HF 1656

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:53am

A bill for an act
relating to insurance; specifying required behavioral health coverage for children
and young adults who have autism spectrum disorder; proposing coding for new
law in Minnesota Statutes, chapter 62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.472] AUTISM SPECTRUM DISORDER; INCLUSION IN AND
PARITY OF COVERAGE REQUIRED.
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new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in
this subdivision have the meanings given.
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new text begin (b) "Autism spectrum disorders" or "ASD" means one or more of the following
conditions as determined by the 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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new text begin (1) autism or autistic disorder;
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new text begin (2) Asperger's syndrome;
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new text begin (3) Fragile X syndrome;
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new text begin (4) Rett's syndrome;
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new text begin (5) childhood disintegrative disorder; or
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new text begin (6) pervasive developmental disorder, not otherwise specified.
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new text begin (b) "Generally recognized services for treatment of autism spectrum disorder"
includes, but is not limited to:
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new text begin (1) evaluation and assessment services;
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new text begin (2) applied behavioral analysis;
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new text begin (3) behavior training and behavior management;
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new text begin (4) speech therapy;
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new text begin (5) occupational therapy;
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new text begin (6) physical therapy; and
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new text begin (7) medications and nutritional supplements.
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new text begin Subd. 2. new text end

new text begin Parity required. new text end

new text begin (a) Health plan coverage of treatment for autism
spectrum disorders, to the extent that the treatment consists of mental health services, is
subject to section 62Q.47. This section does not limit coverage required under section
62Q.47 that applies to autism spectrum disorders.
new text end

new text begin (b) Health plan coverage of treatment for autism spectrum disorders, to the extent
the treatment does not consist of mental health services, is subject to this subdivision and
must comply with the parity requirements of section 62Q.47 on the same basis as mental
health services, except as otherwise expressly provided in this section.
new text end

new text begin Subd. 3. new text end

new text begin Coverage specifications. new text end

new text begin Coverage required under subdivision 2,
paragraph (b):
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new text begin (1) must cover all generally recognized services related to autism spectrum disorder;
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new text begin (2) may be limited to patients who are diagnosed with autism spectrum disorder at
age 25 or younger;
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new text begin (3) may end at age 25; and
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new text begin (4) may be limited to treatment prescribed by the patient's licensed health care
provider under a treatment plan approved by the health plan company.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009, and applies to
coverage offered, sold, issued, or renewed on or after that date.
new text end