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Massachusetts' New Autism Insurance Law

8/7/2010

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On August 3, 2010 Governor Patrick signed the bill , "An Act Relative to Insurance Coverage for Autism" (HB 4935), into law.  The law mandates broader insurance coverage of diagnostic tests, medical treatment, and services for children and adults with autism.  The law will go into effect on January 1, 2011.

Does the law say anything about IEPs and Special Education Services?

Yes.  The statute explicitly states that this new law "shall not affect any obligation to provide services to an individual under an individualized family service plan, an individualized education program or an individualized  service plan." 

This means that for the purposes of special education, nothing has changed.  Schools cannot forgo their legal obligations to autistic students because of this  new law. 

How will this new law affect special education in Massachusetts?

Especially in these difficult economic times, I expect to see more disagreements between school districts and insurance companies over which party is responsible for providing  autism related services. 

As I interpret the current state of the law, schools must provide assessments and services if there is an educational need and insurance companies must cover any remaining medical needs associated with autism. 

Of course, how the courts will interpret this intersection of law has yet to be seen.  Until these issues are clarified by the legal system, both insurance companies and schools may refuse to provide services by claiming that the other party is legally responsible. If this happens, the new law will  have an unexpected consequence - hurting the very population it aims to protect.  

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It is doubtful that any child may reasonably be expected to succeed in life if he is denied the opportunity of an education.
Brown v. Board of Education, 347 U.S. 483 (1954)

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