Requires certain health benefits coverage for diagnosing and treating autism and other developmental disabilities.
This bill will significantly amend New Jersey's health insurance requirements, mandating that insurers provide coverage for new categories of care related to autism and related disorders. As a result, families and affected individuals will gain access to necessary therapeutic services that are critical for their development and quality of life. Additionally, the coverage will include behavioral interventions based on principles of applied behavioral analysis, which are essential for managing and improving social communication for affected individuals. Notably, the bill prohibits insurers from denying coverage based on treatment classifications or limits on therapy visits.
Assembly Bill A606 seeks to enhance health benefits coverage for diagnosing and treating autism and other developmental disabilities. The bill amends existing legislation to broaden the definitions of these disabilities and ensure that health care practitioners are adhering to updated standards for diagnosis, including using the DSM IV-TR and equivalent diagnostic standards published after this date. A significant focus of the bill is to ensure comprehensive coverage for a variety of therapies including occupational, physical, and speech therapies, particularly for young individuals under the age of 21.
Although proponents of A606 argue that it addresses crucial gaps in healthcare coverage for autism and developmental disabilities, there may be potential contention regarding the cost implications for insurers and the healthcare system as a whole. Critics may express concerns about increased premiums and the financial viability of expanding coverage. As the bill mandates comprehensive coverage, ensuring that this new requirement is met without placing undue financial burdens on insurance providers or consumers will be a point of discussion during legislative debates.