Quality Partnerships Critical in Developing Autism Benefits in FL

The incidence of Autism Spectrum Disorders (ASD) is rising dramatically. The Center for Disease Control’s (CDC’s) Autism and Developmental Disabilities Monitoring (ADDM) Network found in a 2007 report that about 1 in 150 (or almost 7 in 1,000) children have an autism spectrum disorder (defined as autistic disorder, Asperger Syndrome, and PDD-NOS) and Rett’s Syndrome.

In May of 2008, the State of Florida passed legislation requiring fully insured health plans to provide coverage for children with autism. The Bill was signed by Governor Crist on the Campus of one of the ICUBA member institutions, Nova Southeastern University. Although ICUBA is not subject to state mandates as it is a nonprofit Multiple Employer Welfare Arrangement operating as a Voluntary Employees' Beneficiary Association in the State of Florida, ICUBA has taken active role in developing an Autism benefit that makes sense and is working closely with Blue Cross Blue Shield of FL, Florida Institute of Technolgy, Magellan EAP, and Nova Southeastern University to create solutions that ensure quality care across the full spectrum of ASD.

ICUBA would expect to implement this benefit in conjunction with the Mental Health Parity Act benefits April 1, 2010. Issues that we would need to address and resolve by the end of the calendar year 2009 in order to meet this deadline are:

• Network Development
• Criteria for Diagnostic Testing
• Appropriate Treatment Setting
• Coordination with State/Federal/Industry requirements
• Plan Design
• Economic and Outcome Measurements
• Reimbursement Methodology
• Impact on Insurance Premiums
• Coverage for Catastrophic Claims