PENNSYLVANIA — Governor Josh Shapiro, alongside Pennsylvania Insurance Department (PID) Commissioner Michael Humphreys, announced on Wednesday a major policy shift that will enhance health insurance coverage for Pennsylvanians living with autism. Starting January 1, 2024, all commercial insurers in the state will be mandated to meet their obligations under Pennsylvania law to provide coverage for autism benefits.
The PID published a Notice in the Pennsylvania Bulletin on November 4, 2023, stating that by no later than January 1, 2024, it will require insurers offering commercial health insurance policies that include coverage for autism services to handle claims for those services in compliance with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and Pennsylvania’s mental health parity requirements.
Speaking at the announcement were several notable figures, including Autism Advocate Michael Alos, State Representatives Jessica Benham and Jamie Flick, Drexel University President John Fry, AJ Drexel Autism Institute Director Dr. Diana Robins, Eagles Autism Foundation Executive Director Ryan Hammond, and PID Commissioner Michael Humphreys.
Governor Shapiro said, “My Administration is making clear that autism services are mental health services with full parity protections, and under our mental health parity laws, we expect insurers to cover treatment consistently and fairly.” He added that this move would remove unnecessary barriers to care for over 55,000 Pennsylvanians with autism and help them secure the treatment they need to live happy, productive lives.
Historically, some commercial insurers have categorized autism services as a physical health benefit, while others categorize all services for autism as mental health benefits. PID’s Notice directs the remaining insurers to treat autism as a mental health condition, subject to parity requirements.
Commissioner Humphreys emphasized the importance of insurers promptly adjusting health insurance policy form language and claims handling processes to provide Pennsylvania consumers with autism the protections afforded by the mental health parity provisions.
State Representative Jessica Benham praised the decision, saying, “Parity between coverage for autism-related care and other services has long been a goal of the disability community.”
Dr. Diana Robins, Director and Professor at the A.J. Drexel Autism Institute, lauded the move as a significant milestone in Pennsylvania mental health parity for autistic individuals, and thanked Governor Shapiro and his Administration for their continued support and action for Pennsylvanians with Autism and Intellectual/Developmental Disabilities.
For support with insurers, Pennsylvanians can contact PID’s Consumer Services Bureau online or at 1-877-881-6388. For more information on the Commonwealth’s commitment to supporting Pennsylvanians with autism, visit pa.gov/autism.
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