This bill mandates a comprehensive study on current health insurance coverage, including Medicare, Medicaid, and private plans, for treatments related to dyspraxia/DCD.
Michael Lawler
Representative
NY-17
The Gabriel Rosenberg Dyspraxia/DCD Coverage Act mandates a comprehensive study on how current health insurance plans cover treatments for Dyspraxia/DCD. The Comptroller General must report to Congress within one year, detailing coverage gaps across Medicare, Medicaid, federal programs, and private insurance. This study will specifically examine what treatments are covered, any age restrictions, and barriers to access. Ultimately, the Act seeks recommendations for improving coverage under all major insurance sectors.
New Act Mandates Year-Long Study on Insurance Coverage for Dyspraxia/DCD Treatments
The newly introduced Gabriel Rosenberg Dyspraxia/DCD Coverage Act isn't changing your insurance policy today, but it’s laying the groundwork for potential future changes. This bill, specifically Section 2, mandates that the Comptroller General of the United States conduct a deep-dive study on how health insurance currently handles treatments for dyspraxia, also known as Developmental Coordination Disorder (DCD).
The Fact-Finding Mission: What’s Covered (And What Isn’t)
Think of this as a massive inventory check on DCD coverage across the entire healthcare system. Within one year of the bill's enactment, the Comptroller General must deliver a report to Congress detailing the current state of affairs. This study will be exhaustive, looking at everything from Medicare and Medicaid (state by state) to other federal programs and, crucially, private group and individual health insurance plans.
For anyone dealing with DCD, the report is required to identify the real-world barriers. The study must specifically look at what services are covered, what age limits plans impose (a major sticking point for many conditions), and the specific roadblocks people face when trying to access treatment. For example, if a child needs occupational therapy for DCD, the study will determine if their private plan covers it, and if that coverage suddenly ends when they turn 18 and are still struggling with coordination issues.
Why This Study Matters to Your Wallet and Your Health
This section is important because it’s the necessary first step before policy can change. Right now, coverage for DCD can be a confusing patchwork, often leading families to pay out-of-pocket for essential therapies. By requiring a detailed analysis, the bill aims to expose the gaps. The Comptroller General is tasked with investigating whether kids with DCD lose their diagnosis—and thus their coverage—once they become adults, even if their symptoms persist (Sec. 2).
Beyond just reporting the facts, the study must include concrete recommendations. The Comptroller General will advise the Centers for Medicare & Medicaid Services (CMS) on whether they should issue official guidance to clarify coverage rules for Medicare and Medicaid. More importantly for most working Americans, they will also offer suggestions on how private insurance plans could improve and expand coverage for DCD treatments. While the bill itself doesn't mandate coverage, it provides the detailed, fact-based ammunition Congress needs to push for better coverage down the line.