At present the current law mandates that insurance companies must provide coverage for treatment of autism spectrum disorder (ASD) only for children ages 5 and under.
Alanna Durkin from the Herald Online reports that advocates who are pushing for the bill to raise the age to 21 say that this is preventing families from getting effective, proven treatment for their children or is forcing them onto Medicard.
Nancy Cronin, executive director of the Maine Developmental Disabilities Council said that:
‘Families may not want to go onto Medicaid or their child may have a mild form of autism, preventing them from qualifying for the approach that teaches children skills by breaking them down into smaller skills, she said. Furthermore, many children aren’t diagnosed with autism until they’re older than 5’
Cathy Dionne, director of programs and administration of the Autism Society of Maine, said that the measure, introduced by Democratic Sen. Colleen Lachowicz of Waterville, could also be a cost saver for Medicaid as some of those costs would go over onto private insurance.
She billed $860,000 to Medicaid for her son’s treatment from ages 4 to 16.
A recent report by the Department of Health and Human Services found that in 2012, the state paid claims for more than 5,830 residents with ASD.
A report by the state’s Bureau of Insurance found the measure would result in higher monthly insurance premiums of nearly $1.50 per person.
The Herald Online reports that Advocates say that while they hope the state would see coverage up to age 21, they’ll see any expansion in coverage for the treatment as a victory.
The full article on heraldoine.com can be found here