Workplaces that Cover Autism Treatment for their Employees

Hi all,

Here is some interesting information about Autism.  

    * 1 in 68 children receive a diagnosis of autism spectrum disorder (ASD) - Source:  U.S, Centers for Disease Control and Prevention

   *  37 states have laws in place requiring insurers to cover autism treatment, the first one being Indiana in 2001  -  Source: Autism Speaks

   *  Among large self-funded employees, 82% include services for autism -   Source: Mercer's 2013 National Survey of Employer-Sponsored Health Plans

 

The large companies that already include comprehensive coverage for autism in their health plans are JP Morgan Chase & Company, United Technologies Corporation, Capital One Financial Corporation, and American Express Company. 

The state Senate of North Carolina has a pending bill requiring insurers to cover the diagnosis and treatment of autism spectrum disorder. The bill would cover screening,diagnosis and a variety of therapies including applied behavioral analysis, which would be covered up to $36,000 a year. 

 

Do any of our members live in states with autism legislation that is not included here?  Please respond ~

Rochelle Kenyon, SME

 

 

Comments

Here is a list of states with autism insurance mandates from Autism Speaks http://www.autismspeaks.org/advocacy/insurance/faqs-state-autism-insurance-reform-laws.  However, caution must be taken as theses laws differ.  In NJ for example, our mandate excludes self-funded/self-insured plans so only covers 25% of plans.  Some states also have mental health parity laws that exceed federal law.  In addition 1 of the 10 Essential Health Benefits under the ACA is "behavioral health" but the definition is left up to the states.  Lastly, EPSDT under Medicaid covers. Lauren Agoratus-Family Voices NJ

Hi Lauren,

Thanks for joining in on this discussion.  We learn so much by hearing directly from practitioners in the field.

The page you referenced on State Autism Insurance Reform Laws at  http://www.autismspeaks.org/advocacy/insurance/faqs-state-autism-insurance-reform-laws >  has such good information.    For families who have a child with autism, finding a state that has enacted autism insurance reform laws could make a huge difference in their lives.  The ability to receive coverage for the medically necessary autism therapies will impact the progress that the child will make.

Regarding the following statement from your original message:  Lastly, EPSDT under Medicaid covers.........  Can you please complete that sentence - and tell us what the acronym EPSDT stands for?

Also, will you tell us more about your agency, Family Voices please?    Do you deal with adults who have autism?   Does your state have adult education programs, either public or private, for adults with autism?

 

I appreciate your contributions.

 

Rochelle Kenyon, SME

 

 

 

 

Hi,

Sure!  EPSDT is "Early Periodic Screening Diagnostic & Treatment" under Medicaid.  Kids with Medicaid can access some therapies for autism under this.  For an overview of EPSDT benefits, see http://mchb.hrsa.gov/epsdt/overview.html.  Family Voices seeks "to keep families at the center of children's health care."  There is a coordinator in every state found at http://www.familyvoices.org/states.  Our organization in NJ goes up to age 26.  An excellent organization for empowering people with autism is the Autistic Self-Advocacy Network at http://autisticadvocacy.org/.  In addition, I refer families to Centers for Independent Living which help individuals with disabilities maximize their potential and are found at http://www.ilru.org/projects/cil-net/cil-center-and-association-directory.

Hi again,

Thanks for the great information and great websites.  There are parents, other family members, and practitioners within our group who will benefit from your insight,

Do we have any users within this group that are parents of children/adults who have autism?  Have you utilized the Early Periodic Screening Diagnostic & Treatment under Medicaid that was referred to here?

Thanks,

Rochelle Kenyon, SME