NC H1897

Requires all health benefit plans in North Carolina, including the State Health Plan for Teachers and State Employees, to provide coverage for diagnosis and treatment of autism spectrum disorders effective January 1, 2011.

Defines covered autism treatments to include behavioral care, pharmacy care, psychiatric care, psychological care, and therapeutic care (speech, occupational, and physical therapy) when prescribed by a licensed physician or psychologist.

Prohibits insurers from denying coverage based on treatments being habilitative or educational in nature, and prohibits termination or refusal of coverage solely because an individual is diagnosed with or has received treatment for autism spectrum disorders.

Limits behavioral therapy coverage to a maximum benefit of $75,000 per year, with co-payments, deductibles, and coinsurance provisions applicable to other medical services.

Restricts health plans to requesting treatment reviews no more than once every 12 months (except for inpatient services) unless the insurer and the individual's physician or psychologist agree more frequent reviews are necessary, with review costs borne by the insurer.