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Saturday, February 2, 2013

Mandate Bill in Utah

On Friday, freshman Sen. Brian Shiozawa, R-Cottonwood Heights and past president of the Utah Medical Association, released SB55, which would require health insurance plans to cover autism treatment.
If passed, Utah would join 32 other states that require insurance coverage, according to the national advocacy group Autism Speaks, which endorsed the bill.
That’s a big "if." Utah’s autism community has been trying for years to mandate coverage, but last year saw their efforts stymied by a bill that instead created three pilot programs treating about 300 children under the age of 6.
Shiozawa, an emergency physician, was unavailable for immediate comment Friday.
But Mirella Petersen, president of Utah Autism Coalition, which is pushing for insurance coverage, said the senator recognizes "we’re in a triage situation. We can’t do much about it [autism] if we’re not going to offer effective, early treatment."
 Autism Speaks endorses the bill:
The Shiozawa bill would cover applied behavior analysis (ABA) up to $50,000 a year for children through age 8, then up to $25,000 a year though age 17. The bill would take effect July 1 of this year.
An autism insurance reform bill enacted last year created a test state program for about 300 children funded through state Medicaid funding and voluntary contributions from the private sector. The Utah Autism Coalition has estimated over 18,000 Utah children have autism.
According to reports in The Salt Lake Tribune, the Medicaid program was hindered by low reimbursement rates which limited the number of providers, while the private sector contributions were slow to materialize. In the meantime, it cited 20 cases of parents surrendering their children to the state because they could not afford to provide them the autism treatments they needed.
Shiozawa's bill would require state-regulated health plans to cover the diagnosis and treatment of autism, including speech, occupational and physical therapy as well as pharmaceutical benefits.
Small businesses would be granted a waiver if they can demonstrate the autism coverage increases their premiums over 2.5 percent over a 12-month period. Actual experience in other states which have enacted autism insurance reform shows the impact has been under 1 percent.