State legislation: New York S.7000 Autism insurance bill; Committee meeting on March 22, 2010.

Prefacing notes. - A previous blog post addressed other autism insurance bills bills previously introduced in the NY State legislature: S 385/A 2759, S 1175, A 3332, S 2366/A 6001, S 6123/A 6888-B.

The stated rationale for the drafting of S. 7000, per an Autism Votes FAQ for S. 7000 , is that S. 7000 represents an effort to consolidate into one bill the multiple pieces of legislation already on the bill docket which were granted hearing in October of 2009.  With the introduction of S. 7000, while the other bills will remain on the docket, the comment in the FAQ is that none of them would be proceeding through the NY Senate. This blog has takes no position on the FAQs or the comments therein.

New York S.7000 : An Act to Amend the Insurance Law and the Public Health Law, in Relation to Coverage for the Screening, Diagnosis and Treatment of Autism Spectrum Disorder
Requires that individual accident and health insurance policies shall provide coverage for screening diagnosis and treatment of autism spectrum disorder.

Sponsored by Senator Neil Breslin (Albany Co.) Chair of the Senate Insurance Committee, Senator Thomas Duane (Manhattan) Chair of the Senate Health Committee, and Senator Charles Fuschillo, Jr. (Nassau Co.)

The bill has been referred to the Senate Insurance Committee; Autism Votes comments that a committee meeting will be held on March 22, 2010 and that a vote is projected to be taken at 11:00 am on Monday, March 22, 2010 in Room 123 in the Capitol Building

S. 7000 does not define applied behavior analysis nor are the providers or competencies addressed explicitly.

However, it does state starting on page 2,

"...Coverage for behavioral therapies required puruant to this subparagraph shall not be denied on the basis that such therapies are educational or habilitative in nature, unless such treatments are provided pursuant to an Individualized Family Service Plan [IFSP] under Section 2545 of the Public Health Law or an Individualized Education Program [IEP] under Article 89 of the Education Law. The provision of services pursuant to an Individualized Family Service Plan or an Individualized Eduation Program shall not affect coverage under the policy for sercices provided on a supplemental basis outside of an educational setting if such services are deemed medically necessary.

(C) This paragraph shall not be construed to affect any obligation to provide services to an individual under an Individualized Family Service Plan under Section 2545 of the Public Health Law of an Individualized Eduation Program under Article 89 of the Education Law.

(D) Nothing in this paragraph shall be construed to prevent a policy from providing services through a network of participating providers who shall meet certain requirements for participation, including provider credentialing..."

As previously stated, Autism Votes has posted a Frequently Asked Questions (FAQ) on S. 7000. While readers are encouraged to read the FAQ first hand, some of the comments in the document are that the clinical report and treatment guideline of the American Academy of Pediatrics, “Management of Children with Autism Spectrum Disorders” which was published in October, 2007, would serve as the standard for covered treatments until treatment guidelines would be developed by the NY Division of Health, the Office of Mental Health, and the Office of Mental Retardation and Developmental Disabilities.

The American Academy of Pediatrics, District II, New York State, and the Medical society of the State of New York have issued memoranda of support for S. 7000.

For further reading
S. 7000 at Open Legislation

New York State Senate
New York State Assembly

Autism Votes New York

Myers, S.M., Plauche Johnson, C.(2007). Management of children With Autism Spectrum Disorders. Pediatrics, 120(5), 1162-1182 (doi:10.1542/peds.2007-2362) 

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State legislation: New York - A full roster of autism insurance coverage legislation

© 2010 Regina G. Claypool-Frey
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