NC House revives bid for autism therapy coverage

Posted March 22

— State House leaders are trying again this session to pass legislation clarifying insurance coverage for adaptive behavior therapy treatment for children with autism.

Autism coverage is already required under state law, but insurers and care providers have been at odds over who can bill for providing behavior therapy without supervision, because state law essentially doesn't recognize the therapy as a treatment.

Last session, on a nearly unanimous vote, the House approved a measure that would set up licensure requirements for adaptive behavior therapists and require insurers to cover their services for children with autism spectrum disorders. However, the measure never got a hearing in the state Senate.

"The Senate has basically said we won’t take up a licensure bill," said Rep. Chuck McGrady, R-Henderson, who sponsored both the 2015 legislation and this year's version, House Bill 307. "What I’ve done with this bill is not make it a licensure bill but require certification."

House Bill 307 would require coverage of $40,000 a year for the behavioral treatment as long as it's conducted by a board-certified therapist.

McGrady told the House Health Committee on Wednesday morning that some states require licensure for coverage of the therapy, while others use national board certification as the qualification for coverage.

"Skin the cat whichever way you want to skin it, but this is the alternative to the bill we passed last year," he said.

Two other committee members noted that military families who relocate to North Carolina are often unpleasantly surprised to find that adaptive therapy is not covered by insurance in North Carolina.

The bill passed the panel unanimously and will be heard next by the House Insurance Committee.


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