HB 4183 Summary

• Requires expense-incurred hospital, medical, surgical group certificates and HMO group contracts to provide coverage for diagnosis and treatment of autism spectrum disorders (autistic disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified).

• Prohibits insurers and HMOs from terminating coverage or refusing to deliver, execute, issue, amend, adjust, or renew coverage solely because an individual is diagnosed with or has received treatment for an autism spectrum disorder.

• Coverage for autism treatment is not subject to dollar limits, copays, deductibles, or coinsurance provisions that do not apply to physical illness generally, except applied behavior analysis is subject to a maximum annual benefit of $50,000.

• Coverage includes evidence-based treatment comprising habilitative/rehabilitative care, pharmacy care, psychiatric care, psychological care, and therapeutic care prescribed by a licensed physician or psychologist.

• Exempts short-term or limited duration policies of no longer than 6 months and applies to policies delivered, executed, issued, amended, adjusted, or renewed 180 days after enactment.