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Alaska Lawmakers Send Autism Mandate Bill to Governor

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The Alaska Legislature has passed a bill that could require individual health insurance policies and some state-regulated group policies to provide rich autism treatment benefits.

Members of the Alaska Senate voted 36-3 Sunday to pass the bill, Senate Bill 74, and the Senate later agreed to the House changes.

S.B. 74 would require insurance coverage for treatments for autism that are believed to be medically necessary.

A therapy could be considered medically necessary if the therapy could help a child “achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the individual and the functional capacity of other persons of the individual’s age,” according to the text of S.B, 74.

“Covered treatment includes medically necessary pharmacy care, psychiatric care, psychological care, habilitative or rehabilitative care, and therapeutic care,” according to the bill text.

The bill defines “habilitative or rehabilitative care” to include “applied behavior analysis or other structured behavioral therapies.”

Applied behavioral analysis (ABA) can cost $30,000 per year or more.

S.B. 74 would exempt fraternal benefit society plans and state-regulated group health plans sponsored by employers with 20 or fewer employees.

The state insurance director could waive the mandate for an employer with 21 to 25 employees “if the small employer demonstrates to the director by actual claims experience over any consecutive 12-month period that compliance with this section has increased the premium cost of the small employer’s health insurance policy by 3% or more during the consecutive 12-month period,” according to the bill text.

The bill would take effect Jan. 1, 2013.

The Associated Press contributed to this report.


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