House panel approves expanding insurance coverage of autistic children

Panel OKs bill to broaden coverage
By Jason Hoppin

A bill that would expand insurance coverage for autistic children cleared a key Minnesota House committee Wednesday on a voice vote.

The bill would require insurance companies to cover treatment for autism, and the House's Health Care and Human Services Policy and Oversight Committee took testimony from several parents of autistic children who say an intensive therapy program has given their children hope they could effectively overcome their disability and lead normal lives.

"I cannot understand how insurance companies are able to refuse to cover this very treatable condition," said Beth Kandaswamy, of Blaine, whose daughter Nina was diagnosed when she was 3 years old.

Autism-related disorders are the fastest-growing developmental disability in the U.S., now affecting one in every 150 children, according to the Autism Society of America. It is more prevalent in boys than girls, and researchers expect the number of cases to grow.

There is no known cause, yet parents see hope in an intensive program of behavioral therapy that requires many hours of treatment per day. But some insurers have balked at paying for the therapy, which can cost up to $100,000 annually, according the Minnesota Council of Health Plans.

"The real problem here that we're trying to get at is they don't cover the proven, intensive, effective behavior therapy," said Amy Dawson, whose son undergoes 36 hours of therapy a week and could eventually become developmentally indistinguishable from his twin sister.

But Kathryn Kmit, a lobbyist for the Minnesota Council of Health Plans, testified that the science is inconclusive on whether behavioral therapy works in every case. She said her group, which represents eight Minnesota insurers, favors a "value-driven benefit" that is "consistent with the most up-to-date science."

"Not all the evidence demonstrates how effective it is," Kmit said, a statement that drew gasps from the audience.

Business interests such as the Minnesota Chamber of Commerce and the National Federation of Independent Business oppose the bill. Mike Hickey, a lobbyist with NFIB, said the requirement might be the tipping point in whether small businesses can afford to offer their employees health insurance.

Insurers such as Blue Cross Blue Shield do cover the therapy, but parents testified that they have had to fight with other insurance companies to obtain coverage. The bill, sponsored by Rep. Kim Norton, DFL-Rochester, and others, would require insurers to cover what are called autism spectrum disorders. At least 10 states require insurers to provide coverage for treatment, and seven of those require health insurers to cover behavior therapy.

Kandaswamy and her husband, Dr. Raja Kandaswamy, both worked at the University of Minnesota when they first noticed their daughter Nina's troubles with speech. Two years later she was diagnosed with autism, but their request for coverage of the therapy program was initially denied.

They successfully appealed. Beth Kandaswamy, who has since quit her job to oversee Nina's treatment, said the benefits are obvious.

"A year ago, we could have no conversation with her. Now, we do," she said.

Dawson also said the benefits of the therapy are clear.

"If you have a kid who doesn't bang her head until she is blind, that is a measurable outcome," Dawson said.

The bill was forwarded to the House Commerce and Labor Committee for further consideration.

Source: http://www.twincities.com/ci_1163077...e=most_emailed

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