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GOVERNOR CUOMO SIGNS LAW, SPONSORED BY AILEEN GUNTHER, TO EXPAND HEALTH CARE COVERAGE FOR TREATMENT OF AUTISM SPECTRUM DISORDER

November 2, 2011

Assemblywoman Aileen M. Gunther (D, C-Forestburgh) announced this afternoon that a bill she co-sponsored (A6305a/S4005a) requiring health insurance providers to offer coverage for the diagnosis and treatment of autism spectrum disorder (ASD) was signed into law by Governor Andrew M. Cuomo today.

The legislation will help families afford the expensive health care costs related to treating loved ones with autism spectrum disorders. Under the new law, health insurance companies will be required to provide coverage for treatment, though coverage may be subject to deductibles, co-pays, and coinsurance consistent with those imposed on other benefits.

“As we have learned, early diagnosis and treatment for loved ones affected by autism spectrum disorder is critical,” Gunther said. “Many families have had to struggle to obtain proper care which is just not acceptable. Families should be able to rely on their insurers when seeking diagnosis and treatment.”

“We applaud the Cuomo and Legislature for providing increased support for individuals with autism and their families. The swift rise in the prevalence of autism has created an acute need for improved screening methods, diagnostic measures and service delivery models to provide enhanced support and resources to parents, teachers, administrators, health professionals and government officials struggling to respond to this pandemic,” said Patrick Dollard, President & CEO, The Center for Discovery.

Previously, state law only required that insurance coverage not exclude the diagnosis and treatment of autism disorder. While some health insurers provide limited coverage for ASD treatment, such as vitamins or occupational therapy, most do not offer coverage for treatments that are deemed not medically necessary. Families had little choice but to pay out-of-pocket for the necessary treatment, with costs sometimes more than $50,000 per year. Many families cannot afford to pay for treatment without a severe economic hardship and may have to forgo effective early treatment of ASD for their children.

With today's signing, New York is the twenty-ninth state to require health insurance coverage for conditions relating to autism spectrum disorder. As with other states, this legislation caps the cost of services per year. The law takes effect one year after its enactment on November 1, 2012 and applies to insurance policies issued or renewed after that date.