October 1st, 2014

Law requires Medicaid coverage of autism services

A new law in Massachusetts will expand assistance and services for individuals with Autism Spectrum Disorders when it goes into effect in November.

Signed by Gov. Deval Patrick on Aug. 5, House Bill 4047 requires Medicaid coverage of evidence-based services for individuals with Autism Spectrum Disorders; allows individuals on the spectrum with a higher IQ to qualify for disability services; creates a teacher endorsement in Autism Spectrum Disorders; creates a savings and expense account so that families can save money for the future of a child on the spectrum; and makes a Massachusetts commission on autism permanent, among other items.

“One of the things I’m most proud of is we established a 529 type plan,” says Rep. Garrett Bradley (D-Hingham) who sponsored the legislation. A 529 plan allows parents to save money for college in a tax-advantaged account typically sponsored by the state or educational institution, according to the U.S. Securities and Exchange Commission Web site.

“We talked to a lot of parents with autism who said, ‘I opened those up when they were kids but unfortunately my child is never going to college. Why can’t we use that act to care for them?’ Unlike other folks with special needs, kids with autism in all likelihood are going to live beyond their parents. As parents, they want to try to be as responsible as possible and set some savings aside for education, medical and dental care, job training, housing, transportation, things like that, tax deferred just like the college savings plan.”

Judith Ursitti, director of state government affairs for Autism Speaks, says the piece of the law that now requires MassHealth to cover evidence-based treatments for those on the spectrum “was a huge step forward.”

In 2011, a law requiring private insurance companies to cover evidence-based treatments went into effect in Massachusetts. Since then, Autism Speaks and others have been working to expand that to public insurance plans to provide coverage for treatments like speech therapy, occupational therapy, physical therapy, psychological services, psychiatric services and Applied Behavior Analysis, Ursitti says.

“Massachusetts truly is leading the country now in this regard and it’s really exciting to see,” she says. Vermont and Oregon are the other two states that require Medicaid coverage of autism services.

Ursitti says often psychiatrists or psychologists are the ones prescribing these therapies. “They are on the front lines of serving the autism population.”

Changes to the law stemmed from recommendations by a Massachusetts commission on autism that was created in 2011. “It’s actually pretty cool to see a state come up with a commission report after studying and talking to people all over the Commonwealth with a list of recommendations that the legislature actually does something about,” Ursitti says. That commission will be a permanent fixture under the new law.

“We did that because there has been a 29 percent increase (in the U.S. Autism Spectrum Disorder population, according to a report by the Centers for Disease Control and Prevention) in the last two years,” says Bradley. “Now we’re at one in 68 from one in 88 kids. We are trying to have a commission set up to advise the legislature and the administration to deal with these things before rather than after the fact.”

For text of the bill, visit malegislature.gov. Bradley says those with questions are welcome to contact his office at 617-722-2520.

By Rivkela Brodsky

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