LI Herald: Legislator wants autism treatments covered

March 23, 2011

by David Weingrad

State Sen. Charles Fuschillo Jr., a Republican from Merrick, has introduced legislation to ensure that people with autism receive insurance coverage for the screening, diagnosis and treatment of autism spectrum disorders.

Currently, those with autism are routinely denied insurance benefits for the treatment of their disorder, forcing their families to pay for costly treatments.

“No family should have to choose between forgoing important health treatments or going broke to get care for their loved ones,” said Fuschillo. “However, many families with a loved one who has autism must do just that because their health insurance company refuses to cover autism treatment costs. This legislation would put an end to that by ensuring that families have the costs of screening, diagnosis and treatment of autism spectrum disorders covered by insurance.”

In addition to requiring coverage, the legislation would prohibit an insurance company from terminating or refusing to renew coverage for someone who has been diagnosed or received treatment for autism.

Assemblyman Joseph Morelle, a Democrat from Irondequoit who is chairman of the Assembly’s Insurance Committee, has introduced a companion bill in the Assembly that would also require insurance companies to pay for autism treatments.

“Autism is a disorder affecting a growing number of families, and they deserve access to affordable health care, insurance and treatments that will help their children lead better lives,” Morelle said. “It is time to establish parity for those with autism.”

Last year, a similar bill sponsored by Fuschillo and Morelle unanimously passed both houses of the state Legislature, but Gov. David Paterson vetoed the measure.

Autism is a neurological disorder that affects normal brain function, including development of communication and social interaction skills.

Autism Speaks, one of the nation’s largest autism science and advocacy organizations, has lobbied aggressively for the new insurance legislation. According to the organization, one in 110 children is diagnosed with autism.

Judith Ursetti, regional director of state advocacy for Autism Speaks, said the American Academy of Pediatrics requires that all children between ages 18 and 24 months be screened for autism. “Lots and lots of kids are being diagnosed with autism,” Ursetti said. “But then the treatments are prescribed, and health plans routinely exclude treatments that are related to autism. It’s a downward spiral of denial that families face.”

One resident who has faced financial difficulties is Michael Giangregorio of Merrick, who has a son with autism. “My family has spent over $85,000 over the years to care for my son, which has depleted our savings and reduced our retirement funds,” Giangregorio said. “Far too many others have been forced to do the same, or worse, could not get care for their loved one because they simply exhausted their finances.”

Ursetti, who has a daughter with Asperger syndrome and a son with classic autism, has gone from state to state to advocate for passage of autism insurance legislation. Five years ago, she said, only two states had laws requiring health insurance companies to insure people with autism. Today, 24 states do. “There’s a national trend that requires health insurance to cover treatment for autism, and many more are working on legislation now, just like New York,” she said.

Ursetti said she believes that insurance companies routinely deny coverage because they consider autism an untreatable condition. “People thought that autism meant ‘hopeless,’ but it really doesn’t,” she said. “There are treatments out there that really make a difference. But they have to have access.”

Ursetti began working with Fuschillo and Morelle last year to write the legislation. “They’re true champions for the cause,” she said. “They really believe in what they’re doing.”