Removes the age restriction for benefits coverage/requires, after 1/1/26, for policies issued or renewed include coverage for reimbursement for provider services at a rate equal to, or greater than, Medicaid establishments of EOHHS.
The bill further stipulates that starting January 1, 2026, all health insurance policies issued or renewed must include coverage for reimbursement of applied behavior analysis services. This reflects a growing recognition of the importance of ongoing specialized care for individuals with autism. Additionally, the bill mandates that reimbursement rates for these services should be comparable to or exceed the prevailing integrated state Medicaid rates, ensuring that health insurance companies provide adequate support for such treatments.
Bill S0788 proposes significant amendments to the existing laws governing coverage for autism spectrum disorders under health insurance policies in Rhode Island. One of the key changes introduced is the removal of the age limit for benefits coverage, previously set at 15 years. This is a critical development as it allows individuals over the age of 15 to continue receiving necessary treatment, which is a substantial shift in policy for many families requiring long-term assistance for autism-related therapies.
The introduction of Bill S0788 marks a pivotal moment in Rhode Island’s approach to autism treatment coverage, emphasizing the need for comprehensive care beyond early childhood. As discussions continue in the legislative assembly, stakeholders will need to carefully weigh the benefits against potential economic impacts to ensure that the bill serves the best interests of the community.
While support for S0788 is widespread among advocates for autism care, there are concerns regarding its fiscal implications for insurance providers and the state. Critics argue that imposing higher reimbursement rates could lead to increased insurance premiums for all policyholders. There are also debates about whether this bill appropriately addresses the needs of individuals without further increasing the financial burdens on taxpayers or insurance companies.