MI HB4476

Health care corporation group certificates must provide coverage for diagnosis and treatment of autism spectrum disorders including autistic disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified.

Coverage for autism treatment is not subject to limits on the number of visits to an autism services provider and cannot have dollar limits, copays, deductibles, or coinsurance provisions that differ from those applied to physical illness.

Applied behavior analysis coverage may be subject to a maximum annual benefit of $50,000.

Health care corporations may request treatment reviews consistent with current protocols and require a treatment plan, with the cost of obtaining a treatment review borne by the corporation.

Treatment for autism spectrum disorders includes habilitative or rehabilitative care, pharmacy care, psychiatric care, psychological care, and therapeutic care when prescribed by a licensed physician or psychologist and determined medically necessary.