Arizona OKs Insurance Mandate for Autism Coverage

March 24, 2008

A bill signed into law by Arizona Gov. Janet Napolitano will impose new mandates for insurance coverage for diagnosis and treatment of the developmental disorder of autism.

The bill signed by Napolitano had support from autism support groups and hundreds of parents.

Insurance and business groups opposed the mandate as costly for employers, but some went along with compromises in the final version of the bill that emerged from the Legislature.

Insurers’ coverage and benefits for the neurological disorder now vary, but the bill generally would require group insurers to provide coverage up to specified maximum dollar limits, subject to deductibles.

“Early diagnosis and proven treatment is the key to reversing this disorder,” said Sen. Amanda Aguirre, a Yuma Democrat who sponsored the Senate version of the bill. “It is imperative that insurance companies start helping to cover the costs families have been burdened with for years.”

Policies for individuals and small businesses — those with 2-50 employees — are excluded from the mandate, and its requirements generally take effect in mid-2009 to allow time for prepare for implementation.

“It’s tremendous for families because treatments that have previously been denied coverage by their insurance companies will now have to be covered,” said Lisa Glow, president of the Phoenix-based Southwest Autism Research and Resource Center.

A major benefit will be increased availability of early intervention services, she said. “Medically necessary behavioral therapies will be covered. This is tremendously important because our children can make big gains with behavioral therapy.”

A federal study released in 2007 said about one of every 150 American children has autism, a higher estimate than previous ones.

The study by the U.S. Centers for Disease Control and Prevention was based on 2002 data from 14 states, including Arizona.

Autism is a complex disorder usually not diagnosed in children until after age 3. It is characterized by a range of behaviors, including difficulty in expressing needs and inability to socialize. The cause is not known.

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