Benefits in NJ

Article in the Courier-Post:

TRENTON -- New Jersey was wrong in denying access to necessary medical therapy for autistic children whose parents are covered under the State Health Benefits Program, the state appeals court ruled today.
Occupational, speech and physical therapy, viewed as standard treatment for the one in 166 children nationwide affected by autism spectrum disorders, did not fall under the program provided by the State Health Benefits Commission, which said coverage cannot be extended "to promote development beyond any level of function previously demonstrated." In other words, because the boys could not previously perform the skills taught in these therapies, the program would not pay for them.A 1999 state law, however, requires coverage parity in medical insurance, meaning state medical coverage for those affected by biologically based mental illnesses must be the same for any other covered sickness. The two rulings today struck down previous court decisions in finding the medical parity act was intended to cover such therapies.