For Good Measure Autism Insurance Legislation: What It Means for Your Child

August 1, 2011

Mrg2010web
Melissa R. Gillis, Esq.

Imagine this: an issue so big that when the governor signs a much-anticipated bill into law so many parents and families want to view the historic event that the signing has to take place at Fenway Park in Boston, instead of the State House, to accommodate the crowd.

Well, that’s exactly what happened on August 3, 2010 when Gov. Deval Patrick signed House Bill 4935 (an Act Relative to Insurance Coverage for Autism Spectrum Disorder, or ARICA) into law. As the crowd cheered, Massachusetts, finally having recognized the unfair and unreasonable burden imposed on families with children diagnosed with autism, became the 23rd state to pass such legislation.

Effective Jan. 1, 2011, private health-insurance plans, employees and retirees under the state plan, hospital service plans, and HMOs are now required to provide coverage of evidence-based, medically necessary autism therapies for diagnosed persons of all ages. After being deemed medically necessary by a doctor, coverage will include habilitative and rehabilitative treatments, psychiatric and other therapeutic care, diagnostic tests, applied behavioral analysis and health treatments, pharmaceuticals, and other care provided, prescribed, or ordered by a licensed physician or psychologist for a person on the autism spectrum, including speech, occupational therapy, and physical therapy. There is no age restriction for any of these treatments to begin or end.

Additionally, insurers cannot establish dollar-amount, annual, or lifetime service limitations on the required coverage...

You may read more at the link below.

by: Melissa R. Gillis

Healthcare News
August 2011

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