DE SB22

Requires all individual and group health benefit plans in Delaware to provide coverage for screening, diagnosis, and treatment of autism spectrum disorders for individuals under 21 years of age, effective 120 days after enactment.

Establishes a maximum benefit of $36,000 per 12-month period for applied behavior analysis services, with annual adjustments based on the Consumer Price Index beginning January 1, 2013.

Prohibits insurers from denying coverage, terminating policies, or refusing renewal based on an autism spectrum disorders diagnosis or treatment, and specifies coverage cannot be denied because treatment is habilitative or nonrestorative.

Defines covered treatment to include behavioral health treatment, pharmacy care, psychiatric care, psychological care, therapeutic care, necessary equipment, and any other care determined medically necessary by the Department of Health and Social Services.

Requires the Department of Health and Social Services to establish standards for autism services providers within 6 months, with Board Certified Behavior Analysts automatically deemed qualified; limits insurer review of ongoing treatment to once per 12 months except by mutual agreement.