HF 234

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:

Section 1.

new text begin [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
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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 section have the meanings given.
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new text begin (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):
new text end

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) pervasive developmental disorder - not otherwise specified;
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new text begin (4) Fragile X syndrome;
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new text begin (5) Rett's syndrome; or
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new text begin (6) childhood disintegrative disorder.
new text end

new text begin (c) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
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new text begin (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.
new text end

new text begin Subd. 2. new text end

new text begin Coverage required. new text end

new text begin (a) A health plan must provide coverage for the
diagnosis, evaluation, and treatment of autism spectrum disorders.
new text end

new text begin (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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new text begin (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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new text begin (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.
new text end

new text begin Subd. 3. new text end

new text begin No effect on other law. new text end

new text begin Nothing in this section limits in any way the
coverage required under section 62Q.47.
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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