News
from New York State Insurance Department
For more information: Andy Mais, Public Affairs Office of the New
York State Insurance Department, 212-480-5262
Mills: New Law Benefits New Yorkers Diagnosed with Autism
NEW YORK, NY -- (09/27/2006; 1600)(EIS) -- Superintendent of
Insurance Howard Mills today announced Governor Pataki has signed
into law legislation which guarantees that New Yorkers with autism
spectrum disorders (ASDs) will not be denied health insurance
benefits because of their diagnosis.
Under the new law, insurers are prohibited from denying hospital,
surgical or medical care coverage to policyholders based solely on
an ASD diagnosis. It covers all New York State health insurance
polices and contracts issued, renewed, modified, altered or amended
on or after Jan. 1, 2007. The law originated amid reports that
children diagnosed with an ASD were denied insurance coverage for
services such as speech therapy and magnetic resonance imaging (MRI)
tests.
"Autism is a complex neurobiological disorder that impacts the
families of affected individuals almost as much as those who have
autism themselves," Superintendent Mills stated. "Governor Pataki
has fought to expand the availability of health insurance coverage
for children and all New Yorkers, and it is only right that those
who struggle with autism spectrum disorders have equal access to the
same medical care as everyone else."
Assemblywoman Audrey I. Pheffer (D-Queens County), chair of the
state Assembly's Committee on Consumer Affairs and Protection, and
State Senator Charles J. Fuschillo, Jr. (R-Nassau County), chair of
the state Senate's Consumer Protection Committee, were the
legislation's co-sponsors.
According to the federal Centers for Disease Control and
Prevention (CDC), autism spectrum disorders are a group of
developmental disabilities defined by significant impairments in
social interaction and communication, and the presence of unusual
behaviors and interests. Many people with ASDs also have unusual
ways of learning, paying attention, or reacting to different
sensations.
ASDs begin before the age of 3 and typically last throughout a
person's life. The disorder spans across all racial, ethnic, and
socioeconomic groups and is four times more likely to occur in boys
than girls, studies have found. Autism Speaks, an advocacy group,
assessed data compiled by the CDC and estimated that one out of
every 166 children will be diagnosed with an ASD.
"The Insurance Department supported this bill and we're very
pleased that Governor Pataki has signed the measure into law,"
Superintendent Mills said. "We have always interpreted state
Insurance Law as prohibiting insurers from denying coverage based on
a diagnosis, and we know how important it is for those with autism
spectrum disorders and their families to see this clearly spelled
out."
The CDC has called ASD conditions a significant public health
concern and urged intervention as early as possible to enable all
affected children to reach their full potential.
If a New York policyholder believes their insurer is wrongfully
denying health coverage, they can file electronically a formal
complaint with the New York State Insurance Department by logging
onto its website, http://www.ins.state.ny.us, and clicking the
"Consumers" icon. The Department also maintains an Insurance Help
hotline at 1-866-NYINSHELP (1-866-694-6743).
