An Act Relative to the Diagnosis and Treatment of Autism Spectrum Disorder
Purpose of the Bill
This proposed legislation seeks to improve access to timely diagnosis and treatment of individuals with Autism Spectrum Disorder (ASD) by requiring health insurance payers to recognize diagnoses and treatment orders of Nurse Practitioners (NPs) and Psychiatric Nurse Mental Health Clinical Specialists (PNMHCSs) in Massachusetts.
Key Provisions
1. Expands the definitions in multiple sections of the Massachusetts General Laws related to the treatment of ASD to include licensed NPs and Psychiatric Nurse Mental Health Clinical Specialists alongside licensed physicians and psychologists for the diagnosis and treatment of ASD.
2. Requires health insurance payers to recognize diagnoses and treatment orders from NPs and Psychiatric Nurse Mental Health Clinical Specialists for ASD.
3. Aligns ASD statutes with the recognized scope of practice authority of NPs and PNMHCSs who diagnose and order treatment for patients with ASD.
Why This Matters
• Access to Care: Major barriers currently exist to timely diagnostic evaluations of individuals with suspected autism spectrum disorder due to a workforce crisis. A delay in diagnosis creates a significant delay in accessing services for individuals with autism spectrum disorder. Trained NPs and PNMHCSs currently diagnose, and order treatment for children with ASD. The majority of children who are diagnosed with ASD under the age of three who access tailored interventions show improved progress, decreased family stress, and lowered long-term costs.
• Insurance Barriers: Due to current statutory restrictions, insurance companies currently reject diagnoses and orders by NPs and PNMHCSs, thereby denying and delaying necessary interventions for children and families.
• Scope of Practice Alignment: NPs and PNMHCSs are advanced practice registered nurses trained to diagnose and manage conditions like ASD and routinely care for these patients in primary and specialty care settings. This bill ensures that insurance statutes align with NP and PNMHCS scope of practice as authorized under Chapter 112, section 80B and recognized by the Massachusetts Board of Registration in Nursing.
Impact of Early Intervention
Research consistently shows that intervention initiated between ages 2 and 4 leads to significantly better developmental outcomes in children with ASD. Early treatment improves cognitive development, improves communication and social skills, decreases problem behaviors, decreases family stress, and lowers long-term costs. Early intervention is not just beneficial but essential for optimizing the developmental trajectory and overall quality of life for children with ASD.
Benefits of Passing the Bill
• Reduces wait times for diagnostic evaluations for ASD.
• Increases access to critical early intervention services.
• Improves outcomes and ensures equitable healthcare delivery for patients with ASD.
• Leverages the skills of NPs to address specialty provider workforce crisis.
• Expands the pool of trained providers eligible to diagnose ASD and order appropriate
treatments.
