Since 2011 NY State has required meaningful coverage for autism under state-regulated plans.
New York’s autism insurance bills, S 4005-A and A 6305A, were enacted in 2011 and became effective on November 1, 2012. Prior to that Autism was considered a preexisting condition and Autism related services in NY STate could be denied.
To which plan types does the state autism insurance law apply?
- Individual Plans – YES
- Fully Insured Large Group Plans – YES
- Fully Insured Small Group Plans – YES
What services are covered by law?
- Diagnosis
- Behavioral health treatment (Applied Behavior Analysis)
- Psychiatric Care
- Psychological Care
- Therapeutic care (i.e. services provided by licensed or certified speech therapists, occupational therapists, social workers and physical therapists)
For purposes of this law, “behavioral health treatment” is defined as “counseling and treatment programs, when provided by a licensed provider, and applied behavior analysis, when provided or supervised by a behavior analyst certified pursuant to the behavior analyst certification board, that are necessary to develop, maintain, or restore, to the maximum extent practicable, the functioning of an individual.”
Does New York have caps on ABA coverage?
No.
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