[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
Lt. Gov. Calley’s Office Issues FAQs on 3-Bill Autism Insurance Reform Package
April 02, 2012
LANSING (April 2, 2012) — The office of Lieutenant Governor Brian Calley issued a series of Frequently Asked Questions to help families and caregivers better understand the three-bill autism insurance reform package voted out of the Legislature on March 29. Governor Rick Snyder is expected to sign the bill shortly.
The FAQs can be found below.
Autism Insurance Reform Frequently Asked Questions
What services are covered by this legislation?
Passing the autism insurance legislation is the first step to creating a network of qualified providers who will be able to service children with autism in Michigan. These services will include Applied Behavior Analysis (ABA)—behavior therapy that is the evidence-based treatment of choice for individuals with autism. The legislation will also cover occupational therapy (OT) for sensory-based interventions and speech therapy.
The first important step is to get an assessment to determine if your child has autism. To qualify for the autism services your child has to be assessed by a physician or psychologist who will use the required diagnostic criteria. Click on this link to find out more about the basic signs for autism: http://www.autismspeaks.org/what-autism
When does this coverage go into effect?
On March 29, 2012, the autism insurance reform passed the legislature. Following the enrollment and printing process of the bills, the Governor is expected to sign the legislation. Early indications are that the legislation will be signed by mid April.
The legislation indicates that insurance companies must comply with coverage requirements within 180 days of the bill signing. This places the effective date sometime in mid October.
It is important to keep in mind that the coverage requirements take effect at your first annual renewal date after the effective date of the legislation. So for example, if the legislation were to take effect in mid October, and your policy renews on January 1, 2013, your coverage will be updated on January 1, 2013.
Does this legislation impact all insurance policies?
Traditional insurance certificates and HMOs are covered by state law and therefore must comply with this legislation.
However, your employer may be self-insured. Such policies are subject to federal law and therefore are not required to comply with this state legislation. Check with your employer to ask if they are “self- insured.”
My employer is “self-insured.” What do I do now?
If you find that your employer is self-insured, all hope is not lost. This legislation included the creation of a state fund that helps pay for autism services when self-insured companies choose to self adopt coverage. Encourage your employer to inquire with the Michigan Department of Licensing and Regulatory Affairs about adding this important coverage to their benefit package. Feel free to contact
Autism Alliance for more information and assistance by clicking here:
What are the coverage levels?
The services provided for under this legislation would be subject to the same copays and deductibles applied within your current policy.
Evidence based autism services are required, but not limited, as follows:
Treatment ages: 0-18 years
Coverage will be provided for children with the medical diagnosis on the autism spectrum
Covers Applied Behavior Analysis (ABA), Speech and Language Therapy, and Occupational Therapy
Allows insurance companies and HMO’s to cap combined annual coverage of ABA Therapy, Occupational Therapy, Speech Therapy and other behavioral services (such as Psychiatry) at the following levels:
$50,000 (6 years and younger) – $40,000 (7-12 years)
$30,000 (13-18 years)
What if my children are covered by Medicaid or MiChild?
Under separate legislation (the Department of Community Health Budget Bill) the Governor has proposed adding similar coverage to Medicaid and MiChild programs. We are hopeful that this legislation will also pass soon and will take effect by the end of this year. Check for updates at http://www.Michigan.gov/autism.
I’ve looked before and cannot find existing services in my area. Where can I find the therapists?
Families will need to check with their insurers about which therapists can be used for intervention. Insurers have the right to set up networks, or designate Centers of Excellence and require that you use those particular providers just as they do for other medical coverage.
Due to decades of no coverage, Michigan lacks enough providers to immediately serve the needs of all of the children in the state with autism. There are currently about 115 Board Certified Behavior Analysts (BCBA) in Michigan, and only about 30 of those provide services to families with autism. There are over 15,000 kids in Michigan with the disability. Building the provider network is of greatest importance. Immediately upon passing this legislation many providers are hoping to expand intervention services. This will take some time, but the infrastructure is being put in place.
The Autism Community Is Not The Autistic Community
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.