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Oregon HB 2918 - Health Insurance

Action Alert: Health Insurance Coverage for Autism!!!!!! Every family who is dealing with autism would certainly agree that autism is a catastrophic medical event. Families are paying premiums, but not receiving the product they have paid for. What is the purpose of health insurance if one cannot use it? HB 2918 seeks to right this wrong and mandates group health insurance carriers to cover autism just like every other neurological condition. Similar to Indiana's mandate, HB 2918 requires individual, group and HMO based policies to cover treatment for autism that is prescribed by the beneficiary's physician in accordance with a treatment plan. Thank you to all the families and professionals who testified or submitted written testimony at the hearing on March 14, 2007! We have been told the parents' stories were powerful! Please continue to submit testimony to Health Committee members over the next two weeks. There will be another hearing in a couple of weeks in which the insurance companies will bring in their experts to say that there is no real treatment for autism and what families are asking to be covered is experimental and unproven. (This was one of their arguments for not covering autism in the first place.) We need your help! At the next hearing, we must pack the room with people holding signs or wearing t-shirts and buttons with photos of the children and the slogan "I CAN'T wait for treatment" and "Wasted Time is Wasted Brain." Legislators and lobbyists have to be astounded by the numbers to get this legislation passed! We will issue an alert as soon as we have the date and time of the next hearing. We have indication that the next hearing could be on or near Monday or Wednesday of the 1st or 2nd week in April. This mandate will open many doors to individuals with autism who would otherwise not get treatment. People with autism have been waiting for appropriate treatment for decades - the time to wait is over! Eight states now have passed similar mandates and more currently have similar bills pending. Please write the following legislators below now and tell them you support this bill!!! Please acknowledge that autism is now a covered condition by your group health plan and thank them for that. Also acknowledge the benefits provided under SB1 such as Speech, OT, and PT as well as mental health visits to Psychiatrists, Psychologists and Social Workers. Only focus on medically necessary treatment that is not covered under SB1, (such as Applied Behavior Analysis), and why we need HB 2918 in addition to SB1. Tell them you support the language in the bill pertaining to insurance companies covering what is in a treatment plan outlined by the physician. Please share your personal stories of frustration trying to get insurance coverage after January 1, 2007 for your child's treatment. Please also share what it would mean to your child and family to finally have health insurance coverage for all medically necessary treatment for autism. Stories about your child's condition prior to starting ABA treatment and how they have improved with ABA treatment are inspirational! These kinds of stories make the point about how medically necessary treatment can ameliorate autism. Many children improve to the point of being indistinguishable from their neurotypical peers. We will not further the passage of this bill by complaining about treatments that were not covered before SB1 which are being covered now, nor will we further the passage of this bill by stating grievances with the school system. While the school system does need improvement, this bill specifically addresses insurance coverage for medically necessary treatments outside of any school setting. Be very mindful of the language you use. Insurance companies do not cover special education or treatments in a private or public educational setting. Talking points: 1. SB1 falls short in providing parity for autism. Under current law, autism is a covered mental condition. Group health insurance companies currently provide coverage for treatments such as occupational therapy and speech therapy. We still need all medically necessary treatment covered. Treatments such as Applied Behavior Analysis and others can still be denied because of language in SB1 concerning medical necessity and state licensing requirements for providers. (Currently there is no licensing requirement or licensing available for providers of behavior analytic treatment in Oregon.) 2. Tell them you support the following language in the bill: "All health benefit plans, as defined in ORS 743.730, shall provide coverage for treatment of a pervasive developmental disorder that is prescribed by the beneficiary's physician in accordance with a treatment plan." 3. Autism is a treatable neurological condition. Please share your inspirational stories of how medically necessary treatment, such as ABA, has helped your child. Please send letters to all of the following Representatives: HB 2918 Sponsors: Representative Peter Buckley Party: D District: 5 Capitol Phone: 503-986-1405 Interim Phone: 541-488-9180 Capitol Address: 900 Court St NE, H-376, Salem,, OR, 97301 Interim Address: 71 Dewey Street , Ashland, OR, 97520 Email: Website: Representative Chris Edwards Party: D District: 14 Capitol Phone: 503-986-1414 Capitol Address: 900 Court St. NE, H-284, Salem, OR, 97301 Email: Interim Email: Website: Representative Paul Holvey Party: D District: 8 Capitol Phone: 503-986-1408 Interim Phone: 541-344-5636 Capitol Address: 900 Court St NE H-475, Salem, OR, 97301 Interim Address: PO box 51048, Eugene, OR, 97405 Email: Website: Representative Chip Shields Party: D District: 43 Capitol Phone: 503-986-1443 Interim Phone: 503-231-2564 Capitol Address: 900 Court St NE, H-389, Salem,, OR, 97301 Interim Address: 1125 SE Madison St, Suite 100B, Portland, OR, 97214 Email: Website: Representative Carolyn Tomei Party: D District: 41 Capitol Phone: 503-986-1441 Interim Phone: 503-653-5180 Capitol Address: 900 Court St. NE., H-286, Salem, OR, 97301 Interim Address: 11907 SE 19th Ave., Milwaukie, OR, 97222 Email: Website: House Health Care Committee Members: Representative Tina Kotek - Vice Chair Party: D District: 44 Capitol Phone: 503-986-1444 Capitol Address: 900 Court St. NE, H-285, Salem, OR, 97301 Email: Website: Representative Mitch Greenlick - Chair Party: D District: 33 Capitol Phone: 503-986-1433 Interim Phone: 503-297-2416 Capitol Address: 900 Court St. NE., H-493, Salem, OR, 97301 Interim Address: 712 NW Spring Ave., Portland, OR, 97229 Email: Website: Representative Dennis Richardson - Vice Chair Party: R District: 4 Capitol Phone: 503-986-1404 Interim Phone: 541-601-0083 Capitol Address: 900 Court St. NE., H-392, Salem, OR, 97301 Email: Website: Representative Suzanne Bonamici Party: D District: 34 Capitol Phone: 503-986-1434 Capitol Address: 900 Court St. NE, H374, Salem,OR,97301 Email: Website: Representative Scott Bruun Party: R District: 37 Capitol Phone: 503-986-1437 Interim Phone: 503-650-6958 Capitol Address: 900 Court St NE, H-477, Salem,, OR, 97301 Interim Address: 2020 8th Ave., PMB 160 - Suite 230, West Linn, OR, 97068 Email: Website: Representative Ben Cannon Party: D District: 46 Capitol Phone: 503-986-1446 Capitol Address: 900 Court St. NE, H-487, Salem, OR, 97301 Email: Website: Representative Linda Flores Party: R District: 51 Capitol Phone: 503-986-1451 Interim Phone: 503-722-1419 Capitol Address: 900 Court St. NE., H-287, Salem, OR, 97301 Interim Address: PO Box 55, Clackamas, OR, 97015-0055 Email: Website: Representative Sara Gelser Party: D District: 16 Capitol Phone: 503-986-1416 Interim Phone: 541-757-6128 Capitol Address: 900 Court St. NE, H-391, Salem, OR, 97301 Capitol Address: 900 Court St. NE H-479, Salem, OR, 97301 Email: Website: Representative Ron Maurer Party: R District: 3 Capitol Phone: 503-986-1403 Email: Website: Background: SB1, mental health parity went into effect on January 1, 2007. Even though autism is a covered condition under SB1, the legislation falls short and we must follow with an autism mandate for the following reasons: 1. Unlicensed providers who provide medically necessary treatment are not covered under SB1. Because the providers are excluded, the treatments can be excluded as well. 2. Under SB1, insurance companies decide what is medically necessary and not the treating physician. If you have any questions, please contact Michelle Vanderwey by phone at (503) 593-4303 or by email at ********************************************************************************************************* SUMMARY OF BILL A BILL FOR AN ACT Relating to health benefit plan coverage of pervasive developmental disorder; creating new provisions; and amending ORS 750.055 and 750.333. 74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session NOTE: Matter within { + braces and plus signs + } in an amended section is new. Matter within { - braces and minus signs - } is existing law to be omitted. New sections are within { + braces and plus signs + } . LC 2151 House Bill 2918 Sponsored by Representative BUCKLEY; Representatives C EDWARDS, HOLVEY, SHIELDS, TOMEI SUMMARY The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject to consideration by the Legislative Assembly. It is an editor's brief statement of the essential features of the measure as introduced. Requires health benefit plan to cover treatment of pervasive developmental disorder subject to same conditions as treatment of physical illness. ...cont/FULL SUMMARY Summary in pdf:


OR Legislative Audio archive Health Care Subcommittee on Health Care Access Testimony on OR HB 2918 Health benefit plan coverage of pervasive developmental disorder --March 14, 2007; 3:00PM Direct to RealMedia file of March 14, 2007 meeting Archived audio meeting records of the subcommittee Oregon Legislative Audio and Video Other info to track legislative bills