Posts Tagged ‘ health insurance ’

Michigan Votes to Mandate Coverage for Autism Therapies

Thursday, April 19th, 2012

A piece of legislation was signed into law today in Michigan, requiring health insurance companies to pay for therapies, medications, and treatments related to autism spectrum disorders (ASD) for children up to age 18. has more on some potential limitations of the otherwise exciting development:

The new law, which will go into effect on October 1, requires insurance companies to pay for autism spectrum disorder (ASD) diagnosis and treatment for children up to age 18.

The state law does not, however, compel “self-funded” insurance plans to carry autism coverage. Those health insurance plans are regulated by federal laws.

Most large employers, such as GM, Home Depot, DTE Energy, and even the State of Michigan provide benefits through a “self-funded health care plan.”

To get self-funded insurers to adopt autism coverage,  the new state law establishes for an incentive program to encourage employers with self-funded insurance plans to adopt autism coverage.

Image: Gavel, via Shutterstock.

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Obesity Screening, Education Prove Challenging for Providers

Tuesday, January 17th, 2012

The new health care law requires that insurance companies screen for and offer prevention measures against the obesity epidemic that affects an estimated one in three U.S. children.  But implementing the law with programs that are proven successful is difficult, health care providers are saying.

The New York Times reports:

Other than intensive hospital-based programs, few proven models exist for helping children and adolescents achieve and maintain a healthier weight, and researchers do not even fully understand the factors that contributed to the rapid rise in childhood obesity in recent years. “If this were easy, if there were clear outcomes for success, we would be investing in these,” said Dr. Samuel R. Nussbaum, the chief medical officer for WellPoint, one of the nation’s largest health insurers.

While there are many community efforts aimed at getting every child to eat better and exercise more, including Michelle Obama’s “Let’s Move” initiative, there is also growing demand for programs that help children who are already seriously overweight. WellPoint and the UnitedHealth Group, another large insurer, are experimenting with new approaches, and even Weight Watchers says it is working to develop a program for children and teenagers. Drug companies and medical device makers are also testing some products on children.

Adults have a difficult enough time losing weight, and the issues are even more complicated with children and teenagers, experts say. Children are still growing, and the goal of any program may be to help them grow into a healthier weight rather than to actually lose pounds. Experts also say that to be successful, programs need to focus on the family as a whole, changing what everybody eats and how much time they are all active, not sitting in front of a computer screen or television.

Image: Doctor weighing a healthy boy, via Shutterstock

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Obama Announces New Preventative Care Measures Aimed at Women

Wednesday, August 3rd, 2011

The Obama administration has announced a number of preventative care measures that health insurance companies will be required to cover under the new health care laws.  Among them are several that affect women.  According to a press release from the US Department of Health and Human Services, the measures include:

  • well-woman visits;
  • screening for gestational diabetes;
  • human papillomavirus (HPV) DNA testing for women 30 years and older;
  • sexually-transmitted infection counseling;
  • human immunodeficiency virus (HIV) screening and counseling;
  • FDA-approved contraception methods and contraceptive counseling;
  • breastfeeding support, supplies, and counseling; and
  • domestic violence screening and counseling.

Religious institutions that offer health insurance to their employees will have the option of whether to cover birth control, citing the Constitutional precedents of religious accommodation.

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Proposal: Make Birth Control Free

Wednesday, July 20th, 2011

A new report has recommended to the US Department of Health and Human Services that it mandate that insurance companies fully cover contraceptives, sterilization and reproductive education at no cost to patients as part of the new health care legislation.  From

The birth control methods, services and education should be available “so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes,” according to a report from the Institute of Medicine, an independent, nonprofit organization that gives advice to decision makers and the public.

Annual HIV tests, breastfeeding support and a well-woman care visit should also be fully covered as preventive services, the report states.

Under most health insurance plans, birth control such as hormone pills and implantable devices are partially covered, but require patients to contribute financially. If the Institute of Medicine committee’s recommendations are accepted by the U.S. Department of Health and Human Services, women will no longer have to shell out co-pays, deductibles or other out-of-pocket fees for approved birth control or sterilization methods.

It’s unclear whether HHS will implement the report’s recommendations. That decision could come as early as August.

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