Monday, July 7, 2008

Louisiana law mandates insurance coverage for treatment of children with autism

Ethan Pitre receives speech therapy
as part of the treatment for his autism.

From The Daily Advertiser July 7:

Louisiana Gov. Bobby Jindal signed into law last week a measure that would mandate insurance coverage of therapy and medication for autism for children through age 17. The new law requires that children with autism receive up to $36,000 in insurance benefits per year, with a lifetime maximum benefit of $144,000.

Although children with autism benefit most from multiple modes of therapy begun in early childhood, Ethan Pitre, 9, has been receiving only physical therapy and speech therapy. It's all the family can afford. Their insurance company covers a portion of the physical therapy expenses, but has a yearly cap of $900 on speech therapy - only enough for a few months each year. His parents cover the rest themselves.

"Our insurance company and a lot of insurance companies consider that when you have a child diagnosed with autism, they want to categorize it into the mental-health category. Most don't pay mental health very well," Terri Pitre, Ethan's mother, said.

Pitre and other members of the Autism Society of Acadiana had met with state Sen. Donald Cravins Jr., D-Opelousas, earlier this year to make him aware of the plight of Louisiana families that include children with autism.

With state Rep. Franklin Foil, R-Baton Rouge, he subsequently co-authored the bill that would offer some relief to those families. It easily cleared both houses and was placed on Jindal's desk June 17. It goes into effect Jan. 1, 2009.

"I don't think there was a 'no' vote in the Legislature," Cravins said.

Advocates for the insurance mandate told Cravins of applied behavior analysis, better known as ABA, a comprehensive approach to therapy for autistic children, which, ideally, involves training everyone who cares for the child, including parents, teachers and therapists. It is most effective if it's implemented as soon as a child is diagnosed, usually around age 2.