New York Governor announces coverage of medically necessary treatments for children with autism

Autism Speaks applauds New York Governor Andrew Cuomo’s inclusion of coverage for medically necessary treatments for children with autism spectrum disorder in proposed budget.

January 15, 2019

Autism Speaks commends Governor Cuomo’s announcement today that New York children diagnosed with autism who are covered by Medicaid will now have coverage for medically necessary care. 

Timely access to medically necessary treatment, including applied behavior analysis, is critical for children diagnosed with autism spectrum disorder (ASD). The State of New York recognized this and took an important step in 2011, when it passed legislation requiring state-regulated health plans to cover medically necessary care for ASD. Since then, individuals diagnosed with ASD have had access to meaningful interventions, often reducing their need for special education services and improving their quality of life, opening the door for further education and employment. Now people with autism who are covered by Medicaid will also have this benefit.

“Governor Cuomo’s vision and action on behalf of children with autism spectrum disorder can change the trajectory of many lives, not only children with autism but their families and the providers who serve them,” said Angela Geiger, president and CEO of Autism Speaks. “All of us at Autism Speaks – including volunteers who have been tireless advocates for this coverage for many years - are deeply grateful for his leadership and commitment to our community both in 2011 and today.”

According to the most recent estimates from the Centers for Disease Control, one in every 59 children in the United States is diagnosed with autism spectrum disorder. Currently, an estimated 25,000 New York children with an autism diagnosis are unable to access the most basic, evidence-based treatments for their diagnosis.

“At Autism Speaks, our Autism Response Team regularly receives inquiries from families desperately seeking coverage for their children who are on Medicaid plans,” added Thomas Frazier, chief science officer at Autism Speaks. “This change will have a positive impact on thousands of individuals and families touched by autism.”

In addition to advocacy efforts in the private health insurance market, Autism Speaks works with state Medicaid agencies and stakeholders around the country to ensure access to medically necessary care pursuant to Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment mandate and the Center for Medicaid and CHIP Services Informational Bulletin on Clarification of Medicaid Coverage of Services to Children with Autism.

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