HB284 Summary

• Requires health benefit plans to cover screening, diagnosis, and treatment of Autism Spectrum Disorder for insured individuals up to 18 years of age in group policies with at least 51 employees.

• Mandates coverage for evidence-based care including behavioral health treatment, pharmacy care, psychiatric care, psychological care, and therapeutic care as prescribed by licensed physicians or psychologists.

• Establishes maximum annual benefits for applied behavior analysis: $40,000 (ages 0-9), $30,000 (ages 10-13), $20,000 (ages 14-18), and $10,000 (age 19+), with allowance for exceeding limits upon prior insurer approval if medically necessary.

• Prohibits health benefit plans from denying coverage, refusing to contract with, or terminating coverage based solely on an Autism Spectrum Disorder diagnosis.

• Requires Alabama Medicaid and Children's Health Insurance Plan (ALL Kids) to provide coverage and reimbursement for Autism Spectrum Disorder treatment at the same levels as health benefit plans, effective December 31, 2018.