New law requires insurance companies to cover cost of autism therapy

Posted at: 11/30/2012 9:28 PM
Updated at: 11/30/2012 11:27 PM

Good news this month for parents with children who have autism spectrum disorders. A  law went into effect at the beginning of the month requiring insurance companies to cover the cost of therapy.

New York is the 33rd state to add an insurance mandate related to autism.

Before this bill, no therapy services were covered. The county and school districts covered the cost and when children went to school full time, at-home care stopped unless parents were willing to pay out of pocket. This new bill changes that, but there is a catch.

Lisa Ferri said, “If I could add something to their day just to give them more help, my therapy, more assistance that has made such a great difference for them. So far, it would be just be amazing. It would be a wonderful thing for all families.”

Lisa Ferri has three young boys. Two have autism. She knows first hand how beneficial and how expensive therapy can be.

Ferri said, “They are thriving and I do credit most of that to the therapy we've had. When Nicholas was in birth to 3 range all the services were covered by Monroe County. He did literally get, until the time he was in preschool, about 30 hours a week and depending what therapist can range from $60 to $120 an hour.”

Both Ferri's children had a type of therapy called applied behavior analysis or ABA.
Denise Rhine said, “Many children it starts with one-on-one teaching to look at the skills they have build on the skills they have and as well as work on the deficit areas.”

It is everything from teaching the kids to speak, to how to hold a conversation.

Under the law that went into effect November 1, insurance companies are required to cover up to 45,000 a year for this kind of therapy. Also, there are now no age restrictions on who can get this in-home care. But on Halloween, lawmakers added another hurdle for families to climb.

Rhine said, “Emergency mandates were put out. you have to be a board certified behavioral analysis, a BCBA, which is fine the 32 other states that have autism coverage have that, but they also put on there you have to be a licensed professional.”

Rhine, the Clinical Manager at Center for Autism and Related Disorders, says this drastically reduces the number of service providers. At a meeting on Friday at Rhine's office, parents were told about the new law and also encouraged to sign letters to lawmakers to drop the emergency mandates.

If you have questions about the insurance coverage and this new law, you can find more information by contacting the Center for Autism and Related Disorders by going to their website or by calling them at (855) 345-2273.