Of greatest immediate interest to parents of children with autism, however, is the 12th point in the Act, which "Requires that health insurers cover the diagnosis and treatment of autism spectrum disorders, including Applied Behavioral Analysis therapy and assistive communication devices."
The bill covers diagnosis of autism, as well as the following treatments:
- Medications prescribed by a physician and any health-related services necessary to determine the need or effectiveness of the medications
- Occupational therapy
- Physical therapy
- Speech therapy
- Services provided by a psychiatrist or psychologist
- Professional, counseling, and guidance services and treatment programs, including applied behavior analysis and other structured behavioral programs, communication devices and other assistive technology devices
At present, of course, the language in the insurance portion of this bill is quite vague and open-ended.
Physicians, for example, may prescribe all kinds of medical treatments for people with autism. Some, such as chelation or hyperbaric oxygen, are not generally approved by mainstream researchers. Would they be paid for if prescribed?
Many occupational therapists do offer traditional OT services. But in addition they may offer sensory integration therapy, a technique which is not generally covered by HMO's. OTs may also provide floortime therapy and other types of play therapy which are considered to be "developmental" as opposed to "behavioral." Would these services be covered?
Psychiatrists and psychologists offer a very wide range of services to children and families living with autism. Would all of these be covered?
As with all bills, the Autism Treatment Acceleration Act has a long way to go before it becomes law. Doubtless, much of the open-ended language now included will be altered.
Are you familiar with this act? How open-ended do you feel it should be? Share your thoughts.
This act sort of reflects what some states have already passed into law. For many families, their insurance doesn’t cover the basic things like O.T and Speech which most kids would benefit from. This law would prevent the denials of that coverage and like the state passed laws, they generally do have a yearly limit, such as for ABA. I’d imagine any act or state law would not pass every single therapy option out there for insurances to cover, they’d include the ones most children have shown benefits from, like Speech, O.T, ABA psychiatrist or psychologist (which many insurances do not cover which is often required if you want the best info on med options). I doubt any act will or would include therapy options that are not FDA approved like HBOT or chelation, or the ones that have little backing that they’d benefit the majority. And finally, face it, some choices are always just going to be out of pocket expenses. If such acxts included every thing under the sun, pretty soon we’ll see even more options of therapies popping up just to get in on this act. We should be grateful and thrilled for the 6 above mentioned. It is a great start.
I support the act because it includes critically needed services for adults on the spectrum. Treatments covered should be those that have documented effectiveness.
I support this. Right now it is on a state to state basis and if you move to another state, many make you start from scratch, re-testing etc. Also, CA as part of it’s budget cuts is planning on cutting ST and OT, this is a disgrace and must be stopped! OT and Speech Therapy are some of the most important tools to insure children with ASD have a change to live a life where they can function in society! Shame on the Gov using short term thinking! This will cost the state millions in the future with thousands of children unable to function when speech therapy and OT might have made the difference in their lives. Please support this bill!
This has nothing to do with State funded programs. This is on a federal bases to mandate private insurance companies to over the listed services under that employee plan. This is an Act well needed, since so far only some states are attempting to pass insurance mandates and there is flaws on that sate end. For instance I live in one state, but hubbies insurance is based out of another state where the main company is.
As for State funded programs, those cuts aren’t just happening in California. The Gov of my state is slashing as well. The economy right now is very bad and this Acceleration Act will at least enable parents to gain services via their own insurance regardless of the State cuts.
Please publish the names of the Congressmen/women that vote against saving our children. I will be watching this very closely.
Sensory integration therapy should be covered.
Sensory integration therapy is actually one of the therapies proven to work by studies. It’s not just Aba anymore.
Many schools do cover it though it would be great if Hmo’s covered some. Our school covered sensory covered OT once every other month.
Sensory intergration is not as expensive as other treatments and works well with floortime and other play therpies.
My son is currently nineteen and I would like clarification on how this bill would work for him. Would insurance still cover his Therapy after he finishes School? What would he be entitled to after twenty-one?
My 9 year old grandson has Autism. He is a healthy child yet because he has Autism, he had been denied even basic health insurance. His parents have paid a lot of money out of pocket because they want his treatment and progress to continue. However, he is being discriminated against just because he is Autistic. A second concern is health insurance for him once he is an adult and/or in the case of death of one or both parents. Please get the Autism Treatment Acceleration
Act passed ASAP! This ATAA also needs additional sponsors. Call your Congressional representatives to ask them to be co-sponsors and then question why this Act has not been passed and when will action take place. What date can we look forward to having positive action?
Your description of this bill is some-what misleading. To date, no Republicans in the Senate have signed-on to co-sponsor this bill.
Also, something that most people are unaware of is the fact that even if you live in one of the 15 states that do have an autism insurance law, you may not be covered. Large employers generally offer “self-insured” health care and are not governed by state law. They fall under the Employee Retirement Income Securities Act (ERISA). This can only be changed by Congress.
This is an amazing bill and must be passed. If you go to http://www.thomas.gov and search for the bill number (S.819 or H.R.2413) you can see who is co-sponsoring and what progress has been made.
I would like to make an observation from the perspective of Federal civilian employees: none of the offered health care plans under the oversight of the Office of Personnel Management (OPM) within the United States government cover Applied Behavior Analysis (ABA). The only one that does is the US Military’s Tricare Echo to the best of my knowledge. My 8-year-old son is not covered for ABA and I am paying out of pocket for therapists even though my state mandates state group insurance plans must insure for ABA (Federal plans don’t have to abide by state law- oops!). I have started spending my savings and hope this bill passes, but I can’t go this route for too long or I will have to discontinue services when my money runs out. I am still waiting for OPM to finalize denial of coverage. The insurer is Mail Handlers Benefit Plan subcontracted to United Behavioral Health (hiss!). I have written my Congressman to look into UBH’s customer service(lack thereof) so maybe they can light a fire for someone else. I am hanging on in hopes this bill becomes law- I wish it had been last year. Sigh.
For those that have spent tons of money on ABA therapy, please do some research into the Floortime therapy (www.icdl.com). It is a family-centered approach that assumes that your child can grow, develop, and love, and shows you how to do it one step at a time. Do you want your child to simply look at you when you are talking, or do you want your child to be engaged with you. There is a great deal of scientific backing to this, contrary to what many ABA researchers will admit.
Regarding insurance coverage, your insurance company is going to make money off of you one way or another. If this act is passed, it’s just a matter of time until your insurance premiums will equal what you’re spending on therapy. I’m all for being covered, but we have to see the big picture, too.
Great Act! We just hope that it will cover adult individuals with atuism and not end at age 14 or 26.
we live in CT and my daughter lives in a group home for adults with atuism . She is over 30 years old. Being born arouong the time the IDEA became law, she did not get an appropriate education from the start. She still needs all the basic autism therapies including Alternative Augmentative Communication Therapy as she is nonverbal. The ok to the treatment was given only a couple of years ago as adult services in CT are not mandated . Now the program is being cut again due to the budget crunch. It is sad as she was making progress and the staff in the group home was finally buying into learning to use her augmentative device more.