"Autism Treatment Acceleration Act of 2009 - Federal Autism Insurance Reform (S. 819, H.R. 2413)

In his Presidential campaign statement on Autism Spectrum Disorders, then-Senator Barack Obama committed to bringing autism insurance reform to our entire nation. His statement put forth that Obama and Biden "will mandate insurance coverage of autism treatment and will also continue to work with parents, physicians, providers, researchers, and schools to create opportunities and effective solutions for people with ASD."

In an effort to put his words into action President Obama has asked Illinois Senate colleage Senator Richard Durbin (D-IL), along with Senator Robert Casey (D-PA) and Senator Robert Menendez (D-NJ) to introduce comprehensive autism legislation, including a section addressing broad based federal autism insurance reform. The compaion bill in the House (H.R. 2413) has been introduced by Representatives Mike Doyle (D-PA), Chris Smith (R-NJ), Eliot Engel (D-NY), and Hank Johnson (D-GA).

The “Autism Treatment Acceleration Act of 2009” (ATAA) contains a total of twelve sections, each putting forth a different program for autism. A key feature of the bill is Section 12, which contains the provisions for federal reform of autism insurance coverage. If passed, Section 12 will require all insurance companies across the country to provide coverage for evidence-based, medically-necessary autism treatments and therapies.

Summary of the ATAA:

S. 819 - Sponsored by Senator Richard Durbin (D-IL), Senator Robert Casey (D-PA), Senator Robert Menendez (D-NJ)

H.R. 2413 - Sponsored by Rep. Mike Doyle (D-PA), Rep. Chris Smith (R-NJ), Rep. Eliot Engel (D-NY), Rep. Hank Johnson (D-GA)

Demonstration Project - Creates a demonstration project to develop Autism Care Centers in order to increase access to quality health care services and communication among healthcare providers, educators, and other providers of services; enable beneficiaries to designate a personal primary care coordinator as a source of contact for a family; and provide a full array of medical, behavioral, mental health, educational and family care services to individuals and families in a single location.

Adult Services Demonstration Project - Creates a demonstration project to provide an array of services to adults with autism spectrum disorders including: post secondary education, vocational and self advocacy skills, employment; residential services, supports and housing; nutrition, health and wellness; recreational and social activities; and transportation and personal safety.

Registry (Senate bill only) - Establishes a voluntary population-based autism spectrum disorders case registry to help understand the root causes, rates, and trends of autism.

Public Education and Awareness Campaign - Develops a national multimedia campaign to increase public education and awareness about healthy developmental milestones and autism throughout the lifespan. Campaigns will be targeted at a general public audience or specific audiences such as medical, criminal justice, or emergency professionals.

Interdepartmental Coordinating Committee - Establishes an Interdepartmental Coordinating Committee to coordinate and advise on government activities relating to research, services, and programs for individuals with autism spectrum disorders. Members will include representatives from relevant governmental agencies (Dept. of Health and Human Services, Dept. of Education, etc) and members representing individuals with autism, parents, service providers, and advocacy groups.

National Network for Autism Spectrum Disorders Research and Services - Establishes a National Network in order to strengthen linkages between research and service initiatives at the federal, regional, state and local levels, and facilitate the translation of research on autism into services and treatments that will improve the quality of life for individuals with autism and their families. A national data repository will be created to share emerging data, findings, and treatment models.

National Training Initiative - Creates a national training initiative on autism and a technical assistance center to develop and expand interdisciplinary training and continuing education on autism spectrum disorders.

Insurance Coverage - Requires that health insurers cover the diagnosis and treatment of autism spectrum disorders, including Applied Behavioral Analysis therapy and assistive communication devices.

• This section is based on the Autism Speaks model insurance reform bill that has been used to craft bills in states across the country
• The bill currently has no age cap, dollar cap, or cap on the number of visits to a therapy provider
• The bill covers diagnosis of autism, as well as the following treatments:
  • Medications prescribed by a physician and any health-related services necessary to determine the need or effectiveness of the medications
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Services provided by a psychiatrist or psychologist
  • Professional, counseling, and guidance services and treatment programs, including applied behavior analysis and other structured behavioral programs, communication devices and other assistive technology devices
• If passed, this federal bill will supersede all state laws and become the “floor” requirement for all insurance companies. However, a state may pass a law that enhances this federal law, going above and beyond what the federal law offers
• While state laws can only apply to fully-funded health plans, this bill will apply to all fully-funded and self-funded individual and group health plans, including state and local government plans (state and local government plans that are self-funded can opt-out of the requirement. This is true of current requirements, such as mental health parity)
• The House bill specifically applies to the Federal Employee Health Benefit Plan (FEHBP) and TRICARE" - From the Autism Votes Website.

This may be a really good move. I would love to see insurance coverage for many autism related services including ABA, OT, PT and ST. But I would also love to see DAN! doctors covered by insurance. Many of them are really saving our children, they should be under this coverage too.