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Wednesday, October 3, 2012

"Essential Health Benefits" in CA

Autism Speaks reports on a new law in California:
Governor Jerry Brown has signed legislation that incorporates autism insurance benefits, including ABA coverage, as part of California's "essential health benefits" package that many individual and small group insurance plans must offer starting in 2014 under the federal Affordable Care Act (ACA).
The selection of an essential health benefits package is a key step forward as each state implements the ACA which was enacted in 2010 and upheld by the U.S. Supreme Court last summer. Congress specified 10 essential health benefits, such as hospitalization, emergency care and prescription drugs, as well as "habilitative services" and "behavioral health treatment."
The bill signed by Governor Brown, AB-1453, sponsored by Assemblyman Bill Monning, designates the Kaiser Small Group HMO 30 plan as California's essential health benefit benchmark plan. This includes coverage for benefits required by laws enacted before December 31, 2011, such as Mental Health Parity and SB.946, the autism insurance reform law. However, it does not cover grandfathered plans or self-insured plans which are governed under federal law.
California's autism insurance reform bill, SB.946, sponsored by Senate President pro Tem Darrell Steinberg, was signed into law a year ago by Brown.