Spartanburg Herald Journal: Autism treatment: Gaps in coverage, low Medicaid reimbursements plague SC

Twelve years after the passage of a groundbreaking bill that requires insurance providers to cover up to $50,000 annually for autism treatment, a key proponent of that legislation said gaps in coverage still remain that must be closed.

That’s among the key problems families facing an autism spectrum disorder diagnosis must still grapple with, according to Lorri Unumb, vice president for state government affairs at the national advocacy organization Autism Speaks.

Unumb said South Carolina passing Ryan’s Law in 2007 was once a trailblazing decision, but she said the state now lags many others in terms of progress on similar legislation. Unumb also said Medicaid reimbursement rates still lag nearby states, a problem that hits South Carolina’s autistic community hard.

“There are still issues with access to medically necessary care for folks with autism,” Unumb said. “When the Legislature passed Ryan’s Law years ago, they decided to exclude a couple of different insurance groups on purpose, because we didn’t know how covering really expensive (applied behavior analysis) treatments were going to impact premiums, especially for things like small group policies.”

A legislative fix pushed by Unumb has passed both the South Carolina House and Senate in years past, but it has never cleared both hurdles in the same legislative session.