HB 6847 Summary

• Expands health insurance coverage for autism spectrum disorder diagnosis and treatment to include behavioral therapy, psychiatric/psychological services, prescription drugs, physical therapy, speech pathology, and occupational therapy for individuals under age 21.

• Removes annual and aggregate dollar limits on behavioral therapy coverage that previously capped benefits at $50,000/year for children under 9, $35,000 for ages 9-12, and $25,000 for ages 13-14.

• Prohibits health insurers from imposing visit limits, higher copayments, coinsurance, or deductibles for autism spectrum disorder treatment compared to other medical conditions.

• Limits utilization review of autism treatment plans to once every six months unless the treating provider agrees otherwise, and requires diagnoses to remain valid for at least 12 months.

• Requires the Commissioner of Developmental Services to designate evidence-based services and interventions for autism spectrum disorder treatment and establishes a working group to develop uniform behavioral health data collection standards across state agencies and insurers.