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MI HB4604

Bill

Status

Introduced

5/3/2011

Primary Sponsor

Jimmy Womack

Click for details

Origin

House of Representatives

96th Legislature

AI Summary

  • Requires health insurance plans and HMOs in Michigan 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 denying, terminating, or refusing to renew coverage solely because an individual is diagnosed with or has received treatment for autism spectrum disorder.

  • Eliminates visit limits for autism services providers and prohibits dollar limits, copays, deductibles, or coinsurance that do not apply to physical illness, except applied behavior analysis is limited to a maximum annual benefit of $50,000.

  • Defines covered treatment as evidence-based care including habilitative or rehabilitative care, pharmacy care, psychiatric care, psychological care, and therapeutic care prescribed by a licensed physician or psychologist as medically necessary.

  • Allows insurers to request treatment reviews and require treatment plans at the insurer's cost, using evidence-based care and managed care cost-containment practices; effective 180 days after enactment for all policies issued or renewed in Michigan.

Legislative Description

Insurance; health; coverage for certain treatments related to autism; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406s.

Insurance, health

Last Action

Printed Bill Filed 05/04/2011

5/4/2011

Committee Referrals

Insurance5/3/2011

Full Bill Text

No bill text available