LEG NEWS: West Virginia SB 145 & HB 2858 Autism Insurance Coverage

With the state legislative season started, new autism insurance mandate bills continue to come online, and
West Virginia also has two bills in the legislature related to insurance coverage and potentially coverage of applied behavior analytic services to children with ASD.

• Senate Bill No. 145: Requiring health insurers provide full autism coverage (By Senators Kessler, White, Jenkins and Laird)
  similar to HB 2858 (see below for HB 2858)
  Introduced January 13, 2010; referred to the Committee on Banking and Insurance; and then to the Committee on Finance.
  

The language of SB 145 is broad and non-specific as to specific coverage, stating under,

"ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-18. Autism spectrum disorder full coverage.
     A group or blanket accident of health insurance policy or issuing a group or blanket policy for delivery in this state which provides coverage for hospital, surgical, or medical care coverage shall include full coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder, regardless of whether such prevention, early detection, diagnosis or treatment methods are research based or experimental. Each policy will also provide full (in-state or in-network) coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder even if the individual is unable to receive a service, or treatment, within the State of West Virginia and must receive this service, or treatment, from an out-of-state provider."

and,

• H. B. 2858 (Cameron and Dominic Law): Requiring insurance coverage for autism spectrum disorder
  (By Delegates Rodighiero, Reynolds, Hatfield, Eldridge, Moore, Barker, Miley, Sobonya, Guthrie and Caputo)
  Introduced January 13, 2010; referred to the Committee on Banking and Insurance then Finance.

This bill has more detail on the nature of the coverage (see bill text for the full detail), and states

"(3) Coverage for behavioral therapy may not exceed a $50,000 maximum benefit per child per year.",

although "behavioral therapy" is not specified as applied behavior analysis, per se, and no definition of applied behavior analysis nor "behavioral therapy" is given in HB 2858. Provider, or competencies of the provider of "behavioral therapy" are not stated in the bill as filed.

For further information

Autism Votes West Virginia
(FYI: currently there is no info on the bills or legislative tracking, but that could change).

West Virginia Legislature bill status function

West Virginia legislature bill personalized bill tracking

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