California SB 946 (Steinberg) requires Private Health Plans and Insurance Companies to provide coverage for behavioral health treatment (BHT) for individuals with autism or pervasive developmental disorders. BHT treatment must meet the standards set out in the bill. The new law is effective from 7/1/2012 and expires on 7/1/14. If the Federal government does not establish Autism behavioral health treatment as a "essential health benefit", this bill will automatically expire on 7/1/14.
Please pass this legislation on to your teachers, support staff, administrators and parents. This law may encourage a pediatrician to refer in house for diagnosis of Autism, as the insurance company can no longer deny BHT. Early treatment and medical identification is critical, especially when some families do not contact the Regional Center. If services are not offered by insurance companies when requested by families, the family could file a complaint with the Department of Managed Health Care as a "willful violation of these provisions which is considered a crime". If the child qualifies for Regional Center Services, the regional center is already billing insurance for reimbursement of medical and mental health services (behavior health treatment).
http://www.aroundthecapitol.com/Bills/SB_946/20112012/
http://leginfo.ca.gov/pub/11-12/bill/sen/sb_0901-0950/sb_946_bill_20110909_amended_asm_v95.html
http://www.autismvotes.org/site/c.frKNI3PCImE/b.3937859/k.13F7/California.htm
A health plan must cover the same or equal benefits for certain mental health conditions that it covers for other medical conditions. This is called "mental health parity." It is a law in California. For example, if your plan offers prescription drug benefits, whether drugs are prescribed for a mental health or medical condition, they must be covered at the same rates. The co-payments, deductibles, and maximum lifetime benefits charged for mental health conditions must be the same as those for medical conditions.
The Mental Health Parity Law ensures the same medical care coverage for the following mental health conditions:
You can ask for a referral from your primary care doctor, your mental health care provider, or your health plan. In some plans, you may be able to make an appointment directly with a mental health care provider. Read your Evidence of Coverage (a booklet about your benefits) or call the phone number on your Membership Card to find out what you need to do to see a mental health provider. Some plans have a behavioral health care phone number on the membership card. You can call this number.
Mental health care can include:
http://www.hmohelp.ca.gov/dmhc_consumer/br/br_mentalhlth.aspx
DSM-V proposed revisions: http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=94 Articles of interest: http://www.science20.com/science_20/redefining_autism_dsmv-86289 http://www.science20.com/truth_universally_acknowledged/dsmv_new_revised_opportunities_pharma http://www.science20.com/science_autism_spectrum_disorders/blog/use_terms_when_discussing_autism_intelligence_impairment_and_disability http://www.psychologytoday.com/blog/my-life-aspergers/201201/how-will-the-dsm-v-changes-in-autism-affect-people
Invitation to Preview Autism Resource Guide
Dear Colleagues, I cordially invite you to preview my award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools. Filling a critical void in the autism literature, this authoritative yet accessible text provides school psychologists, special educators, support professionals, advocates, and parents with a best practice guide to screening, assessment, and intervention for school-age children with autism spectrum disorders (ASD). Grounded in the latest research, special features include illustrative case examples and an index to 50 evidence-based best practice recommendations. This book also makes an ideal text for graduate-level training courses in special education and is certain to become a widely used resource. The free preview is available at: <http://books.google.com/books?printsec=frontcover&id=cwyGUFkMFDoC#v=onepage&q&f=false> Thanks for your time. Lee A. Wilkinson, PhD, NCSP http://bestpracticeautism.com http://works.bepress.com/lee_wilkinson/
Dear Colleagues, I cordially invite you to preview my award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools. Filling a critical void in the autism literature, this authoritative yet accessible text provides school psychologists, special educators, support professionals, advocates, and parents with a best practice guide to screening, assessment, and intervention for school-age children with autism spectrum disorders (ASD). Grounded in the latest research, special features include illustrative case examples and an index to 50 evidence-based best practice recommendations. This book also makes an ideal text for graduate-level training courses in special education and is certain to become a widely used resource.
The free preview is available at: <http://books.google.com/books?printsec=frontcover&id=cwyGUFkMFDoC#v=onepage&q&f=false>
Thanks for your time.
Lee A. Wilkinson, PhD, NCSP
http://bestpracticeautism.com
http://works.bepress.com/lee_wilkinson/
