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Wednesday, April 7, 2021

Portantino Bill on Insurance

The Politics of Autism includes an extensive discussion of insurance.

From Pasadena Now:
Senate Bill 562, authored by Senator Anthony J. Portantino (D – Pasadena), passed the Senate Human Services Committee Tuesday. The measure will eliminate barriers to help patients with Autism Spectrum Disorder (ASD) access Behavioral Health Treatment (BHT) in California.

“SB 562 will increase healthcare access to many autistic patients in California,” Portantino said in a prepared statement.

“Statistics tell us that 1 in 59 children born today are diagnosed with autism. Early intervention is the key to helping these children live up to their potential and health insurance coverage for behavioral health treatment is critical. Research has proven that children with autism greatly benefit from behavioral health treatments and show remarkable progress,” Portantino statement read. “By expanding the types of qualified state certified coverage, this bill will allow children to receive the treatment their physician has prescribed in a timely manner.”

Current law requires that health insurance companies cover all physicians or psychologists prescribed medically necessary, evidence-based BHT for ASD. Due to a loophole in the law, patients with ASD are being denied coverage for physician and psychologist prescribed evidence-based BHT. In some cases, coverage is only being offered for one form of BHT.

Additionally, a shortage of network providers has created a six to twelve month wait list for BHT services.

SB 562 will eliminate the existing statutory obstacles and require health insurance coverage for all forms of medically necessary, evidence-based BHT for Californians with ASD without diminishing consumer protections. The measure expands the number of qualified professionals by authorizing already State certified professionals to administer BHT within their professional competence, thereby reducing or eliminating the waiting list for services.

SB 562 also details the requirements for a Qualified Autism Service Paraprofessional to insure health insurance coverage, including background checks to protect California children. The measure will protect the interests of California consumers and the state by closing the loopholes in the law and ensuring that every Californian is covered.

“The DIR/Floortime Coalition of California wants to thank Senator Portantino for his ongoing leadership and support on behalf of California families,” said Andrea Davis, President of the DIR/Floortime Coalition. “Senate Bill 562 will help Californians with autism receive the treatment prescribed by their physician treatment that they both need and deserve. For too long Californians on the autism spectrum have only been covered for one type of behavioral health treatment. This legislation will correct that and allow Californians to receive the physician-prescribed, medically necessary, evidence-based treatment approach selected specifically for them. Not all Californians with autism are alike. They deserve a treatment approach chosen for their specific circumstances and needs. Treatments chosen specifically for the client will allow them to achieve their full potential and lower costs for the state, for the insurance company, and for the family. We are happy to support this much needed legislation.”

SB 562 is sponsored by the DIR/Floortime Coalition of California. Supporters of the bill include: Center for Developmental Play and Learning, Cherry Crisp Entertainment and Productions, Child Development Institute, Dr. Barbara Stroud, Clinical Psychologist, Fresno City College, Greenhouse Therapy Center, Holding Hands Pediatric Therapy and Adult Services, NeuroRelational Framework Institute, Positive Development, Professional Child Development Associates, Stanford University Schwab Learning Center, the Washington Elks Therapy Programs for Children, INC., and Touchstone Family Development Center.