Commissioner may promulgate rules governing the interpretation or administration
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