Relates to coverage for applied behavior analysis and for developmental, individual-differences, relationship-based treatment of autism spectrum disorder.
Summary
Bill S05107 aims to amend New York's insurance law to ensure comprehensive coverage for the screening, diagnosis, and treatment of autism spectrum disorder (ASD). It mandates that all insurance policies providing medical coverage must include provisions for ASD-related services, including applied behavior analysis and developmental, individual-differences, relationship-based treatment, with a maximum benefit of 680 hours of treatment per calendar year per covered individual. The bill also prohibits insurers from denying coverage based solely on an individual's ASD diagnosis or treatment history, ensuring that such coverage aligns with other medical benefits provided under the policy.
Impact
If enacted, S05107 will significantly enhance the protections for individuals diagnosed with autism spectrum disorder in New York State. It will require insurers to provide essential services that are often critical for the development and well-being of individuals with ASD. The bill will also standardize the coverage requirements across different insurance policies, potentially reducing disparities in access to necessary treatments and therapies for autism.
Sentiment
The sentiment surrounding Bill S05107 appears to be generally supportive, as it addresses a critical need for improved insurance coverage for autism-related services. However, there may be concerns from some insurance providers regarding the potential financial implications of mandated coverage and the limits on treatment hours, which could lead to discussions about the sustainability of such requirements.
Contention
Notable points of contention may arise from insurance companies that could argue against the financial burdens imposed by the mandated coverage requirements. Additionally, there may be differing opinions on the appropriateness of the maximum benefit cap of 680 hours for treatment, with some advocates for autism services potentially seeking higher limits to meet the diverse needs of individuals with ASD.
Same As
Relates to coverage for applied behavior analysis and for developmental, individual-differences, relationship-based treatment of autism spectrum disorder.
Relates to coverage for applied behavior analysis and for developmental, individual-differences, relationship-based treatment of autism spectrum disorder.
A bill for an act relating to Hawki coverage for the treatment of autism spectrum disorder applied behavior analysis services, and the autism support program.(Formerly HSB 122.)
A bill for an act relating to Hawki coverage for the treatment of autism spectrum disorder applied behavior analysis services, the autism support program, and making an appropriation.(See HF 509.)
A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder and including applicability provisions.(See HF 330.)
Human services: medical services; coverage for diagnosis of autism spectrum disorders and treatment of autism spectrum disorders; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109u.
A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder and including applicability provisions. (Formerly HF 5.) Effective date: 07/01/2025. Applicability date: 01/01/2026.
A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder and including applicability provisions. (Formerly HF 5.) Effective date: 07/01/2025. Applicability date: 01/01/2026.