The descriptions below provide a brief overview of currently listed Practice Board Sponsored Events at the ABAI 36th Annual Convention, San Antonio, TX, May 28 - June 1, 2010.
For full and most current information, please consult the 2010 Annual Convention Home, and find "ABAI Practice Board Sponsored Events" under "Program Scheduling and Workshop Registration".
SATURDAY, 5/29/2010
# 103 Business Meeting
7:30 PM - 8:20 PM
217B (CC) ABAI Practice Board Open Meeting: This Ain't Your Daddy's ABA! Chair: Michael F. Dorsey (Endicott College)
The ABAI Practice Board Open Meeting is a forum for ABAI members to meet the members of the Practice Board and its' various committees. The organizational philosophy of the Practice Board is a “Bottoms-Up” approach to member service, soliciting from the practitioner members of ABAI what they need from ABAI to be more successful in their day-to-day professional roles. The members of the Practice Board will review for the audience the steps completed this year toward this end and will seek to gain a better understanding of additional areas of need.
# 114 ABAI Expo
8:30 PM - 11:00 PM
Exhibit Hall A (CC)
50. The ABAI Education Board CHARLES T. MERBITZ (Chicago School of Professional Psychology)
51. The ABAI Practice Board—Meeting the Needs of Practitioners MICHAEL WEINBERG (Orlando Behavior Health Services, LLC), Thomas L. Zane (The Center for Applied Behavior Analysis at The Sage Colleges), Jennifer R. Zarcone (University of Rochester Medical Center), Travis Thompson (University of Minnesota), R. Douglas Greer (Teachers College, Columbia University), Michael J. Dougher (University of New Mexico), Jon S. Bailey (Florida State University), Josh Pritchard (University of Nevada, Reno)
52. ABAI Practice Board: Licensure Committee–Current Status and Developments MICHAEL F. DORSEY (Endicott College)
53. The Practice Board Governmental Affairs Committee Eric Billington (United Health Group), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.), Megan Guidi (Vinfen Corporation), Amy Kenzer (Center for Autism and Related Disorders, Inc.), R. WAYNE FUQUA (Western Michigan University)
54. ABAI Membership Board PHILIP N. HINELINE (Temple University), Jay Moore (University of Wisconsin-Madison), Edward K. Morris (University of Kansas)
55. ABAI Program Board: An Overview of the Program Convention System RAMONA HOUMANFAR (University of Nevada, Reno), Raymond C. Pitts (University of North Carolina, Wilmington)
56. ABAI Student Committee Erick M. Dubuque (University of Nevada, Reno), Sarah M. Dunkel-Jackson (Southern Illinois University), JOSH PRITCHARD (University of Nevada, Reno)
57. ABAI's Board of Affiliated Chapters GORDON BOURLAND (Trinity Behavioral Associates)
SUNDAY, 5/30/2010
# 261 Symposium
3:00 PM - 4:20 PM
201 (CC)
OTH; Service Delivery ABAI Practice Board Presents a Symposium for Parents: How to Get Medical Insurance Funding for Your Child’s Applied Behavior Analysis Program Chair: Amy Kenzer (Center for Autism and Related Disorders, Inc.)
History of Funding for Applied Behavior Analytic Services: Background Perspective for Parents of Children on the Autism Spectrum DOREEN GRANPEESHEH (Center for Autism and Related Disorders, Inc.), Michael F. Dorsey (Endicott College)
What Every Parent of a Child With Autism Needs to Know: Current Status of Medical Insurance Legislation Requiring Coverage for Applied Behavior Analytic Services in 15 States DOREEN GRANPEESHEH (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.)
Not All Insurance is Created Equal: Distinguishing Between Good and Bad Insurance Plans for Autism AMY KENZER (Center for Autism and Related Disorders, Inc.), Bryce Miler (Center for Autism and Related Disorders)
A Practical Tutorial for Parents on How to Get and Maintain Insurance Funding for Your Child’s Applied Behavior Analysis Program BRYCE MILER (Center for Autism and Related Disorders, Inc.), Doreen Granpeesheh (Center for Autism and Related Disorders, Inc.)
# 296 Symposium
4:30 PM - 5:50 PM
201 (CC)
OTH; Service Delivery ABAI Practice Board Presents Advice for Professional Behavior Analysts: How to Access and Maintain Medical Insurance Coverage for Your Behavioral Services Chair: Arthur E. Wilke (Center for Autism and Related Disorders, Inc.)
A Behavior Analyst’s Perspective on the History of Third Party Funding for Applied Behavior Analytic Services for Children With Autism DOREEN GRANPEESHEH (Center for Autism and Related Disorders, Inc.), Michael F. Dorsey (Endicott College)
Legislation Requiring Insurance Coverage for Applied Behavior Analytic Services in 15 States: What Every Behavior Analyst Should Know DOREEN GRANPEESHEH (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.)
How to Get Approved by Insurance Companies Who Fund Behavioral Services: Practical Advice for Behavior Analysts BRYCE MILER (Center for Autism and Related Disorders, Inc.)
Navigating the Maze of Billing Medical Insurance for Behavioral Services DENNIS DIXON (Center for Autism and Related Disorders, Inc.), Bryce Miler (Center for Autism and Related Disorders, Inc.)
MONDAY, 5/31/2010
# 453 Panel Discussion
3:00 PM - 4:20 PM
Seguin (Grand Hyatt)
CSE; Service Delivery BACB CE Offered. CE Instructor: Michael Weinberg, Ph.D., BCBA Behavior Analyst Licensure: Current Status in States With Licensure Laws Chair: Michael Weinberg (Orlando Behavior Health Services, LLC)
KIMBERLY NIX BERENS (Center for Advanced Learning, Inc.) JIM BOUDER (The Vista School) MICHAEL F. DORSEY (Endicott College) JOHN SCIBAK (Massachusetts House of Representatives; The Vice-Chair of the Joint Committee on Economic Development and Emerging Technologies and the Co-Chair of the Oral Health Legislative Caucus) MICHAEL WEINBERG (Orlando Behavior Health Services, LLC)
SB 204, AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO AUTISM SPECTRUM DISORDERS COVERAGE.
currently in the Senate Finance Committee. SB 204 defines applied behavior analysis, includes it for coverage under the "habilitative or rehabilitative care" category, and includes among those denoted as an "Autism services provider", "practitioners with the national certification of board-certified behavioral analyst",or any person, entity, or group meeting the standards set by the Department of Health and Social Services.
Meeting information:
Date: Friday, May 21, 2010
Time: 1:00pm - 6:00pm (hourly sessions)
Location: Autism Delaware Newark Office
Street: 924 Old Harmony Road, Suite 201
City/Town: Newark, DE View Map
RSVP at Facebook and/or to Kim Siegel, kim.siegel@delautism.org
Attendees will able to learn more about the latest information on SB 204 and write letters to legislators. Talking points, contact information, sample letters, paper, envelopes, and refreshments will be provided.
Every hour there will be a review of the legislation and what it will (and will not) accomplish and answer questions before beginning letter writing. The first hourly session starts at 1:00pm, sessions will continue through the afternoon, with the last session beginning at 5:00pm and ending at 6:00pm.
Again, please RSVP at Facebook and/or to Kim Siegel, kim.siegel@delautism.org to sign up for a time slot so that organizers can ensure that there will be enough volunteers, supplies, and snacks during the session.
Summary of some state and Federal legislation and statute
May 16, 2010
Note: While this is a best effort to track and report legislation for the purposes of education and reference, no claim is made of comprehensiveness, completeness or accuracy, and posting does not constitute legal advice.
Readers are urged to consult noted references and relevant governmental sources to obtain exact legislative and statutory language.
Red dots = states with passed licensing law (7) Yellow=states with passed autism insurance law Green = states with autism insurance legislation in progress Gray= states with autism insurance legislation that failed to pass in 2010.
Licensing legislation - passed (red dots)
(BACB)=BACB certification alone is competency for license
(BACB+) = BACB and additional requirements
(other) = other requirements
Arizona (2008)/January 1, 2011 - Note: this is year delay, via HB 2207 (2009) which specified certain deposits and accounting changes to enact Laws 2008, Chapter 288. (other). State Board of Psychologist Examiners
Missouri (2010)/ HB 1311 - (BACB). Behavior Analyst Advisory Board under the State Committee of Psychologists [blogpost] 5/16/10 awaiting signature of Governor Jay Nixon.
Nevada (2009)/May 29, 2009 for purpose of establishing licensing and certification requirements. July 1, 2011 for all other purposes. Language of AB 162 as enrolled. Ch. 331. (BACB). Board of Psychological Examiners, adding 2 more members, one of whom is a licensed behavior analyst. Also certifies autism behavior specialists.
Oklahoma (2009)/November 1, 2009 - license and training program. Licensing Act language at the BACB. (BACB). Licensed by the Developmental Disabilities Services Division of the Department of Human Services.
Pennsylvania (2008)/ 1 year from effective date of regulations promulgated or July 1, 2012 - license is for "Behavior Specialist". Licensing requirements as outlined in Act 62 from PA DPW (other). State Board of Medicine
Wisconsin (2010)/30 days after publication date; Publication date May 25, 2010. SB 667/2009 Wisconsin Act 282 - (BACB). Department of Regulation and Licensing; an advisory committee may be appointed to advise on regulation. [blogpost]
Licensing legislation - in progress (open red dot)
Autism insurance legislation - passed (yellowon map) - red below indicates also a license in that state.
NB- legislation does not affect ERISA self-insured plans or may have other state specific coverages, restrictions or exclusions depending on state's statute and regulation.
Kansas (2010)/upon publication in the Kansas Statute Book. SS for HB 2160. Limited pilot program under Kansas State Employees Health Care Commission for evaluation for future possible expansion. (BACB + additional conditions) See Autism Votes Kansas [blogpost]
Missouri(2010)/January 1, 2011 or after, when new plan issued.HB 1311Behavior Analyst Advisory Board to Board of Psychologist Examiners.(BACB). 5/16/10 awaiting signature of Governor Jay Nixon.
See Autism Votes Missouri, [blogpost]
New Hampshire HB 569-FN (2010)/January 1, 2011 - . Bill is clarification of existing statute. 5/16/10 awaiting signature of Governor John Lynch.
See Autism Votes New Hampshire [blogpost]
Vermont S. 262. (2010)/July 1, 2011 but no later than July 1, 2012. Limited to children age 18 mos. to 6 yrs. Law includes feasibility study for expansion to older minors, other programs and coverage of BCBAs. 5/16/10 awaiting signature of Governor Jim Douglas.
See Autism Votes Vermont [blogpost]
District of Columbia B18-0528 Introduced on November 19, 2009. Last hearing on March 24, 2010. May be inactive, but status is unclear. Autism Votes District of Columbia
North Carolina (subject to change by conference committee) HB 589 = S 375 - specifies "behavioral therapy, including but not limited to ABA. Service provider not specified. Legislative session commenced May 12, 2010 runs through mid July, dependent on adjournment resolution. Autism Society of North Carolina, Autism Votes North Carolina. [blogpost]
Ohio HB 8. ABA included under habilitative or rehabilitative care. Provider not specified. Passed House on 12/8/09; in Senate Insurance, Commerce & Labor Committee since 12/9/09. Autism Society of Ohio, Autism Votes Ohio
Rhode Island HB 7260. Covers ABA. Bill being held for further study; Rhode Island legislature adjourns late June. S.2422. Does not cover ABA. Instructs higher ed to evaluate increasing preparation programs for PT, OT, nursing program and financial and scholarship incentives. Autism Votes Rhode Island [blogpost];
Autism insurance legislation - failed to pass or modified (M) from original purpose in 2010 (gray on map)
Alaska HB 187; (May be on hold pending task force review) Did not specify competencies of "autism service provider". Legislature adjourned 4/18/10. [blogpost]
(M) Georgia SB 161 - Insurance; require certain coverage for autism spectrum disorders; provide definitions. Modified by House Committee on Insurance to appoint a task force for study of education and services. Legislature adjourned.
Maryland HB 1091 & SB 1028; Legislature adjourned before significant action taken [blogpost]
Minnesota HF 359; language transferred to House HHS Omnibus Health Care bill; excised in Conference Committee [blogpost]
Mississippi SB 2055, SB 2129, SB 2175, SB 2363, SB 2607, HB 1496. All "Died" in House and Senate Insurance Committees.
Missouri SS/SB 618. Similar bill HB 1311&1341 passed in 2010 legislature. [blogpost]
Virginia SB 464; reduced amount and age of coverage. Tabled by House Commerce and Labor committee. [blogpost]
Washington HB 1210 & SB 5203; Carried over from 2009. No significant action taken in special session. [blogpost]
California SB 1282 Applied behavior analysis services: California Behavioral Certification Organization. [blogpost]
Massachusetts S. 45 Level IV Treatment Interventions & S. 46 Special Commission on Behavior Modification. [blogpost]
Massachusetts S 2293, formerly S. 223 "An Act to improve augmentative and alternative communication opportunities for children with disabilities" Bill History. Problematic reference is inclusion of "facilitated communication" as communication modality.
New York S.03676 Provides an exemption for individuals performing behavior analysis. [blogpost]
Other significant legislation on hold or "failed".
Alaska HB 425 (On hold pending task force study). Would have created intervention system for ABA and provided supervised experience towards BACB certification. Legislature adjourned 4/18/10. [blogpost]
Mississippi SB 2457 ("Died" in Education; Appropriations Committees). would have phased in training of personnel and routine school use of "applied behavior science" for the state's students with ASD.
Missouri SB 1030 Creation of Behavior Analyst Advisory Board and licensure. Language rolled into autism insurance bills SS/S. 618 and passed HB 1311&1341. [blogpost]
*Federal legislation in progress
Restraint and seclusion legislation
S. 2860 "A bill to protect students from inappropriate seclusion and physical restraint, and for other purposes". [blogpost]
Note: Many states are currently in the process of reviewing regulation or creating legislation issue of restraint and seclusion under the urging of Secretary of Education Arne Duncan and prompting of this Federal legislation. Please refer to your state legislature or Department of Education for the status of such actions.
Thomas.gov (Search engine of the Library of Congress)
Federal Register: Tuesday, February 2, 2010 Part IV:
Department of the Treasury, Internal Revenue Service, 26 CFR Part 54
Department of Labor, Employee Benefits Security Administration, 29 CFR Part 2590
Department of Health and Human Services, Centers for Medicare & Medicaid Services, 45 CFR Part 146
Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Final Rule http://edocket.access.gpo.gov/2010/pdf/2010-2167.pdf
A news report indicates that North Carolina is poised to bring autism insurance bills for legislative consideration,
"On Tuesday [May 11, 2010], Joint Study Committee voted to move the bill from the study phase to the legislative approval process.
North Carolina now joins a growing list of states where autism insurance reform is underway. Nineteen states have enacted autism insurance reform since 2007 and with this action North Carolina becomes the eleventh additional state to introduce autism insurance reform legislation. The legislation now moves to House and Senate subcommittees for review and recommendation."
The General Assembly website shows that the referenced bills which were postponed since August 7, 2009 , and are currently listed under conference committee study are,
House Bill 589 (= S375) (2009 Title): An act to require health benefit plans and the state health plan to cover hearing aids and replacement hearing aids; and to require the state health plan for teachers and state employees to provide coverage for autism treatment disorders.
The most recent version of the legislation stated coverage for "behavioral therapy" including, but not limited to applied behavior analysis, classified under habilitative and rehabilitative care, with treatment including care provided or ordered by a licensed medical doctor or a licensed psychologist who determines the care to be medically necessary. The service provider or competencies of the delivery of behavioral therapy or applied behavior analysis is not defined.
For further reading Family Pushes For NC Autism Insurance Coverage Bill In NC House, Senate Could Relieve Financial Burden
POSTED: 6:18 pm EDT May 12, 2010
UPDATED: 6:53 pm EDT May 12, 2010
Update, 5/12/10, 6:20PM PDT - The Missouri Senate newsroom reports that the licensing provisions for Behavior Analysts have been retained in the final passed bill,
"In addition, a state Behavior Analyst Advisory Board is established under the State Committee of Psychologists within the Division of Professional Registration. The new board is charged with establishing and overseeing licensure and registration requirements for behavior analysts and assistant behavior analysts who provide therapies for children with autism spectrum disorders."
On Tuesday, May 11, 2010 a joint House-Senate conference committee of the Missouri Legislature drafted a Committee Substitute for the Senate Committee Substitute for House Committee Substitute for House Bill Nos. 1311 & 1341 .
On Wednesday, May 12, 2010 this Conference Committee Substitute was adopted and passed by both the House (144-16) and the Senate (27-6) of the Missouri Legislature.
News stories report that the coverage for autism spectrum disorders is $40,000/year for ABA up to age age 18, but the full and exact language of the Conference Committee Substitute, or whether any changes were made to the licensing conditions for Behavior Analysts is unavailable at this time. It is expected that Missouri Governor Jay Nixon will sign the passed legislation.
Despite concerted last minute actions by interested stakeholders, the final version of the Minnesota HHS Omnibus bill determined by Conference Committee and passed in the Minnesota Legislature did not contain the insurance provisions for autism treatment which were contained in the House version. The Committee split on this inclusion, with all of the House members voting in favor of inclusion and those in the Senate opposed. While discussion of this Conference Committee version was allowed on the floors of the Legislature, amendment was not, so that the reported version was in essence the final version.
This legislation now goes to Minnesota Governor Tim Pawlenty. It is reported that he may veto it in its current form because of Medicaid changes; this would send it back to the Legislature, but re-inclusion of the insurance coverage even in that eventuality seems a distant possibility.
**5:35 PM PDT, Tuesday 5/11/10 - Minnesota Northland Association for Behavior Analysis (MNABA) has posted on Facebook the latest update, which is that the Senators on the conference committee voted against adoption of the autism insurance language. There may still be time to weigh in, but the word is that deliberation is in the evening of 5/11 Please see their action alert at Facebook for the specific information action to be taken. **
The Autism Advocacy Law Center blog is currently following closely the legislative conference on the House (HF2614) and Senate (S2337) versions of the Health and Human Services Omnibus Bill. That blog, and a perusal of the bills' comparative language indicates that the House version of the Omnibus Bill contains the language originally found in the House bill, HF 359, the Autism Healthcare Protection Act, and the Senate version does not.
96.3 (b) A health plan must provide coverage for the diagnosis, evaluation, assessment,
96.4 and medically necessary care of autism spectrum disorders that is evidence-based,
96.5 including but not limited to:
(...)
96.8 (2) applied behavior analysis and intensive early intervention services, including
96.9 service package models such as intensive early intervention behavior therapy services
96.10 and Lovaas therapy;
97.13 (5) services must be provided by a mental health professional or, as appropriate, a
97.14 board-certified behavior analyst, a qualified mental health practitioner, or a qualified
97.15 mental health behavioral aide.
97.16 (e) Providers under this section must work with the commissioner in implementing
97.17 evidence-based practices and, specifically for children under age 21, the Minnesota
97.18 Evidence-Based Practice Database of research-informed practice elements and specific
97.19 constituent practices.
A mental health professional who uses the services of a qualified mental health
97.29 practitioner, board-certified behavior analyst, or qualified mental health behavioral aide for
97.30 the purpose of assisting in the provision of services to patients who have autism spectrum
97.31 disorder is responsible for functions performed by these service providers. The qualified
97.32 mental health professional must maintain clinical supervision of services they provide
97.33 and accept full responsibility for their actions. The services provided must be medically
97.34 necessary and identified in the child's individual treatment plan. Service providers must
97.35 document their activities in written progress notes that reflect implementation of the
97.36 individual treatment plan.
(...)
98.13 EFFECTIVE DATE. This section is effective August 1, 2010, and applies to
98.14 coverage offered, issued, sold, renewed, or continued as defined in Minnesota Statutes,
98.15 section 60A.02, subdivision 2a, on or after that date.
Although Missouri was one of the first state legislatures to forward autism insurance legislation in this session, with the support of Governor Jay Nixon and the stated support of the Speaker of the Missouri House - as a Friday, May 14, 2010 adjournment for the General Assembly approaches it may come down to the wire whether one of the bills passes. One news story reported that the Senate President Pro Tem was optimistic that an autism insurance bills would pass before the week ends.
The bill with potentially the highest probability of passage is,
the Senate Committee Substitute for HB 1311 & 1341, which was listed on the House Calendar under the heading of
In lay terms, the House refuses to concur with the passed Senate version and requests that the Senate recede from that version or, failing to do so, to grant the House a conference. **As of 6:00PM PDT, May 10, 2010 the Senate refused to recede and a Conference has been granted.**
The related,
Senate bill, SS/SB 618 Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions
was passed on March 18, 2010 in the Senate and sent to the House where it received relatively little action until the end of April. At the current time, SS/SB 618 has been reported with a Do Pass with House Committee Substitute, but is not showing on the House Calendar.
One of the clauses of the House Committee Substitute for SS/SB 618 was to change the reimbursement condition in the perfected Senate version from reimbursement for Board Certified Behavior Analysts to reimbursement for licensed practitioners and to include language specifying establishment of a Board and other relevant details.
At this point, both SS/S 618 and HB 1311& 1341 both have clauses for the,
Establishment of the Behavior Analyst Advisory Board under the State Committee of Psychologists within the Department of Insurance, Financial Institutions and Professional Registration to establish licensure and registration requirements for behavior analysts, assistance behavior analysts, and line therapists who provide applied behavior analysis therapies for children with autism spectrum disorders. The board shall consist of the following 7 members:
1) 3 licensed behavior analysts;
2) 1 licensed behavior analyst holding a doctoral degree;
3) 1 licensed assistant behavior analyst;
4) 1 professional member of the committee; and
5) 1 public member.,
and defines function, duties and conditions of licensing.
As stated in the summary of the House Committee Substitute sumamary, "the licensing provisions are similar to those contained in the perfected version of HB 1311 and 1341 (2010)."
These clauses mirror the language of the now defunct SB 1030, which was a standalone licensing bill.
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.
S. 262 “An act relating to insurance coverage for autism diagnosis and treatment”, reverted to original title upon passage from AN ACT RELATING TO A STUDY OF COVERAGE OF APPROPRIATE SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS
With this concurrence, S. 262 has passed the legislative hurdle and the next step is approval by Vermont Governor Jim Douglas .
S. 262 as introduced called for health insurance coverage of autism spectrum disorders. The Senate on March 23, 2010 passed a modified version which excised the insurance clauses in favor of creating a study committee. On consideration in the Vermont House, the House Committee on on Health Care and Wellness restored language specifying insurance coverage for a covered age range of 18 months to 6 years of age or entry to first grade, whichever is earlier. This amended version would also extend coverage to state employees. With some additional amendment, this House version was approved by the Vermont House on Thursday, May 6, 2010.
Some language of interest relating to behavior analysis and behavior analysts (readers are advised to read entire text for full and definitive language),
Sec. 2. 8 V.S.A. § 4088i is added to read:
§ 4088i. COVERAGE FOR DIAGNOSIS AND TREATMENT OF AUTISM SPECTRUM DISORDERS
(a) A health insurance plan shall provide coverage for the diagnosis and
treatment of autism spectrum disorders, including applied behavior analysis
supervised by a nationally board-certified behavior analyst, for children,
beginning at 18 months of age and continuing until the child reaches age six or
enters the first grade, whichever occurs first.
(...)
(d) As used in this section:
(1) “Applied behavior analysis” means the design, implementation, and
evaluation of environmental modifications using behavioral stimuli and
consequences to produce socially significant improvement in human behavior.
The term includes the use of direct observation, measurement, and functional
analysis of the relationship between environment and behavior.
(2) “Autism services provider” means any licensed or certified person
providing treatment of autism spectrum disorders.
(...)
(5) “Habilitative care” or “rehabilitative care” means professional
counseling, guidance, services, and treatment programs, including applied
behavior analysis and other behavioral health treatments, in which the covered
individual makes clear, measurable progress, as determined by an autism
services provider, toward attaining goals the provider has identified.
(6) “Health insurance plan” means Medicaid, the Vermont health access
plan, and any other public health care assistance program, any individual or
group health insurance policy, any hospital or medical service corporation or
health maintenance organization subscriber contract, or any other health
benefit plan offered, issued, or renewed for any person in this state by a health
insurer, as defined in 18 V.S.A. § 9402. The term does not include benefit
plans providing coverage for specific diseases or other limited benefit
coverage.
Sec. 3. APPLICABILITY AND EFFECTIVE DATE
(a) Sec. 2 of this act shall take effect on July 1, 2011, and shall apply to all health insurance plans on and after July 1, 2011, on such date as a health
insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012.
(b) This section and Secs. 1 and 4 of this act shall take effect upon passage.
Sec. 4. EVALUATION OF COVERAGE FOR SCHOOL-AGE CHILDREN; IDENTIFICATION OF SAVINGS AND EFFICIENCIES
(a) The agencies of administration and of human services and the
department of education shall evaluate the feasibility and budget impacts of
requiring health insurance plans, including Medicaid and the Vermont health
access plan, to provide coverage of autism spectrum disorders, including
applied behavior analysis supervised by a nationally board-certified behavior analyst for children under the age of 18 who have been diagnosed with an autism spectrum disorder. The agencies and department shall also assess the
availability of providers of services across Vermont for individuals with autism
spectrum disorders. No later than January 15, 2011, the agencies and
department shall report their findings and recommendations regarding
expanding coverage of treatment for autism spectrum disorders to school-age
children and the availability of providers to the house committees on health
care and on appropriations and the senate committees on health and welfare
and on appropriations.
(...)
(d) If the report required by subsection (c) of this section or the findings of
the committees of jurisdiction indicate that sufficient funds will not be
available to offset the state’s share of expenditures related to the coverage
requirement established in Sec. 2 of this act in fiscal year 2012, it is the intent of the general assembly to consider whether to proceed with implementation of such coverage requirement.
News reports are that North Carolina families will be converging on the capitol on Monday to meet with legislators and weigh in to Committee on the need for helath care reform and financial relief.
HB 569-FN - As amended by the Senate: AN ACT clarifying insurance coverage for diagnosis and treatment of pervasive developmental disorder or autism.
passed in the New Hampshire Senate and is anticipated to receive Governor John Lynch's signature. The passage came after some delay from its passage in the New Hampshire House on January 6, 2010.
(...)
2 New Section; Coverage for Treatment of Pervasive Developmental Disorder or Autism. Amend RSA 417-E by inserting after section 1 the following new section:
417-E:2 Coverage for Treatment of Pervasive Developmental Disorder or Autism
I. For the purposes of this chapter, treatment of pervasive developmental disorder or autism as required under RSA 417-E:1, III(h) shall include the following:
(a) Professional services and treatment programs, including applied behavioral analysis, necessary to produce socially significant improvements in human behavior or to prevent loss of attained skill or function. To be eligible for coverage, applied behavior analysis must be provided by a person professionally certified by the national Behavior Analyst Certification Board or performed under the supervision of a person professionally certified by the national Behavior Analyst Certification Board.
(...)
(d) III. The policy, contract, or certificate may limit coverage for applied behavior analysis to $36,000 per year for children 0 to 12 years of age, and $27,000 from ages 13 to 21. An insurer may not apply payments for coverage unrelated to autism spectrum disorders to any maximum benefit established under this paragraph.
V. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to the insurance coverage requirements established under this section.
(...)
3 Applicability. This act shall apply to all group policies, contracts, and certificates issued or renewed on or after January 1, 2011.
4 Effective Date.
I. Sections 1 and 2 of this act shall take effect January 1, 2011.
