Minnesota Legislature
SF 3272
as introduced - 92nd Legislature (2021 - 2022) Posted on 02/22/2022 08:22am
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A bill for an act
relating to insurance; modifying coverage for autism spectrum disorder; amending
Minnesota Statutes 2020, section 62A.3094, subdivision 2.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2020, section 62A.3094, subdivision 2, is amended to read:
Subd. 2.
Coverage required.
(a) A health plan issued to a large employer, as defined
in section 62Q.18, subdivision 1, must provide coverage for the diagnosis, evaluation,
multidisciplinary assessment, and medically necessary care of deleted text begin children under 18deleted text end new text begin individualsnew text end
with autism spectrum disorders, including but not limited to the following:
(1) new text begin any new text end early intensive behavioral and developmental therapy based in behavioral and
developmental science, includingdeleted text begin ,deleted text end but not limited todeleted text begin ,deleted text end all types ofnew text begin : (i)new text end applied behavior
analysisdeleted text begin ,deleted text end new text begin ; (ii)new text end intensive early intervention behavior therapydeleted text begin ,deleted text end new text begin ;new text end new text begin (iii)new text end deleted text begin anddeleted text end intensive behavior
interventionnew text begin ; (iv) social communication, emotional regulation, and transactional support
(SCERTS); and (v) floortimenew text end ;
(2) neurodevelopmental and behavioral health treatments and management;
(3) speech therapy;
(4) occupational therapy;
(5) physical therapy; deleted text begin and
deleted text end
new text begin
(6) play therapy;
new text end
new text begin
(7) art therapy;
new text end
new text begin
(8) music therapy; and
new text end
deleted text begin (6)deleted text end new text begin (9)new text end medications.
(b) The diagnosis, evaluation, and assessment must include an assessment of the child's
developmental skills, functional behavior, needs, and capacities.
(c) The coverage required under this subdivision must include treatment that is in
accordance with an individualized treatment plan prescribed by the enrollee's treating
physician or mental health professional.
(d) A health carrier 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.
(e) A health carrier may request an updated treatment plan only once every six months,
unless the health carrier and the treating physician or mental health professional agree that
a more frequent review is necessary due to emerging circumstances.
(f) An independent progress evaluation conducted by a mental health professional with
expertise and training in autism spectrum disorder and child development must be completed
to determine if progress toward function and generalizable gains, as determined in the
treatment plan, is being made.