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New York legislation to mandate health insurance coverage of autism treatments Posted: June 20th, 2011

By Maryalene LaPonsie

Once considered a relatively rare disorder, the Centers for Disease Control and Prevention (CDC) report that an average of 1 in 110 children in the United States have an autism spectrum disorder (ASD).

The disorders range from mild to severe and may include social impairments, repetitive behaviors and communication difficulties. Data compiled by the CDC indicates that it costs $3.2 million to provide lifetime care for an individual with ASD.

In response to the rising prevalence of ASD and the cost of treatment, many states are considering legislation to require health insurance companies to pay for certain autism therapies.

According to the advocacy group Autism Speaks, New York is the latest state poised to make this health insurance mandate.

The legislation, A.6305A and S.4005A, was passed unanimously by the Legislature to do the following:

  • Provide coverage for autism treatments such as Applied Behavioral Analysis
  • Require that speech therapy, occupational therapy and physical therapy be covered for autism to the same extent a health insurance policy approves those services for other conditions
  • Prohibit the denial of health care coverage because of ASD
  • Prohibit a health insurance company from discriminating against individuals with ASD in terms of treatment for other medical conditions

Both bills are currently awaiting final approval by Governor Andrew Cuomo. If signed into law, New York would become the 27th state to mandate health insurance coverage of autism therapies.