Big Update!!!

I don't have a lot of time to get into all of the details of what happened today, but I'll give you all the high level. Over the weekend, I was told that the feeling was that our bill was not going to the agenda this week - if at all... I started working with Ralph Rodighiero on the details of what was going on, and planned to speak with the Insurance Chairman Monday morning. During this conference between the three of us, there was an attempt to not move the bill this week, and likely not at all this year. The points were made why, and Ralph and I made the counterpoints of why it SHOULD be there. After a lengthy discussion, Delegate Kominar asked for specific points and the bill to be revised. So, I then created the new language and emailed it to him and Ralph, and specifically asked that this bill be amended in this week's committee meeting (on the agenda) and not delayed any longer. It wasn't too long after that, Kominar informed Ralph personally that the bill would be ran in his committee this week. I also asked Delegate Kominar that if any of the new language was a concern to him - he needed to contact me ASAP so it could be addressed by Tuesday, or before the committee meeting on Wednesday at 10 AM.

So, for now at least, everything is still good and ready for this week. If anything new comes up, I'll let you all know... Below is the language of the amendment that will be introduced at the meeting and how the bill will look - if no other changes occur to the bill.


§33-15-22. Autism insurance act.
(1) Every policy which provides coverage for hospital, surgical, or medical care coverage in the state of West Virginia shall include full coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder, which will include all prevention, early detection, diagnosis and/or treatments and therapies that are considered research based, specifically for autism spectrum disorder, and any FDA approved treatments.
(2) Every policy will also provide full in-state or in-network coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder even if the individual is unable to receive a service, or treatment, within the State of West Virginia and must receive this service or treatment from an out-of-state provider.
(3) For purposes of this section, "autism spectrum disorder" means a neurobiological condition that includes Autism, Asperger syndrome, Retts syndrome, or Pervasive Development Disorder.
(4) Every policy will implement the following guidelines of this bill:
(a) The benefits and coverage provided pursuant to this section shall be provided to any person diagnosed with autism spectrum disorder under twenty-six (26) years of age.
(b) Coverage for behavioral therapy will not exceed a seventy-five thousand dollar maximum benefit per child per year.
(c) Only specialized behavioral therapies will be covered for autism spectrum disorder.
(d) There will be no visitation limits for medical doctor and specialist visits.
(e) There will be no visitation limits for Occupational Therapy, Physical Therapy, Speech Therapy, and Vision Therapy.
(f) Coveage will be provided for up to four (4) visits, or consultations, with a certified Nutritionist per year.
(g) Any FDA approved treatment will be covered for autism spectrum disorder when recommended, or prescribed, by a medical doctor or specialist.
(h) All medical, or medicines, and bio-medical, or vitamins and supplements, treatments will be covered in full for autism spectrum disorder when recommended, or prescribed, by a medical doctor, specialist, or nutritionist.
(i) Coverage for early detection and diagnosis will be provided in full, regardless if a person does or does not receive a diagnosis of autism spectrum disorder.
(j) Coverage for all medical testing performed on a person diagnosed with autism spectrum disorder will be provided in full when recommended, or prescribed, by a medical doctor or specialist.
(k) Coverage will be provided for a person diagnosed with autism spectrum disorder for specialized diets at fifty percent (50%) when recommended, or prescribed, by a medical doctor, specialist, or nutritionist.
(l) Coverage for music and/or listening therapy will be provided in full when recommended, or prescribed, by a medical doctor or specialist and when supervised by professionals that possess a certification in that specific music or listening therapy.
(5) This act shall become effective July 1, 2008.

NOTE: The purpose of this bill is to provide insurance for the detection and treatment of autism spectrum disorders.