as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:34am
A bill for an act
relating to insurance; requiring coverage for autism spectrum disorders;
proposing coding for new law in Minnesota Statutes, chapter 62A.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
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(a) For purposes of this section, the terms defined
in this section have the meanings given.
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(b) "Autism spectrum disorders" means one or more of the following conditions as
determined by criteria set forth in the most recent edition of the Diagnostic and Statistical
Manual of Mental Disorders of the American Psychiatric Association (DSM-IV Manual):
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(1) autism or autistic disorder;
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(2) Asperger's syndrome;
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(3) pervasive developmental disorder - not otherwise specified;
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(4) Fragile X syndrome;
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(5) Rett's syndrome; or
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(6) childhood disintegrative disorder.
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(c) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
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(d) "Health care practitioner" means a medical doctor, mental health professional,
or board certified behavior analyst: (1) who is licensed, certified, or registered by an
appropriate agency of this state; (2) whose professional credential is recognized and
accepted by an appropriate agency of the United States; or (3) who is certified under the
TRICARE military health system.
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(a) A health plan must provide coverage for the
diagnosis, evaluation, and treatment of autism spectrum disorders.
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(b) Coverage required under this section shall include treatment that is in accordance
with a treatment plan prescribed by the insured's treating health care practitioner.
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(c) A health plan may not refuse to renew or reissue, or otherwise terminate or
restrict, coverage of an individual solely because the individual is diagnosed with an
autism spectrum disorder.
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(d) A health plan may request an updated treatment plan only once every six months
from the treating health care practitioner to review medical necessity, unless the health
plan and the treating health care practitioner agree that a more frequent review is necessary
due to emerging clinical circumstances.
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Nothing in this section limits in any way the
coverage required under section 62Q.47.
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This section is effective August 1, 2009, and applies to
coverage offered, sold, issued, or renewed on or after that date.
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