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Analyzing State Autism Private Insurance Mandates for Allied HealthServices: A Pilot Study

机译:分析国家自闭症私人保险对健康的要求服务:初步研究

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摘要

Due to the prevalence, severity, and costs associated with autism spectrum disorders (ASDs), it has become a public health issue. In response, state governments have adopted ASD-specific private insurance mandates requiring coverage of ASD screening, diagnosis, and treatment. Despite rapid uptake of these laws, differences exist in the type and levels of coverage, especially for allied health services including occupational therapy. We piloted a structured legal research methodology to code ASD insurance mandates that impact allied health service provisions. State private insurance mandates were obtained from WestlawNext. A coding methodology was piloted on 14 states and included variables for age and service limits, treatments covered, and medical necessity. Coding methods were feasible and highly reliable among raters. Ten of 12 states had a coverage mandate, many with specific provisions for allied health providers. A full analysis of all 50 states is warranted to identify provisions affecting allied health providers serving individuals with ASD.
机译:由于自闭症谱系障碍(ASD)的患病率,严重性和费用,它已经成为公共卫生问题。作为回应,州政府采用了针对ASD的私人保险指令,要求涵盖ASD的筛查,诊断和治疗。尽管迅速采用了这些法律,但承保的类型和水平仍然存在差异,特别是在包括职业治疗在内的专职医疗服务方面。我们试行了一种结构化的法律研究方法,以对影响专职医疗服务规定的ASD保险法规进行编码。州私人保险委托书是从WestlawNext获得的。在14个州试行了编码方法,其中包括年龄和服务限制,所涵盖的治疗方法和医疗必要性的变量。编码方法在评估者中是可行且高度可靠的。 12个州中有10个州具有承保范围,其中许多州对专职医疗人员有具体规定。有必要对所有50个州进行全面分析,以找出影响到为ASD个人服务的专职医疗人员的规定。

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