The APA, in partnership with the Coalition of Labor (CLO) on campus, identified the need for autism coverage for our respective membership. The APA and the CLO have been advocating within the Joint Health Care Committee to provide autism coverage. We were successful in achieving the first critical step in autism coverage through bargaining the Wage and Health Memorandum of Understanding 2014-2017.
Michigan mandated under Public Act 101 of 2012 that commercial and non-profit insurance carriers provide autism coverage. Michigan State University is a self-insured provider and does not fall under the stipulations of the new law. Any coverage had to be bargained in the Wage and Health Memorandum of Understanding.
The new coverage shall commence on January 1, 2014. It will cover Autism Diagnosis, Pharmaceuticals, Psychiatric, Psychological, and Therapeutic services (Speech, Occupational, Applied Behavior Analysis, and Physical therapies; and social workers) for children that have been assessed and diagnosed by one of three Center of Excellence on autism: Spectrum Health System, University of Michigan Health System or Michigan State University (this new assessment center is anticipated to be operational by January 2014).
Diagnosis and assessment prior to January 1, 2014 may include assessments from Henry Ford Hospital, Detroit Children’s Hospital, Spectrum Health System or the University of Michigan Health System. If you child has already been assessed and diagnosed through these centers, your claims will be covered as of January 1, 2014.
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Research shows that early assessment and treatment of autism has the best medical and behavioral outcomes. The coverage will focus on the early childhood years. The coverage will up for children up to and through age 8. The annual maximum for services will be $40,000.
The Legislature appropriated funds for self-insured employers like MSU by creating an Autism Reimbursement Program. The fund was appropriated with $15 million dollars in 2012-2013 fiscal year and an additional $11 million dollars for 2013-2014 fiscal year.
MSU has an expert on autistic medical coverage in Dr. Jane Turner, a professor at the College of Human Medicine, Department of Pediatric and Human Development. Dr. Turner is onGovernor Snyder’s newly created Autism Council charged with overseeing Michigan’s Autism Spectrum Disorders (ASD) State Plan. http://www.michigan.gov/snyder/0,4668,7-277–281766–,00.html. Having a leader in the field on campus will assisted MSU in agreeing to add autism coverage to the self-insured plan. She is a true advocate for children with autism.
If your family will benefit from MSU covering autistic claims and related behavioral, speech and occupational coverage, please contact the APA office at (517) 353-4898 or email [email protected]. APA would like to work with you to ensure the coverage is implemented for the best outcome for your family.
For more information:
1)Â Â Â Â For additional information and resources, families may want to contact Autism Alliance of Michigan, autismallianceofmichigan.org or Autism Speaks, www.autismspeaks.org.
2)Â Â Â Â Autism Reimbursement Program information
http://www.michigan.gov/lara/0,4601,7-154-62954-287554–,00.html
3)Â Â Â Â Senate Fiscal Agency Analysis of PA 101
http://www.legislature.mi.gov/documents/2011-2012/billanalysis/Senate/pdf/2011-SFA-0414-N.pdf
4)Â Â Â Â Frequently Asked Questions about PA 101
http://www.michigan.gov/documents/lara/LARA_Autism_Fund_FAQ_FINAL_400157_7.pdf
http://www.michigan.gov/documents/difs/Autism_Reimbursement_FAQ_416096_7.pdf