MO HB950

Repeals and replaces section 376.1224 of Missouri law to expand insurance coverage requirements for autism spectrum disorder diagnosis and treatment.

Requires all group health benefit plans issued or renewed on or after January 1, 2011 to provide coverage for diagnosis and treatment of autism spectrum disorders, including applied behavior analysis, psychiatric care, psychological care, therapeutic care, and pharmacy care.

Establishes a maximum benefit of $40,000 per calendar year for applied behavior analysis services for individuals through age 18, adjustable triennially for inflation, with exceptions for medically necessary services exceeding the limit upon prior approval.

Allows reimbursement for applied behavior analysis services to be made to autism service providers or board-certified behavior analysts, including payments for line therapist services provided under their supervision when included in the treatment plan and deemed medically necessary.

Permits the director of insurance to grant waivers to small employers if compliance increases health insurance policy costs by 2.5 percent or greater annually, and requires annual reports to the legislature on implementation costs and number of covered individuals.