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Calls to Action

#37: Maryland Finalizes Autism Insurance Reform

ANNAPOLIS (May 5, 2014) -- Gov. Martin O'Malley today signed a professional licensing bill for behavior analysts, the final step in Maryland's multi-year effort to require insurance coverage of medically necessary autism treatment. By virtue of the bill-signing, Maryland became the 37th state to enact autism insurance reform.

The bill-signing by O'Malley [left] followed the enactment of new regulations in March by the Maryland Insurance Administration (MIA) that require coverage of autism treatment by fully funded small and large group plans, the state employee health plan, and coverage purchased through Maryland's health insurance marketplace created under the Affordable Care Act.

Coverage is required through age 18 for psychological care; speech, occupational and physical therapy; and behavioral health treatment, including applied behavior analysis (ABA). A minimum of 25 hours weekly of ABA has to be covered through age 5; from age 6 through 18, the requirement drops to 10 hours weekly.

The law signed by O'Malley, SB.694, created a state licensing process for behavior analysts. Without the law, access to ABA therapy was limited to a smaller pool of practitioners licensed in other fields, such as psychology.

"Autism Speaks applauds Governor O'Malley, our legislative champions and partner organizations for bringing this process to a successful conclusion, delivering urgently needed insurance coverage to Maryland kids with autism," said Judith Ursitti, Autism Speaks director of state government affairs. "In particular, we thank Senators Kathy Klausmeier and Mac Middleton, Speaker Mike Busch and Delegates Kirill Reznik, Ariana Kelley, and Pete Hammen for their many hard years of work on this issue.

Maryland followed a different path than the 36 other states which have enacted autism insurance reform. While debating a bill that would have required the coverage in 2012, the Legislature chose instead to pursue regulatory changes to its existing habilitative care law.

Following a year of study, MIA first proposed regulations in September 2013. But the proposal drew so many demands for changes that a revised set was issued early in 2014, incorporating a number of the requested changes. 

Autism Speaks, Pathfinders for Autism and the Maryland Association of Behavior Analysts will host a series of information session thsi month to familiarize families and providers with the new regulations. Learn more here.

Maryland joins Nebraska and Utah which have enacted reform this year; the North Carolina Senate next week starts work on finalizing a bill approved last year by the state's House of Representatives.