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ThumbsDown“Under this bill taxpayers will pay for medical services provided by counties and school districts which insurance companies are now required to reimburse,” said Tom Abinanti, Majority Leader of the Westchester County Legislature, and parent of a child diagnosed with autism.

The New York Assembly passed a bill yesterday that would radically change autism health insurance coverage for the worse. The Senate approved the measure last week.
 
If Governor David Paterson signs the bill, treatment for autism will have to meet an unprecedented new standard that is much higher than used for treatments of any other disorder under New York law, or the law of any other state or the federal government. Autism treatments will have to be "evidenced-based, clinically proven and peer reviewed." Treatments for all other disorders under New York law only need to meet the commonly used standard of “medically necessary.” “Chemotherapy for certain conditions often does not meet these criteria, especially “clinically proven,” but individuals are not denied coverage of chemotherapy.” said Dr. Mary Schuetz, a Board Certified Developmental Pediatrician from East Aurora. “Even the use of antibiotics, which is much more of a common occurrence, rarely follows these requirements.”
 
It is also expected that this standard will be used to deny coverage of occupational therapy, speech therapy, physical therapy and other commonly used interventions. The sponsors of the bill had circulated earlier in the session a 2007 article published by the American Academy of Pediatrics that they claimed that would serve as “guidelines” for approved treatments. The article said that occupational therapy and speech do not meet their criteria for efficacy, speech is uncertain and physical therapy was omitted entirely. [1]
 
“By imposing a higher standard for autism, the bill would limit coverage and create bureaucratic hurdles to obtaining medically necessary care,” said Michael Smith, a Clifton Park resident, and Northeast Director of the Foundation for Autism Information and Research. “The civil rights of tens of thousands of New York children with autism will be violated.”
 
The chairs of the insurance committees, Senator Neil Breslin (D-Delmar) and Assemblymember Joseph Morelle introduced the bill. “It’s a great bill for insurance companies, it’s a great bill for Senator Breslin and Assemblymember Morelle, it’s a great bill for everyone but the taxpayers, and people with autism!” said Christine Hoff, a parent of a child with autism from Buffalo.
 
The proposed law does not identify any treatments that insurers must cover, but instead would require four state agencies to jointly define covered treatments, a bureaucratic hurdle required for no other disorder under New York Law.  “Can you imagine four state agencies agreeing on anything?” said John Gilmore, executive director of the Garden City-based Autism Action Network.  “And this shuts out everyone but the agencies in making these decisions.”
 
And the bill will end up costing the taxpayer.  “Under this bill taxpayers will pay for medical services provided by counties and school districts which insurance companies are now required to reimburse,” said Tom Abinanti, Majority Leader of the Westchester County Legislature, and parent of a child diagnosed with autism.
 
The bill also partially repeals a law passed in 2006 that prohibits the widespread practice of insurers denying coverage for healthcare not related to autism to people who have an autism diagnosis. "This is a step backwards, not a step forward, in insurance coverage for Autism,” said Kathy Eiss, president of the Western New York Chapter of the Autism Society of America.”  
 
Opponents of the Autism Speaks bill who had been advocating for an alternate bill, which has been stuck in the insurance committees, are weighing options on how to proceed.
 

Comments

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G

http://www.care2.com/causes/health-policy/blog/new-york-passes-autism-insurance-bill/

Does anyone know if it is true that unless your insurance carrier is located within the same state as yours then you can't access the insurance benefits that have been passed? This sounds assinine. How many people's insurance carriers are located within the same state as they reside? This is Kristina Chew claiming this, who knows less than anyone about anything about autism IMO, so I was wondering if this is factual?

Jake Crosby

You know, I'm not happy this bill passed - and I might be a black sheep for saying this - but it's progress compared to what New York had before: nothing.

Maurine Meleck

Someone from New York please write a letter to the New York Times. Yesterday's article was praising the bill with Peter Bell saying it was the most sweeping(and best bill) of any states that have passed autism insurance bills.
Maurine

Cindy W.

Not to keep harping, but I WARNED YOU PEOPLE TWO YEARS AGO. It doesn't matter until it happens to you. And if you're from NY....it's happened to you.

So join me in the "sour grapes...i've been screwed" club. I opened membership a LONG FLIPPING TIME AGO.

Jake Crosby

booo!

Cindy W.

Same thing that happened here in Pennsylvania. Don't say we didn't warn you! And AoA did a piece on that debacle too. THANK YOU AoA for actually telling the truth (on so many levels). Are you people paying attention yet? Or are you going to continue to drink the AS kool aid until the entire insurance system screws us over again?

Rob Smith

"dont these legislators realize 1 in 100 is an awful lot of parents... and they VOTE?"

This is the problem when you on politicians to solve problems, they are going to side with whoever has the most money, voters, volunteers, etc. The reality is the autism parents who care, don't have the time or resources to become heavily involved in politics. We're too busy and broke trying to recover our children. I don't know what the answer is, but I'm too much of a cynic to think that the typical pol is going to side with an unorganized group of financially stretched autism parents against Big Pharma or the teacher's unions, to pick two examples.

Col

dont these legislators realize 1 in 100 is an awful lot of parents... and they VOTE?

spacekitty

This is why parents need to not allow their child to be labeled before there have been appropriate medical assessments. Prove your children are sick and give them evidence. We paid for our own assessments, porved our child was sick. Our chelation is covered by insurance. Our son had no official label, so although they tried to fight back with a label to deny coverage, they could not. It is up to the primary care giver to show the evidence for their evidence based medicine since the standards of care have all the balls lined up nicely for the insurance companies. Autism Speaks is speaking for a label used by the insurance companies... not for sick children

Gayle

This bill is indeed a victory for the insurance companies and not for the people of autism in New York! I find it hard to believe that Autism Speaks would sponsor a bill that is clearly not in the best interests of our children with autism! This is a sad day for all New Yorkers who have a family member with autism. I am sure that Governor Patterson will sign this flawed bill into law.

sara

Wow - Autism Speaks has really set itself up nicely. They are a lobby for the 'other side' with most of the world believing they are advocates for children.

Coralie

Isn't there some other explanation for Autism Speaks' insistence on this bill?? I wonder just because, while it may have its flaws, AS is an organization filled with parents of affected kids -- I can't believe the organization would want a legislative win that would hurt families! Ideas???

John Gilmore


Autism Speaks wants to rack up "wins", regardless of whether the legislation does any good for people with autism. And Autism Speaks has a track record of barging into states with their own legislation regardless of what else is going on locally. They aren't interested in working with local groups. In fact I think they perceive that as a negative that will take some of the lustre off of brand "Autism Speaks". It is a really sad day when Autism Speaks is so desperate for a win that they will agree to support bills that will actually take away the limited services we have. And they use the money from all those walks to do it.

AnneS

This is bad news! AutismSpeaks has really mucked things up.
Why did this bill even come up, when there was already an autism insurance bill in place?

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