A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder and including applicability provisions.
What changed between versions
Clarified the definition of autism spectrum disorder to align with the American Psychiatric Association's diagnostic manual and removed redundant language about 'autistic disorders'.
Added a new prohibition on aggregate annual or lifetime limits for biologically based mental illness coverage benefits related to autism spectrum disorder.
Established minimum coverage requirements of 30 inpatient days and 52 outpatient visits annually for autism treatment, with no limits on outpatient visits for applied behavior analysis.
Set a maximum annual benefit amount of $36,000 for autism spectrum disorder treatment under state employee plans, with annual adjustments based on the consumer price index.
Removed subsection 3 of section 514C.31, which previously allowed dollar limits on applied behavior analysis coverage.
Added care management provisions including prior authorization and approval for applied behavior analysis coverage.
Changed the age eligibility for applied behavior analysis coverage from under 19 years to under 21 years for state employee group plans.