New York State
Insurance Department


ISSUED 9/27/2006

FOR IMMEDIATE RELEASE

MILLS:  NEW LAW BENEFITS NEW YORKERS DIAGNOSED WITH AUTISM

            Superintendent of Insurance Howard Mills today announced Governor Pataki has signed into law legislation which guarantees that New Yorkers with autism spectrum disorders (ASDs) will not be denied health insurance benefits because of their diagnosis.

            Under the new law, insurers are prohibited from denying hospital, surgical or medical care coverage to policyholders based solely on an ASD diagnosis.  It covers all New York State health insurance polices and contracts issued, renewed, modified, altered or amended on or after Jan. 1, 2007.  The law originated amid reports that children diagnosed with an ASD were denied insurance coverage for services such as speech therapy and magnetic resonance imaging (MRI) tests.

           “Autism is a complex neurobiological disorder that impacts the families of affected individuals almost as much as those who have autism themselves,” Superintendent Mills stated.  “Governor Pataki has fought to expand the availability of health insurance coverage for children and all New Yorkers, and it is only right that those who struggle with autism spectrum disorders have equal access to the same medical care as everyone else.”

            Assemblywoman Audrey I. Pheffer (D-Queens County), chair of the state Assembly’s Committee on Consumer Affairs and Protection, and State Senator Charles J. Fuschillo, Jr. (R-Nassau County), chair of the state Senate’s Consumer Protection Committee, were the legislation’s co-sponsors.

            According to the federal Centers for Disease Control and Prevention (CDC), autism spectrum disorders are a group of developmental disabilities defined by significant impairments in social interaction and communication, and the presence of unusual behaviors and interests.  Many people with ASDs also have unusual ways of learning, paying attention, or reacting to different sensations.

            ASDs begin before the age of 3 and typically last throughout a person's life.  The disorder spans across all racial, ethnic, and socioeconomic groups and is four times more likely to occur in boys than girls, studies have found.  Autism Speaks, an advocacy group, assessed data compiled by the CDC and estimated that one out of every 166 children will be diagnosed with an ASD.

            “The Insurance Department supported this bill and we’re very pleased that Governor Pataki has signed the measure into law,” Superintendent Mills said.  “We have always interpreted state Insurance Law as prohibiting insurers from denying coverage based on a diagnosis, and we know how important it is for those with autism spectrum disorders and their families to see this clearly spelled out.”

            The CDC has called ASD conditions a significant public health concern and urged intervention as early as possible to enable all affected children to reach their full potential.

            If a New York policyholder believes their insurer is wrongfully denying health coverage, they can file electronically a formal complaint with the New York State Insurance Department by logging onto its website, http://www.ins.state.ny.us, and clicking the ‘Consumers’ icon.  The Department also maintains an Insurance Help hotline at 1-866-NYINSHELP (1-866-694-6743).


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