BOSTON — The Brain Injury Association of Massachusetts gathered Wednesday to push for private insurance companies to cover cognitive rehabilitation, kicking off Brain Injury Awareness Month with a campaign for legislation they said will cost the state nothing and lead to only a 4-cent increase, on average, in people’s monthly insurance payments.
The association held a policy briefing at the State House on a bill that would require commercial health insurance plans to cover cognitive rehabilitation services used to treat brain injuries.
The bill would prohibit private insurance companies from including unreasonable lifetime or annual limitations on treatment visits, require them to cover reasonable expenses for periodic reevaluations and expand coverage to include individual practitioners and treatment facilities qualified to provide care. Care, under the bill, would also be covered for people with all forms of acquired brain injuries, which can be caused by brain tumors, infectious diseases, diabetic complications, strokes and traumatic brain injuries.
Currently, workers compensation insurance and veterans administration insurance cover cognitive rehabilitation, but almost all private insurance plans do not, leaving many families to pay for it out of pocket, supporters said.
Maureen Butler, a rehab counselor, spoke about working with people after they have been declared physically fit, but still need cognitive help.
“Definitely, cognitive rehabilitation is not covered under almost all commercial health insurance plans, and people are, like Rep. (Kim) Ferguson said, very startled when they still have needs, they’re still getting better, and their therapist and their doctors are saying, ‘Oh, this is great rehab that we recommend for you,’ and then they find out it is not covered by their insurance plan,” she said. “It is startling, it is heartbreaking, really, to see.”
This is the third time the bill has been filed, and last year, the bill was recommended by the Joint Committee on Financial Services and the Joint Committee on Healthcare Financing, but stalled out in the Senate Ways and Means Committee at the end of the session.
In 2016, the bill was sent to the Center for Health Information Analysis, which found that the typical increase in monthly rates for insurance plans would range from 1 cent to 19 cents, but on average would increase only 4 cents. And since the bill would only apply to private insurance policies, it would not cost the state government any money.
This session the bill was presented by Rep. Kimberly Ferguson, a Holden Republican, and Senate President Emerita Harriette Chandler. Both spoke at the briefing about their dedication to this cause.
Nicole Godaire, CEO of the Brain Injury Association of Massachusetts, spoke about working to get a vote on the bill early this session.
“Anybody can get a brain injury, anywhere, any time, anyone,” Godaire said. “I think it’s fair and adequate that all people should have access to care and medical treatment.”