Archive for the 'Insurance' Category

Autism Speaks, the US’s largest autism science and advocacy organization has launched a national TV ad campaign that highlights failure of many private insurers to cover some autism treatment.

The ad features two families, both with boys who need medical care, but only one getting the proper treatment needed due to the insurance the family is carrying.

The ad ends with the number to contact Speaker of the House Nancy Pelosi, urging her to make healthcare reform that stops autism discrimination.

Thirty seconds in length, the ad will air nationally on CNN, CNBC, and MSNBC. You can find more on Autism Speaks’ initiative at autismvotes.org.

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Consumer Group Wants All Autism Treatment Covered

Written by Staff on Wednesday, July 1st, 2009 in Autism, Insurance, Therapy.

karschsp on Flickr

karschsp on Flickr

Consumer Watchdog, a California state group that monitors insurance practices, says that insurers that deny treatment for autism prescribed by a patient’s doctor are violating mental health and other laws.

“Californians, including those stricken with autism and their parents and caregivers, expect regulators to enforce the law, not to side with insurance companies seeking to boost their profits by denying patients the care they need,” said Harvey Rosenfield, founder of the nonprofit organization.

They’re asking a judge to order the Department of Managed Health Care to require such providers to cover these treatments.

One such treatment that has been declined by insurers is applied behavioral analysis, a type of behavior modification therapy, which can cost as much as $70,000 per child.

In addition, insurers are arguing that ABA is educational, which would mean they aren’t required to cover it.

Insurers are claiming they’re follow the law and provide reimbursement for most autism treatments according to the 1999 Mental Health Parity Act, but the dispute still remains over certain types of treatments, like ABA.

via latimes.com

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Mykyl Roventine on Flickr

Mykyl Roventine on Flickr

Why is Daniel Tammet considered a Savant? Guess which state is taking steps to ensure insurance companies cover autism costs? Where will parents in Mississippi take their autistic children once the Mississippi Child Development Institute closes? Find out on today’s autism beat.

Daniel Tammet is one of those outrageously smart individuals who can speak 11 languages, recite pi to 22,500 decimal places (We know it’s 3.14…then some other numbers) and is one of fewer than 50 people in the world known as a prodigious savant. Asperger’s individuals, you’re in good company. By the way, the man who took Daniel’s photo, for the article, Stephen Wiltshire, is also autistic. [Nouse.co.uk]

The Mississippi Child Development Institute has announced it’s closing its doors at the end of the summer session. Although it’s working on creating a new autism clinic, it won’t open by the start of the new school year. The school services students with autism and other developmental delays and instructs students by functional level, instead of placing them in grade levels. [clarionledger.com]

Michigan House Committee votes to acquire better insurance coverage for autistic children. The legislation was approved 19-0 by a House Health Policy Committee and next heads to the Democratic-led House. [freep.com]

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HMO Covering Autism Is “Death Spiral” For Health Care

Written by Staff on Wednesday, June 3rd, 2009 in Autism, Insurance.

Thee Erin on Flickr

Thee Erin on Flickr

Alain Enthoven, professor emeritus of management at the Graduate School of Business at Stanford University has written a piece advocating against HMOs covering certain services for autistic children that would normally be covered by schools and other state services.

Legislative mandated treatment for needs of certain populations is already driving up health care costs and the burden would be transferred to employers and employees, causing HMOs to lose their financial advantage over other types of health care plans.

“There are proposals, not yet in legislative language, to require California HMOs, in addition to the medical services they already provide, to cover extensive educational and behavioral services for autistic children, services that are more appropriately the responsibility of state regional centers for the developmentally disabled and of school districts. These services have been estimated to cost more than $40,000 per child per year.”


“Families of autistic children will find ways to get covered by HMOs. The cost burden of additional mandated services will shift to the remaining HMOs, forcing up their premiums, and these HMOs will lose market share at an accelerating pace. Health economists call this a “death spiral,” and I think it has already begun.”

(more…)

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What game is helping autistic children learn to identify emotions? Will Connecticut be the next state to require health insurance companies to cover costs of diagnosing and treating autism? Hey, a tax break to parents of autistic children would be nice too. But only in West Virginia for now. It’s all summed up on today’s autism beat.

Thomas Tank Engine, an Australian based game may help children with autism better identify emotions. The game asks children to identify when Thomas the Tank is happy, sad, and so forth. A game like this should not be reserved for child’s play. Husbands should invest in a copy to better understand their wives emotions.[cnn.com]

A bill requiring insurance companies to cover autism diagnosis and treatment has passed in both the House of Representatives and Senate and now waits on Connecticut governor M. Jodi Rell’s desk for a signature. No pressure or anything, governor. If Rell signs the bill, it would take into effect January 1, 2010. Required coverage for children under 16 would include behavioral therapy, prescription drugs, and other psychological and psychiatric services. [courant.com]

A tax break, please, is what parents of autistic children in West Virginia are hoping lawmakers will reconsider. According to governor Joe Manchin and other lawmakers, the bill will probably resurface during the legislature’s special recession. The proposal would give tax breaks to parents who set up trust funds similar to some college savings plans. [Charleston Daily Mail]

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