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After years of hard work, in 2006, the autism community finally overcame insurance
Repeals New York’s Current Ban on Discrimination
company opposition and convinced the New York legislature to prohibit insurance
companies from denying coverage for medical treatments they otherwise cover solely
because the patient is diagnosed with autism.
The proposed law would eliminate the ban and allow a return to discriminatory practices.
Taxpayers pay for medical services for children with autism which are provided by county
Shifts Treatment Costs from Health Insurers to Taxpayers
governments and school districts from when the children are diagnosed (usually as
infants) to their high school graduation.
New York law requires counties to bill commercial health insurance companies; yet the
companies refuse to pay. For example, while 44% of children in Early Intervention pro-
grams (infants/toddlers) have commercial health insurance, commercial carriers paid only
2% of claims in 2009.
The proposed law would change New York law to insulate insurance companies from
having to pay for kids’ treatments for which their parents are paying insurance premiums.
The proposed law does not enumerate any treatments or types of treatments that must be
Doesn’t guarantee coverage for any treatment – and may exclude many.
covered -- or even that treatments prescribed by the patient’s doctor must be covered.
The proposed law provides that four state agencies shall create regulations to define the
treatments to be covered and creates an unrealistic standard (used nowhere else in NY
law) for them to apply -- which standard would exclude most of the treatments that now
benefit children with autism.
While more people with autism are reaching adulthood, the proposed law is silent on
requiring coverage for adults.