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State Insurance Mandates

Autism Speaks State Autism Insurance Reform Initiative

Q:     What is the Autism Speaks State Autism Insurance Reform Initiative?

A:     Autism Votes, an Autism Speaks initiative, is working to change state insurance laws to require private health insurance policies to cover the diagnosis and treatment of autism spectrum disorders (ASDs).  In connection with its State Autism Insurance Reform Initiative, Autism Speaks is keeping track of the states that have enacted autism insurance reform laws.

Many of the state autism health insurance mandates are based on the same model legislation – Autism Speaks’ model legislation.  This model legislation is based on Ryan’s Law in South Carolina.

Q:     How extensive are the state mandated autism benefits mandates?

A:     Federally mandated ERISA preemption is the primary reason that more of the Florida’s children are not eligible for mandated benefits.  See “Q& A: ERISA Preemption – Basic Information.” All state insurance benefits mandates are similarly limited in scope because of ERISA preemption.

Florida passed an autism benefits mandate in 2008.  Only 14% of Florida’s children are eligible for benefits under Florida’s autism insurance mandate.  (See “Florida’s Autism Insurance Benefits Mandate: Who Will Benefit, Who Will Not, and Why?”)

State mandated autism insurance benefits also include extensive exemptions.  For example, small employer and individual plans are exempt.  See “Florida’s Autism Insurance Benefits Mandate: Who Will Benefit, Who Will Not, and Why? Chapter 4: Mandate Exemptions.”

Behavioral Lifeboat is researching the extent of coverage of all state mandated autism benefits.

Q:     Are there any exceptions to ERISA preemption?

A:     See “Q& A: ERISA Preemption – Basic Information –  Q:  Are there any exceptions to ERISA preemption?

These general answers may or may not apply to your specific circumstances.  You should consult a lawyer or other specialist if you think you are entitled to benefits that you do not receive.  Behavioral Lifeboat can help you do that.

If you have questions, please comment in the Behavioral Lifeboat blog.

© 2011 Behavioral Lifeboat, Inc.

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About Behavioral Lifeboat

Behavioral Lifeboat is a nonprofit organization. Our mission is to make evidenced-based behavioral therapy accessible to all by increasing awareness, helping to make comprehensive insurance benefits affordable and meaningful, helping schools provide more effective behavioral therapy programs, and providing grants to make such therapy affordable when other solutions are not available.

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