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Insurance Mandates Commission to vote on autism, hearing aids

8:33 AM, Nov 18, 2013   |    comments
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ATLANTA -- Members of the Governor's Special Commission on Insurance Mandates will vote on three critical issues during a meeting on Monday afternoon.

They'll decide whether private insurance companies in Georgia should be required to cover the cost of autism treatments, children's hearing aids and medical foods for children with severe allergies.

The commission's decision is non-binding, but it will set the tone for any debate by lawmakers in the new year.

Autism Treatments

Autism Speaks and parent advocates are pushing for a bill that would require insurance companies to cover the cost of autism treatment to include up to $50,000 a year for behavioral health treatment.

RELATED | Autism bill opponents make case against mandate

Documents produced by some members of the commission found that evidence supports the effectiveness of certain established treatments, but the cost of the mandate could be an issue.

The Affordable Care Act also makes the debate more complicated.

COMPLETE COVERAGE | Affordable Care Act

Even if the mandates commission recommends approval, and the bill eventually passes, it would not apply to any of the insurance plans offered through the insurance exchanges.

Children's Hearing Aids

Georgia law requires that all children get tested for hearing loss at birth.

If they need hearing aids, Medicaid will cover the cost, but private insurance companies don't have to pay for them.

RELATED | Children's hearing aid bill faces roadblock

A group called Let Georgia Hear is pushing for a bill to change that.

The bill would benefit working families who make too much to qualify for Medicaid but not enough to afford children's hearing aids, which can cost as much as six thousand dollars every three to five years.

The bill is now before the special commission on insurance mandates. 

11Alive's Jennifer Leslie went through some of the research by members of the commission, who found that hearing aids are medically effective and lead to clinically significant outcomes.

But the cost of the mandate could be an issue, and the Affordable Care Act makes it even more complicated.

Children's hearing aids are not included as an essential health benefit offered by plans on the insurance exchanges, so the state would have to pick up the extra cost of any new mandates.

The commission estimates the cost of this mandate could range from $800,000 to $9 million a year.

Advocates for the bill are hoping the mandates commission will find the medical evidence outweighs the cost.

Medical Foods

Members of the Georgia Medical Foods Coalition have been rallying support for HB 73.

It would reimburse families for the cost of medical foods used in the treatment of certain metabolic disorders, gastrointestinal diseases and allergic conditions.

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