What’s New in the Empire Plan for 2014?

Autism coverage is required under New York state insurance law for screening, diagnosis and treatment of autism spectrum disorders including Applied Behavioral Analysis (ABA) services.  Effective January 1, 2014, the Empire Plan’s annual cap for ABA services is changing from $45,000 to a maximum annual of 680 hours of service, network and non-network combined.

The United States Preventive Services Task Force recommends a onetime screening for Hepatitis C infection to adults born between 1945 and 1965. According to the United States Centers for Disease Control and Prevention (CDC), approximately 75% of Hepatitis C infection and about 73% of Hepatitis C-associated mortality occurs in individuals born between 1945 and 1965 – the baby boomer generation. New York State Department of Health statistics show that as many as 150,000 New Yorkers are unaware of their Hepatitis C status. A new law (A.1286-A/S.2750-A) will ensure that all individuals born between 1945 and 1965 are offered a hepatitis C screening test or diagnostic test whenever they are a patient at a hospital, clinic or a physician’s office. United Health Care started covering the screening for this category of patients effective October 1, 2013.