HB 1101 - Autism Spectrum Disorder

• Creates section 381.988 requiring physicians to screen minors for autism spectrum disorder per American Academy of Pediatrics guidelines when parents report symptoms, and refer to specialists if medically necessary.

• Allows parents direct access without referral to Early Steps Program or other appropriate specialists for at least 3 visits per policy year if physician determines specialist referral is not medically necessary.

• Defines "appropriate specialist" as a licensed professional with autism evaluation experience and training in validated diagnostic tools, including psychologists, psychiatrists, neurologists, and developmental or behavioral pediatricians.

• Amends insurance laws (sections 627.6686 and 641.31098) effective January 1, 2018, requiring insurers and health maintenance organizations to provide direct patient access to appropriate specialists for minimum 3 visits annually for autism screening, evaluation, or diagnosis.

• Maintains existing autism coverage requirements including $36,000 annual and $200,000 lifetime limits for treatment services including speech therapy, occupational therapy, physical therapy, and applied behavior analysis.