[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
Autism Insurance Bill Introduced in Missouri State General Assembly
(Jefferson City, MO – March 13, 2008) Legislation was recently introduced in the state of Missouri by State Representative Sam Page (D-82), House Bill 2351, and Senator Chris Koster (D-31), Senate Bill 1229 that requires appropriate insurance coverage for autism spectrum disorders. The bills would require Missouri healthcare policies to cover applied behavior analysis (ABA) and other treatments prescribed by an insured’s treating physician. Both bills are identical and the language of the bill closely follows model legislation drafted by Autism Speaks earlier this year.
Read HB 2351 sponsored by Representative Sam Page.
Read SB 1229 proposed by Senator Chris Koster.
SECOND REGULAR SESSION
94TH GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVES PAGE (Sponsor), LAMPE, ROBB, SPRENG, HARRIS (23), ZWEIFEL, OXFORD, NORR, SCHOEMEHL, HODGES, YAEGER, NASHEED, DARROUGH, TALBOY, GEORGE, WILDBERGER, ROORDA, KOMO, DOUGHERTY, SHIVELY, DONNELLY, MEINERS AND SCHIEFFER (Co-sponsors).
D. ADAM CRUMBLISS, Chief Clerk
To amend chapter 376, RSMo, by adding thereto one new section relating to mandatory insurance for autism.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto one new section, to be known as section 376.1224, to read as follows:
376.1224. 1. For purposes of this section, the following terms shall mean:
(1) “Applied behavior analysis”, the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relations between environment and behavior;
(2) “Autism service provider”, any person, entity, or group that provides treatment of autism spectrum disorders;
(3) “Autism spectrum disorders”, a neurobiological disorder that includes any of the pervasive developmental disorders as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, including Autistic Disorder, Asperger’s Disorder, Rett’s Syndrome, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified;
(4) “Carrier”, shall have the meaning ascribed to such term in subdivision (6) of subsection 2 of section 379.930, RSMo;
(5) “Diagnosis of autism spectrum disorders”, medically necessary assessments, evaluations, or tests in order to diagnose whether an individual has an autism spectrum disorder;
(6) “Evidence-based research”, research that applies rigorous, systematic, and objective procedures to obtain valid knowledge relevant to autism spectrum disorders;
(7) “Habilitative or rehabilitative care”, professional, counseling, and guidance services and treatment programs, including applied behavior analysis, that are necessary to develop, maintain, and restore, to the maximum extent practicable, the functioning of an individual;
(8) “Medically necessary”, any care, treatment, intervention, service, or item that is prescribed, provided, or ordered by a licensed physician or a licensed psychologist in accordance with accepted standards of practice and that will, or is reasonably expected to, do any of the following:
(a) Prevent the onset of an illness, condition, injury, or disability;
(b) Reduce or ameliorate the physical, mental, or developmental effects of an illness, condition, injury, or disability; or
(c) Assist to achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the individual and the functional capacities that are appropriate for individuals of the same age;
(9) “Neurobiological disorder”, an illness of the nervous system caused by genetic, metabolic or other biological factors;
(10) “Pharmacy care”, medications prescribed by a licensed physician and any health-related services deemed medically necessary to determine the need or effectiveness of the medications;
(11) “Small employer”, shall have the meaning ascribed to such term in subsection 2 of section 379.930, RSMo;
(12) “Therapeutic care”, services provided by licensed or certified speech therapists, occupational therapists, or physical therapists;
(13) “Treatment for autism spectrum disorders”, shall include the following care prescribed, provided, or ordered for an individual diagnosed with an autism spectrum disorder by a licensed physician, licensed psychologist, or certified registered nurse practitioner if the care is determined to be medically necessary:
(a) Psychiatric care;
(b) Psychological care;
(c) Habilitative or rehabilitative care;
(d) Therapeutic care;
(e) Pharmacy care;
(f) Nutritional supplements;
(g) Applied behavior analysis therapy;
(h) Any care, treatment, intervention, service or item for individuals with an autism spectrum disorder which is determined by the department of health and senior services, based upon its review of best practices or evidence-based research, to be medically necessary.
2. Each carrier or health benefit plan that offers or issues health benefit plans which are amended, delivered, issued, or renewed after January 1, 2009, shall provide individuals under twenty-one years of age coverage for the diagnosis of autism spectrum disorders and for the treatment of autism spectrum disorders to the extent that the diagnosis and treatment of autism spectrum disorders are not already covered by the policy of accident and health insurance or managed care plan.
3. With regards to a health benefit plan, a carrier shall not deny or refuse to issue coverage on, refuse to contract with, refuse to renew, or refuse to reissue or otherwise terminate or restrict coverage on an individual solely because the individual is diagnosed with an autism spectrum disorder.
4. Coverage provided under this section for applied behavior analysis shall be subject to a maximum benefit of fifty thousand dollars per year, but shall not be subject to any limits on the number of visits to an autism service provider. After December 30, 2008, the director of the department of insurance, financial and professional registration shall, on an annual basis, adjust the maximum benefit for inflation using the Medical Care Component of the United States Department of Labor Consumer Price Index for All Urban Consumers. Payments made by an insurer on behalf of a covered individual for any care, treatment, intervention, service, or item, the provision of which was for the treatment of a health condition unrelated to the covered individual’s autism spectrum disorder, shall not be applied toward any maximum benefit established under this subsection.
5. Coverage under this section shall be subject to co-payment, deductible, and coinsurance provisions of a health benefit plan to the extent that other medical services covered by the policy of health benefit plan are subject to these provisions.
6. This section shall not be construed as limiting benefits which are otherwise available to an individual under a health benefit plan. The health care services required by this section shall not be subject to any greater deductible or co-payment than other health care services provided by a health benefit plan.
7. The department of health and senior services shall establish standards to be utilized by health benefit plans for the credentialing of autism service providers. The department of health and senior services may require that health benefit plans grant credentials to any autism services provider whom the department of health and senior services determines meets or exceeds the department of health and senior services’ credentialing standards.
8. Except for inpatient services, if an individual is receiving treatment for an autism spectrum disorder, a health benefit plan will have the right to request a review of that treatment not more than once every six months unless the health benefit plan and the individual’s licensed physician or licensed psychologist agrees that a more frequent review is necessary. The cost of obtaining any review will be borne by the carrier.
9. This section shall not apply to health benefit plans offered solely to an individual or through a small employer.
More With Autism Votes
More With Autism Votes
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.
[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]
Fact: Vaccines Do Not Cause Autism.