NYS-Autism Insurance Reform

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Please Contact Albany Today for Real Autism Insurance Reform _

Take Action!_

(http://capwiz.com/a-champ/utr/1/NXIVMGACYG/DKNVMGADGJ/4891222601) Why we

oppose S700/A10372 and support S6123/A6888

 

 

Please take a few minutes to send an email to your legislator asking him

or her to support S6123 in the New York Senate and A6888 in the New York

Assembly by clicking on the Take Action button. These bills will provide real

autism health insurance reform.

 

We are opposed to S 7000 and A 10372, the bills Autism Speaks crafted with

insurance industry lobbyists, that provides no assurance that any

healthcare will be provided to people with autism.

 

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The following are our primary concerns with S7000/A10372:

 

Current non-discrimination language in New York Law is eliminated

 

The non-discrimination language the autism community fought so hard for in

2006 is deleted from the insurance law [medical conditions otherwise

covered by the policy solely because the treatment is provided to diagnose or

treat] and no new language to address this problem is proposed. Deletion of

this language may allow the legal return of the denial of non-autism

related medical services.

 

The treatment guidelines are vague and uncertain

 

The language in S7000/A10372 provides no certainty of what, if any

treatments or therapy, would require coverage:

 

" ...THE CURRENT AND SUBSEQUENTLY PUBLISHED CLINICAL REPORTS AND TREATMENT

GUIDELINES OF THE AMERICAN ACADEMY OF PEDIATRICS FOR THE SCREENING,

DIAGNOSIS AND TREATMENT OF AUTISM SPECTRUM DISORDER SHALL SERVE AS THE

STANDARD OF TREATMENT AND THERAPY OPTIONS TO BE COVERED PURSUANT TO THIS

PARAGRAPH. "

 

A simple enumeration of services used to treat autism and commonly

occurring co-morbid conditions, as is found in Assembly Bill 6888, would

provide

clarity and certainty that necessary and well-established procedures and

methods would be provided. At the very least, the American Academy of

Pediatrics guidelines appear to provide no support for occupational therapy,

physical therapy or care for the immunological problems commonly afflicting

people with autism. We are concerned that this lack of clarity will allow the

denial of many commonly provided services and require lengthy, expensive

and time-consuming appeals to obtain currently provided care.

 

It is unclear how adults will be covered

 

S7000/ A10372 only makes mention of guidelines created by the American

Academy of Pediatrics. What access adults with autism will have access to is

undefined and unclear. More and more adults need care as the leading edge of

the autism explosion that began at the end of the 80s ages into adulthood.

 

" Evidenced based and clinically proven " is an unfair standard that appears

nowhere else in New York Law

 

We are unaware of any other instance in New York State law where the vague

and potentially onerous standard of " evidence based and clinically proven "

is used to assess medical interventions. This standard has been used in

other states to deny many of the treatments and therapies supporters of S7000

believe will be covered. This standard alone calls for our opposition to

this bill.

 

The proposed four-agency regulatory mechanism is ponderous, conflicted,

inappropriate and excludes important stake-holders

 

S7000/A10372 calls for a group of four state agencies to create

regulations to govern what services shall be provided. S7000/A10372, however,

proposes no timelines, no mechanism to involve experts outside of the agencies,

no

mechanism for the participation of people with autism, their families or

advocates, and no appeal process.

 

Two of the agencies provide care to large populations of people with

autism, and therefore, have a direct financial incentive to limit care. The

lead

agency in this proposal, the Department of Health has no significant

autism-related programs or institutional expertise in autism care. The

Department of Health does not even gather statistics on the number of New

Yorkers

with an autism diagnosis. This is a wholly inadequate and unacceptable

method to determine autism care in New York

 

These are all fatal flaws in the current language of S7000/A10372. While

we would prefer the passage of S6888, we are, however optimistic that

discussions between lawmakers and the broad range of groups within the autism

community could lead to the creation of mutually acceptable language for an

amended S7000/A10372.

 

 

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