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Autism Speaks Applauds Pennsylvania House Speaker Dennis O’brien and State Lawmakers For Passing Strongest Autism Insurance Mandate In The Nation

July 03, 2008

NEW YORK, NY (July 3, 2008) -- Autism Speaks today applauded Pennsylvania House Speaker Dennis O’Brien and state lawmakers for passing the strongest autism insurance reform legislation in the country. The bill (HB 150) to create a new “Autism Spectrum Disorders Coverage” provision of Pennsylvania insurance law was amended by the House on Tuesday and sent back to the Senate on Wednesday night where it passed 49-1.  Autism Speaks thanked bill co-sponsors House Speaker Dennis O’Brien and Senator Jane Orie, and Senators Don White, Dominic Pileggi, Joseph Scarnati, Michael Stack, Robert Mellow and Anthony Williams for their support in helping to protect the children of Pennsylvania with autism spectrum disorders.
“We agree with Speaker OBrien that the House amendments make the strongest autism insurance mandate bill in the nation even stronger,” said Elizabeth Emken, Autism Speaks vice president of government relations. “We thank the members of House for their unanimous support and the members of the Senate for their nearly unanimous support as we continue to work together to ensure fair treatment and proper health care for all children with autism. We will continue to urge other states to follow suit and enact similar legislation to end autism discrimination in insurance coverage across the country.”
The Pennsylvania bill provides $36,000 a year for Applied Behavior Analysis and other necessary treatments up to age 21, with no lifetime cap. It also creates a first ever, under Pennsylvania law, expedited appeals procedure for denied claims, as a safeguard to ensure the law is followed. The bill also turns the existing state welfare program for autism into a statutory requirement, to ensure that those who receive government provided services can continue to do so, while allowing for the development of a private sector delivery system with insurance reimbursement, offering families an alternative to coverage through Medicaid.
The amended version of the bill includes new wording that will ensure greater continuity of care for children on private insurance and for children using Pennsylvania’s Medical Assistance program. The bill also now states that the autism diagnosis will last for "at least" 12 months (versus only 12 months.) “This distinction will ease the burden on parents because they will not be required to have their child diagnosed every year,” said Emken.
The Pennsylvania bill addresses discrimination against individuals with autism, and provides them the same medical necessity standards as afforded individuals with cancer, diabetes, and the common cold, allowing individuals with autism to be treated as all others are in the private insurance market.
The bill is expected to be signed into law by the governor in the next ten days. Once enacted, the law will require private insurers to provide coverage beginning in July 2009.
 
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