PARITY: Aspergers MUST be treated: LAW

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Cascadians
Pileated woodpecker
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30 Nov 2008, 3:52 pm

Good news for those who want a diagnosis and help:

The Federal Government has made coverage of Aspergers the LAW.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed into law on October 3, 2008. This is H.R. 6983 which requires:

Equity in financial requirements, such as deductibles, co-payments, coinsurance, and out-of-pocket expenses.

Equity in treatment limits, such as caps on the frequency or number of visits, limits on days of coverage, or other similar limits on the scope and duration of treatment.

Equality in out-of-network coverage.

HR 6983 does not affect state laws that offer stronger consumer protections.

No insurance company or medical facility can discriminate against age. An adult with Aspergers must have access to full treatment.

No insurance company or medical facility can discriminate against the fact that Autism is becoming epidemic and say that they cannot handle the number of requests for diagnosis or treatment. They must hire more staff. They must provide full diagnosis and treatment.

Aspergers Syndrome is a neurological condition. It is a Pervasive Developmental Disorder. It is a permanent disability but its symptoms can be mitigated with therapies. The brain can actually be rewired and the gaps connected.

In Oregon also, medical insurance MUST cover Aspergers. Senate Bill 1, Mental Health Parity, includes Pervasive Developmental Disorders as defined in the DSM IV-TR (effective January 1, 2007).
House Bill 2918, also a mandate, expands the definition of Pervasive Developmental Disorders (PDD) and defines PDD as a neurological condition (effective January 1, 2008).

So now what we have to do is match up what therapies and treatments will help us.
Everybody is unique in their presentation and what they need.

We have to be proactive in pinpointing our problems and telling our Drs how we want our difficulties addressed.



dadum
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30 Nov 2008, 4:33 pm

Cascadians wrote:
No insurance company or medical facility can discriminate against the fact that Autism is becoming epidemic


MORONS, how many times does this "increase" have to be explained?



SierraBell
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30 Nov 2008, 5:05 pm

My god.....what a mad world...



NocturnalQuilter
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30 Nov 2008, 5:27 pm

Cascadians wrote:
Autism is becoming epidemic...


Like HIV?
Or Bird Flu?



Greentea
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30 Nov 2008, 5:29 pm

The brain can actually be rewired and the gaps connected.

Where did you read this???


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demeus
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30 Nov 2008, 6:22 pm

Your statements are somewhat correct but I see 2 issues with the OP

Quote:
No insurance company or medical facility can discriminate against the fact that Autism is becoming epidemic and say that they cannot handle the number of requests for diagnosis or treatment. They must hire more staff. They must provide full diagnosis and treatment.


And where are the extra therapists suppose to come from? For example, if 3000 OT experts are needed in the USA to fulfill the demand and the colleges graduate only 2000, where are the hospitals suppose to get the extra 1000. In the meantime, the salaries and costs will go through the roof which leads me to my 2nd comment.

Quote:
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed into law on October 3, 2008. This is H.R. 6983 which requires:

• Equity in financial requirements, such as deductibles, co-payments, coinsurance, and out-of-pocket expenses.

• Equity in treatment limits, such as caps on the frequency or number of visits, limits on days of coverage, or other similar limits on the scope and duration of treatment.

• Equality in out-of-network coverage.


This is true only if you get insurance coverage on the open market or is a PDD was not considered a pre-existing condition. Due to the increase in costs this will add to insurance, more businesses will be required to drop health insurance as a part of compensation (businesses are not required to supply health insurance as a part of compensation). This will force more people into the open market and guess what, PDDs are considered an uninsurable condition which means you can be denied in the same way someone with diabetes, MS, or cancer can be denied. If you are lucky, your state will have an insurance of last resort program, with the associated higher price. Otherwise, you are SOL when it comes to insurance.

This will primarily work for those whose children are dx'd with an PDD as long as they stay with the same company and do not exhaust the maximum benefits. All others will find that this law means absolutely nothing.



pakled
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30 Nov 2008, 6:55 pm

I'll still keep things to myself until I can trust employers. I've known people who worked at EEOC, and if you're in a 'right to work' state, you can be fired for any reason, or no reason at all. If you set things up right, not even race, color, creed, etc., can stop them.



LiendaBalla
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30 Nov 2008, 7:55 pm

If this is a paridy, shouldn't it be in the "fun and games" folder?