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Autism Awareness Month & Insurance Coverage

You may or may not have seen the ribbon with colorful puzzle pieces on car bumpers and pondered the meaning. I personally did not quite know until I typed it into Google. The puzzle pieces signify the mystery and complexity of the autism spectrum.

Autism is a developmental disorder that appears in the first 3 years of life, and affects the brain's normal development of social and communication skills. Autism is a physical condition linked to abnormal biology and chemistry in the brain. The exact causes of these abnormalities remain unknown, but this is a very active area of research. There are likely combinations of factors that lead to autism.°

April denotes Autism Awareness month. This is means educating others on what affects 1% of the population. The Centers for Disease Control and Prevention (CDC) estimate that an average of one in 110 children have an autism spectrum disorder (ASD). More children than ever before are being classified as having autism spectrum disorders. The CDC estimates that up to 730,000 people between the ages of 0 and 21 have an ASD. While we’re no authority on the topic, we do want to share with you changes in the insurance world as it affects Autism.

Effective July 1, 2012, California requires that insurance plan contracts provide hospital, medical, or surgical coverage to provide coverage for behavioral health treatment for pervasive developmental disorder or autism. The coverage shall be provided in the same manner and shall be subject to the same requirements as provided in Section 1374.72. (California Senate Bill 946)

These treatments include professional services and treatment programs, including applied behavior analysis and evidence-based behavior intervention programs that develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism and includes speech-language pathology and audiology.

We will have more information toward the end of April from the insurance carriers with specifics (summaries/EOC’s). We will share this with you at that time.