ASSEMBLY PASSES ROBERTS/PRIETO/VOSS BILL FOR INSURANCE COVERAGE FOR AUTISM-SPECTRUM TREATMENTS

ASSEMBLY PASSES ROBERTS/PRIETO/VOSS BILL FOR INSURANCE COVERAGE FOR AUTISM-SPECTRUM TREATMENTS

(TRENTON) - Legislation Speaker Joseph J. Roberts Jr., Assemblyman Vincent Prieto and Assemblywoman Joan Voss sponsored to require health insurers to provide coverage for medically necessary treatments of autism-spectrum disorders today passed the General Assembly.

The measure (A-2238) passed 71-4 with one abstentions. It stems from the enactment in 2007 of seven laws that made New Jersey a national leader in providing support to families affected by autism.

"Failing to help a child try to overcome the obstacles presented by autism will lead to costlier problems later," Roberts said.  "Autistic adults who have not received the proper treatment will leave our families, communities and state with new and more expensive challenges. Not only are we making people's lives better, we're doing it in a very cost-effective way. This is just an incredibly good investment."

 "Families living every day with this baffling disorder need the assurance that autism treatments recommended by their doctors will be covered by insurers," said Prieto (D-Hudson). "Autism already robs a person of so much; treating it shouldn't also rob a family of their finances."

The measure was endorsed in committee by Bob Wright, grandparent to an autistic child and co-founder of Autism Speaks. The group was involved in successfully lobbying the United Nations to recognize World Autism Day and Congress to provide more research money.

The bill would require health insurers to cover the expenses of treatments deemed medically necessary for autism-spectrum disorders, including: Childhood Disintegrative Disorder, Asperger's Disorder and Rhett's Syndrome. Insurance coverage would apply for physical, speech or occupational therapy and behavioral interventions.

Coverage expenses would be capped at $36,000 annually and eligible treatments would be limited to individuals 21 years of age and younger. The measure also would give insurers the right to review a doctor's prescribed and detailed treatment plan.

In enacting the legislation, New Jersey would become the 11th state to authorize insurance coverage for autism therapies.

The sponsors noted that some doctors believe early treatment of autism can help mitigate many of the later-life problems associated with the disorder.

According to the most recent statistics from the federal Centers for Disease Control and Prevention, New Jersey claims the nation's highest reported rate of autism - one of out of every 94 children. The national rate is one out of 150 children.

"Even though science still has a limited understanding of autism-spectrum disorders, doctors and families know that early treatment can provide some hope for a normal life," said Voss (D-Bergen), whose son suffers from Asperger's Syndrome, a form of autism. "New Jerseyans living with autism and their families should never feel as if they are facing this disorder alone."

There currently is no cure for autism, and its cause also remains unknown.

The bill now heads to the Senate, where a companion measure also is poised for a floor vote.