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Oregon Governor, Advocates Celebrate Autism Insurance Reform

August 27, 2013

SALEM (Aug. 27, 2013) -- Governor John Kitzhaber conducted a bill-signing ceremony in his office today with the Oregon autism community to celebrate the enactment of legislation that made Oregon the 34th state to enact autism insurance reform.

Sponsored by Sen. Alan Bates of Medford, the new law (SB.365) was approved unanimously by the Legislature and then officially signed August 14 by Kitzhaber. The enactment was celebrated publicly today with the bill-signing ceremony in the Governor's office. (Left: Autism Speaks Director of State Government Affairs Judith Ursitti looks on as Kitzhaber signs the bill.)

"Over the 2013 Legislative session, I was moved to hear from individuals and families about how autism affects our fellow Oregonians," said Governor Kitzhaber. "I was proud to join supporters of Senate Bill 365 at the ceremonial signing and I believe this bill is an important first step for our state."

The law, which requires coverage of applied behavior analysis (ABA), will take effect in 2015 for public employees and 2016 for state-regulated health plans. Oregon joins Minnesota and the District of Columbia which also enacted autism insurance reform this year; similar efforts are underway in Maryland and Ohio.

The new law establishes requirements for state-regulated health plans to approve and manage autism treatment, including ABA and any other medical or mental health services identified in an individualized treatment plan. To qualify, kids must begin treatment before age 9; up to 25 hours of ABA per week will be covered and continue for as long as medically necessary, regardless of age.

Existing Oregon laws require coverage of autism treatment for older patients and those seeking more than 25 hours of ABA per week.

A seven-member Behavior Analysis Regulatory Board will be created within the Oregon Health Licensing Agency to license providers.

The new law will also impact Medicaid coverage through the Oregon Health Plan. The Oregon Health Evidence Review Commission (HERC) is now reviewing ABA in order to update the state’s prioritized list of health services covered through Medicaid. HERC began the study before the bill was signed by Kitzhaber.

Kitzhaber in July signed a related measure, SB.414, sponsored by Senator Chip Shields of Portland, which strengthens the enforcement powers of the state Insurance Division. The agency is now able to order health plans to pay restitution to consumers if they violate the law or their contracts. State regulators previously had very limited enforcement powers over the insurance industry which has an exemption under Oregon's anti-fraud laws.