SCS/SB 45 - This act adds therapeutic care for developmental and physical disabilities, as such terms are defined in the act, to the insurance coverage mandate for autism spectrum disorders, and makes the mandate applicable to policies issued or renewed on or after January 1, 2020, rather than to group policies only. Medical necessity of coverage provided under the act shall be determined by the health benefit plan. The act specifies that autism spectrum disorder shall not be subject to any limits on the number of visits an individual may make to an autism service provider. Coverage for therapeutic care provided under the act for developmental and physical disabilities may be limited to a number of visits per calendar year, provided that additional coverage shall be provided if approved and deemed medically necessary by the health benefit plan. Provisions requiring coverage for autism spectrum disorders and developmental or physical disabilities shall not apply to certain grandfathered plans as described in the act.
This act repeals a provision of law directing the Department of Insurance, Financial Institutions, and Professional Registration to grant small employers waivers from the coverage requirements under certain circumstances. The act also repeals a provision requiring the Department to submit annual reports to the legislature and requiring health carriers to supply certain diagnosis and coverage information for the report.
This act applies to policies issued, delivered, or renewed on or after January 1, 2020.
This act is similar to provisions in SS/SCS/HCS/HB 399 (2019), SB 1074 (2018), HCS/HB 1658 (2018), SB 456 (2017), and HB 1011 (2017).
ERIC VANDER WEERD