Coverage for autism spectrum disorders advances

Senators advanced a bill from select file April 9 that would require insurance coverage for children with autism spectrum disorders.

LB254, as originally introduced by York Sen. Greg Adams, would have renamed the Nebraska Educational Television Commission.

Lincoln Sen. Colby Coash introduced an amendment, adopted 41-0, that replaced the original bill. The amendment incorporated provisions of his LB505, which would require insurance coverage for applied behavior analysis and other autism spectrum disorder treatments.

The measure would require that insurance plans in Nebraska provide coverage for autism screening, diagnosis and treatment provided by a board-certified behavior analyst or licensed psychologist. Disease-specific and self-funded employee plans would be exempt from the bill’s provisions.

Required annual coverage amounts would be a maximum of $25 hours per week until the insured person is 21 years old. An insurer would have the right to request a review of an individual’s treatment every six months.

The measure would not apply to qualified health plans in individual and small group markets sold through and outside the state’s health insurance exchange that are required to include essential health benefits under the federal Affordable Care Act.

Coash thanked the families who have worked to get coverage for their children.

“These are families that struggle. They’ve done much more than I have based on the love for their children,” he said. “They fight for their kids and they have hung through this issue for the past two years.”

The amendment also incorporated provisions of LB397, originally introduced by Lincoln Sen. Danielle Conrad, which would require the state Department of Health and Human Services to establish a two-year program to provide amino-acid based elemental formulas for the diagnosis and treatment of food allergies, food protein induced enterocolitis syndrome, eosinophilic disorders and short-bowel syndrome.

The program would provide funding when an ordering physician issues a written order stating that amino-based elemental formula is necessary for the treatment of a disease or disorder. A $250,000 appropriation would fund the pilot program, which would provide up to 50 percent of out-of-pocket costs for treatment, not to exceed $12,000 per child in a 12-month period.

Additionally, the amendment incorporated provisions of LB883, originally introduced by Omaha Sen. Jeremy Nordquist. It would repeal the Dec. 31, 2015, termination date for a requirement that individual and group health policies, certificates and contracts and self-funded employee benefit plans—to the extent not preempted by federal law—provide coverage for orally administered anticancer medication on a basis no less favorable than intravenously administered or injected anticancer medications.

Senators advanced the bill to final reading on a voice vote.