March 21, 2014

Chief insurance regulator addresses autism leaders: More than 3,000 Missourians received treatment last year under landmark insurance law

Department of Insurance report shows autism treatments increased by 22 percent in 2013

St. Louis - During a keynote address to the St. Louis Autism Partners on Wednesday, Missouri Department of Insurance Director John M. Huff said the number of individuals treated for autism-related conditions increased by more than 22 percent last year. 

"Missouri's landmark autism insurance law continues to deliver benefits for families impacted by autism," Director Huff said. "Especially encouraging is the low impact these benefits have had on overall health claim costs. I again applaud Gov. Jay Nixon and members of the General Assembly for passing this common-sense legislation to improve health care for thousands of Missouri familes."

Huff pointed to the department's annual Autism Report, which found that last year, 3,070 Missourians received autism treatment, up from 2,508 in 2012. Using data supplied by health insurance companies, the report says insurance claims for autism-related treatments totaled $8.2 million in 2013. That figure is 26.6 percent higher than claims paid in 2012. Still, the number accounts for a small fraction - just 2/10 of 1 percent - of the more than $4 billion in health claims paid by Missouri health insurers during 2013.

A 2010 law signed by Gov. Nixon requires health insurance companies to cover specific autism therapies, including applied behavior analysis (ABA). The department's report says autism treatments have increased more than 92 percent since 2011.

Missouri law does not require health insurance companies to submit their rates to the Department of Insurance, but Huff says the overall claims numbers suggest minimal, if any, impact on the premiums consumers pay.

Other noteworthy findings from the report:

  • Across all market segments, the average per member, per month cost in 2013 for all autism-related claims was 48 cents, and just 22 cents for ABA treatments.
  • More than 1.3 million individuals received coverage from a licensed insurer. Adding public employees and other self-insured entities, the department estimates that as many as 1.6 million individuals have benefited from the autism mandate.
  • All policyholders in the large- and small-group markets now have insurance coverage for autism treatments.
  • The law allows insurers in the individual market to offer extra coverage for autism for an additional cost. Some companies offer it as a standard provision in every policy. As a result, about one-third of consumers enrolled in the individual market have this coverage.

The Department of Insurance has extensive online resources for families and health care providers. Consumers and providers with complaints or questions are encouraged to call the department's Insurance Consumer Hotline at 800-726-7390 or file a complaint at insurance.mo.gov.

St. Louis Autism Partners is composed of executive directors of autism organizations in the metro St. Louis area. The group was created to foster collaboration and to share information among the organizations.

 

About the Missouri Department of Insurance, Financial Institutions & Professional Registration

The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department's seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.

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