VITALE-WEINBERG BILL TO REQUIRE HEALTH BENEFITS COVERAGE FOR AUTISM TREATMENT SIGNED INTO LAW

TRENTON – A bill sponsored by Senators Joseph F. Vitale and Loretta Weinberg which requires New Jersey health insurers to provide coverage for screening for autism and other developmental disabilities as well as any medically-necessary occupational, physical and speech therapy, was signed into law today by Governor Corzine.

“If a treatment or therapy exists which can make life easier for autistic children or the developmentally disabled and their caregivers, insurance companies have a sacred responsibility to provide access to that treatment,” said Senator Vitale, D-Middlesex, and Chairman of the Senate Health, Human Services and Senior Citizens Committee. “Researchers on the cutting edge of their fields are discovering new things about autism spectrum disorders and developmental disabilities every day. We need to put the latest proven therapies within reach of those families who will see the greatest benefit, and we need to give autistic kids and the developmentally disabled a chance to achieve their maximum potential.”

“Autism spectrum disorders and developmental disabilities have reached epidemic proportions in New Jersey, and we must provide access to relief for those families living with the effects of these diseases,” said Senator Weinberg, D-Bergen, and Vice Chairwoman of the Senate Health Committee. “I can’t think of a single parent who wouldn’t go to the ends of the earth to get the best treatment possible for their children, but the high cost of treatments and therapies for autism disorders forces many to make difficult decisions. No parent should be forced to choose between putting food on the table and getting their kids access to the development tools needed to grow into a productive adult.”

The bill, S-1651, requires that insurers in New Jersey would be required to provide insurance coverage for diagnostic and therapeutic services designed to identify and treat autism and other developmental disabilities. Under the bill, insurance companies will be required to provide up to $36,000 per year in coverage for medically necessary behavioral early intervention for all autistic patients under 21 years old. Beginning January 1, 2012, the Department of Banking and Insurance will adjust the maximum benefit to reflect inflation according to the consumer price index.

“Parents purchase health insurance coverage to make sure their kids are covered for any and all medically-necessary expenses,” said Senator Weinberg. “However, in the case of proven treatments and therapies to alleviate the effects of autism spectrum disorders and developmental disabilities, insurance providers in New Jersey had the discretion to just say no. With today’s bill signing, we’re striking a blow for fairness for all health insurance consumers, and we’re giving autistic kids access to the care that will make a difference in their lives.”

The sponsors noted that research has demonstrated that early intervention services, which include speech, physical and occupational therapy, help the majority of young children with autism and other developmental disabilities to learn important skills. Additionally, numerous studies have shown that early treatment of autism spectrum disorders through behavioral intervention may serve to mitigate many of the problems and challenges associated with the disorder.

With today’s bill signing, New Jersey becomes the eleventh state nationwide to have enacted some form of legislation requiring insurance coverage of autism treatment. Most have some form of cap on expenses paid out by insurers – ranging from $36,000 to $50,000 – and most cap the age limit at which insurers must cover treatment – ranging from 6 years old to 21 years old.

“I applaud Assembly Speaker Joe Roberts, Senator Loretta Weinberg, and all the other advocates who remained passionate about this topic,” said Senator Vitale. “Governor Corzine also deserves a lot of credit for maintaining New Jersey’s commitment to the most vulnerable kids who can benefit from treatments and therapies covered under this new law. With today’s bill signing, New Jersey is joining ten other compassionate states in doing the right thing for kids with autism spectrum disorders or developmental disabilities.”

The bill was approved in both houses of the Legislature in June.