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10 June 2010

For children with autism, many of the life skills we take for granted do not come easily. Making friends or going to a baseball game become a challenge due to the social, communication and behavioral symptoms of autism. The good news is that research to help those with autism is moving forward and more resources are now available. A bill passed by the General Assembly and recently signed into law will ensure that Missouri families have access to the life-changing therapies that will improve the quality of life for children with autism.

Prior to the passage of House Bill 1311, insurance companies were not required to cover the diagnosis and treatment of autism. This means that families with a son or daughter with autism were forced to pay thousands of dollars out-of-pocket for treatments, despite the fact that they were paying their premiums. In 2007, the Blue Ribbon Panel on Autism was formed and issued a report recommending that we pass legislation to require private insurance to cover autism. During the 2008 and 2009 legislative session, efforts were made, but this year, we were successful in passing the legislation.

House Bill 1311 requires health carriers that issue or renew health benefit plans on or after Jan. 1, 2011, to provide coverage for the diagnosis and treatment of autism spectrum disorders. The bill also prohibits health carriers from refusing to cover an individual or dependent solely because the individual is diagnosed with an autism spectrum disorder. Coverage for applied behavior analysis (ABA), a common treatment method for autism, is capped at $40,000 annually through age 18.

In addition, a state Behavior Analyst Advisory Board is established under the State Committee of Psychologists within the Division of Professional Registration. The new board is charged with establishing and overseeing licensure and registration requirements for behavior analysts and assistant behavior analysts who provide therapies for children with autism spectrum disorders.

The bill also requires the Missouri Department of Insurance to grant a waiver from the autism insurance standard to small business employers that have group health plans if compliance raises premium costs by a certain percentage. Employers must demonstrate (over any consecutive 12-month period) that compliance with the coverage has increased the premium costs of their health insurance policy by at least 2.5 percent over the course of a calendar year.

Research has shown that children who receive early treatment show significant improvement as opposed to those that receive little or late treatment. Early diagnosis and treatment also contribute to greater financial savings for families, society and the state. Families throughout Missouri have worked and waited for this legislation to pass, and I celebrate with them that the bill has been signed into law.

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