NC H826

Requires all health benefit plans, including the State Health Plan for Teachers and State Employees, to provide coverage for diagnosis and treatment of autism spectrum disorders effective January 1, 2012

Covers 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 terminating coverage or refusing to issue policies 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 treatments reviewed no more than once every 12 months unless medical necessity requires more frequent review

Allows standard co-payments, deductibles, and coinsurance to apply to autism coverage, provided they are not less favorable than those applied to other medical services