Seeking full and fair coverage for the treatment of Autism Spectrum Disorders
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September 21, 2012 -- Advocates for full and fair coverage for the treatment of autistic symptoms were granted another small step today toward aligning all health insurance markets with the benefits required under Connor's Law.
After a lengthy debate that focused primarily on abortion, not autism, the legislature's Joint Health Reform Oversight Committee (see sidebar) voted 5 to 1 to select Matthew Thornton Blue as the Granite State's benchmark for benefit design in the healthcare exhange slated to come on line in 2014. Rep. Andrew Manuse (R, Derry) cast the lone dissenting vote. Matthew Thornton Blue, an HMO sold by Anthem, includes coverage for Applied Behavior Analysis (ABA).
In guidance issued by Secretary of Health and Human Services Kathleen Sebalius last December, every state was given until September 30, 2012 to select an "essential health benefits" benchmark plan. NH policy makers had narrowed the field from 10 to three potential candidates, when they sought an independent review by Compass Health Analytics.
Compass identified Matthew Thorton Blue as the least costly of the three finalists, which also included HMO Blue New England and GEHA, the plan provided federal employees in New Hampshire. Their study indicated that benefits under Connor's Law have an impact of approximately eight tenths of one percent (.082%) relative to the other two plans assessed. Connor's Law is only one of 43 specific benefits required under NH law, many of which have a more significant impact on the cost of health insurance, according to the Compass report.
Beginning in 2014, all individual and small group policies in New Hampshire must, at a minimum, include the same benefits as Matthew Thornton Blue. Previously, policies written for individuals -- as opposed to a group of company employees -- were exempt from Connor's Law.
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The NH Coalition for
Autism Insurance Reform
Selection of a benchmark policy that includes Connor's Law is significant. It continues to demonstrate that insurance coverage for ABA and other important therapies like speech and OT are an expected part of our healthcare delivery system.
We continue to monitor compliance with Connor's Law and urge any family that is experiening difficulty receiving reimbursement under a policy subject to this law to file a consumer complaint with the NH Department of Insurance at http://www.nh.gov/insurance/consumers/complaints.htm.
Please check this site for updates, and thank you for all the good work that you do!
To learn more about Autism Advocacy & Healthcare Reform:
Joint Health Care Reform Oversight Committee 2012
Sen. Jeb Bradley
Sen. David Boutin
Sen. Molly Kelly
Rep. Richard Barry
Rep. John Hunt
Rep. Andrew Manuse