TRACKING AUTISM INSURANCE LEGISLATION

June 10, 2010
Governor Nixon to sign autism insurance legislation
HB 1311 / HB 1341 becoming law!

LEGISLATION TO BE SIGNED:  Today, the Governor begins a tour of Missouri to various locations to sign legislation to bring autism insurance reform to Missouri.  HB 1311/1341 (Scharnhorst/Grill) requires private insurers in Missouri to provide coverage for the diagnosis and treatment of autism spectrum disorders. 

Families with private health insurance have had great difficulty in getting coverage for physician-prescribed autism-related treatments, and many individuals have not been able to purchase policies for their children with autism.  Many are anxiously awaiting the implementation of the new law, which will to into effect in January of 2011. 

The legislation is the result of bipartisan efforts and bipartisan support, with the filed bills having a long list of sponsors and co-sponsors from both sides of the aisle.  2010 was the third year that legislation had been filed and pursued by the autism community.

Governor Nixon has been a long-time supporter of autism issues, and autism insurance reform has been on his list of priorities since the failed attempt in the 2009 legislative session.

EXECUTIVE SUPPORT:  "Children with autism deserve to have the life-changing treatments they so badly need without getting caught up in the tangle of insurance bureaucracy," said Gov. Nixon in August in a speech at the Touchpoint Center for Autism in St. Louis.

"It is clear to me ... that action on autism coverage legislation can wait no longer. A bill that guarantees that insurance providers will cover the most effective treatments for autism must pass this legislative session and it must include substantial provisions that make real differences for real families," said Gov. Nixon.

The Governor's continued support and attention to the issue was a critical driving force to seeing the legislation through to completion this session. 

In his State of the State address this year, Governor Nixon brought autism again to the forefront,  "I have stood with Democratic and Republican legislators on this issue, and laid out the key elements of a bill that we all know will make a real difference in these children's lives."

DETAILS:  The final version of the legislation includes provisions to cover the much-discussed therapy of ABA (up to $40,000 per year, up to age 18) and state licensure provisions for ABA therapists.  Other treatments are not to be subject to visit limits or dollar amounts.  For small business policies, there is an "opt-out" provision if in the future their premiums would be adversely affected by the addition of this specific coverage.

SPONSOR QUOTES:  "I am very happy with the final product," lead Senate sponsor Sen. Scott Rupp said after the bill's passage. "This will dramatically affect thousands of families throughout Missouri."

 "This is a major victory for the many Missouri families who have worked long and hard to see this legislation become reality," said Rep. Jason Grill, the sponsor of HB 1341.  "We have had so many individuals who have worked diligently over the last several years to reach this point.  I am proud to be part of passing this landmark legislation that will make a real difference in the lives of so many children with autism."

FOR A COMPLETE LIST OF BILL-SIGNING LOCATIONS: 

Visit "Governor's Tour Schedule for MO Autism Bill Signings" on Facebook.

THE BUZZ:   

Please be aware that this legislation only affects certain types of policies.  Estimates are that the state mandate will affect 30 to 40 percent of the insurance market. Most large employers' plans are self-funded (ERISA plans) which can only be federally regulated. The legislation includes a "mandated offering" for individual policies, meaning that those policies will now have to offer an option for this coverage.People with individual insurance policies would have the option to buy the coverage but it would not be required.

If families have questions about whether or not this legislation will affect their policies, a good place to start is to contact the employer's HR department to ask if their company plan is subject to changes in Missouri state law.

MAY 12:  TRULY AGREED TO and FINALLY PASSED 

HB 1311 passes both the House and the Senate - now awaits Governor's signature

LEGISLATIVE UPDATE

May 12, 2010:  Jefferson City

For those tracking autism insurance legislation in Missouri, the magic words came today ...
TRULY AGREED TO AND FINALLY PASSED
These are the words listed as you look up the official status of the autism insurance bill that crossed the finish line, HB 1311. 
   Bipartisan support and appreciation were in the air in the state capitol with the final version of HB 1311 requiring insurance coverage for the diagnosis and treatment of autism spectrum disorders passing overwhelmingly in both the Missouri House and Senate. 
   It now awaits the Governor's signature to become law. 
      The lead sponsors in the House (Rep. Scharnhorst, Grill, Grisamore) all expressed their support to countless other legislators who made this piece of legislation possible.  After much discussion of the components of the conference committee sub, it was accepted and then it was approved overwhelmingly 144-16. 

    In the Senate, lead sponsor Senator Scott Rupp quickly took the House-approved version to the floor for final passage, thanking the many who had helped on that side of the capitol.  With his family in attendance, Senator Eric Schmitt received a standing ovation from his fellow senators and the gallery after sharing his touching reflections on having a child with autism.  Senator Days also complimented and congratulated everyone on this accomplishment, while admonishing the insurance industry for making families have to come to the legislature and "beg to get what they already pay for".
The bill passed in the Senate with a vote of 27-6. 

THE BUZZ: 
The components of the bill listed below are seemingly VERY good news compared to where we have been with changes to language during the session. The bill will become effective Jan 1, 2011. Once the bill becomes available - perhaps as early as tomorrow- we will double-check the following and post any corrections if needed.
However, our understanding of what the legislation contains:

     An official and precise interpretation of the statute will most likely be available from the state of Missouri soon.  But until then ...We believe provisional licensure for behavior analysts will be required between 2011-2012. Licensure will then be required beginning Jan 1, 2012.
   The licensure for behavior analysis constitutes a "practice act", which means that the language essentially defines the practice of ABA in Missouri. It does NOT mean that you only have to have a license if you are billing insurance for ABA.  Therefore it applies to anyone who is practicing behavior analysis (with an exemption for public school staff implementing IDEA and 504 Plans, and students doing ABA practicums).

Check the website for the actual bill specifics - when it is released, we will post!