Bill Text: IA HF2167 | 2021-2022 | 89th General Assembly | Enrolled
Bill Title: A bill for an act relating to the definition of autism spectrum disorder for purposes of certain health care coverage, making conforming changes, and including applicability provisions. (Formerly HSB 512.) Effective date: 07/01/2022. Applicability date: 01/01/2023.
Spectrum: Committee Bill
Status: (Passed) 2022-04-21 - Signed by Governor. H.J. 852. [HF2167 Detail]
Download: Iowa-2021-HF2167-Enrolled.html
House
File
2167
-
Enrolled
House
File
2167
AN
ACT
RELATING
TO
THE
DEFINITION
OF
AUTISM
SPECTRUM
DISORDER
FOR
PURPOSES
OF
CERTAIN
HEALTH
CARE
COVERAGE,
MAKING
CONFORMING
CHANGES,
AND
INCLUDING
APPLICABILITY
PROVISIONS.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
Section
1.
Section
225D.1,
subsection
2,
Code
2022,
is
amended
to
read
as
follows:
2.
“Autism”
means
autism
spectrum
disorders
disorder
as
defined
in
section
514C.28
.
Sec.
2.
Section
321.189,
subsection
10,
Code
2022,
is
amended
to
read
as
follows:
10.
Autism
spectrum
disorder
status.
A
licensee
who
has
an
autism
spectrum
disorder,
as
defined
in
section
514C.28
,
may
request
that
the
license
be
marked
to
reflect
the
licensee’s
autism
spectrum
disorder
status
on
the
face
of
the
license
when
the
licensee
applies
for
the
issuance
or
renewal
of
a
license.
The
department
may
adopt
rules
pursuant
to
chapter
17A
establishing
criteria
under
which
a
license
may
be
marked,
including
requiring
the
licensee
to
submit
medical
proof
of
the
licensee’s
autism
spectrum
disorder
status.
When
a
driver’s
license
is
so
marked,
the
licensee’s
autism
spectrum
disorder
status
shall
be
noted
in
the
electronic
database
used
by
the
department
and
law
enforcement
to
access
registration,
titling,
and
driver’s
license
information.
The
department,
in
consultation
with
the
mental
health
and
disability
services
commission,
shall
develop
educational
media
to
raise
awareness
House
File
2167,
p.
2
of
a
licensee’s
ability
to
request
the
license
be
marked
to
reflect
the
licensee’s
autism
spectrum
disorder
status.
Sec.
3.
Section
321.190,
subsection
1,
paragraph
b,
subparagraph
(6),
Code
2022,
is
amended
to
read
as
follows:
(6)
An
applicant
for
a
nonoperator’s
identification
card
who
has
an
autism
spectrum
disorder,
as
defined
in
section
514C.28
,
may
request
that
the
card
be
marked
to
reflect
the
applicant’s
autism
spectrum
disorder
status
on
the
face
of
the
card
when
the
applicant
applies
for
the
issuance
or
renewal
of
a
card.
The
department
may
adopt
rules
pursuant
to
chapter
17A
establishing
criteria
under
which
a
card
may
be
marked,
including
requiring
the
applicant
to
submit
medical
proof
of
the
applicant’s
autism
spectrum
disorder
status.
The
department,
in
consultation
with
the
mental
health
and
disability
services
commission,
shall
develop
educational
media
to
raise
awareness
of
an
applicant’s
ability
to
request
the
card
be
marked
to
reflect
the
applicant’s
autism
spectrum
disorder
status.
Sec.
4.
Section
514C.28,
subsection
1,
Code
2022,
is
amended
to
read
as
follows:
1.
Notwithstanding
the
uniformity
of
treatment
requirements
of
section
514C.6
,
a
group
plan
established
pursuant
to
chapter
509A
for
employees
of
the
state
providing
for
third-party
payment
or
prepayment
of
health,
medical,
and
surgical
coverage
benefits
shall
provide
coverage
benefits
to
covered
individuals
under
twenty-one
years
of
age
for
the
diagnostic
assessment
of
autism
spectrum
disorders
disorder
and
for
the
treatment
of
autism
spectrum
disorders
disorder
.
Sec.
5.
Section
514C.28,
subsection
2,
paragraphs
b,
c,
d,
j,
and
k,
Code
2022,
are
amended
to
read
as
follows:
b.
“Autism
service
provider”
means
a
person,
or
group
providing
treatment
of
autism
spectrum
disorders
disorder
.
An
autism
service
provider
that
provides
treatment
of
autism
spectrum
disorders
disorder
that
includes
applied
behavioral
analysis
shall
be
certified
as
a
behavior
analyst
by
the
behavior
analyst
certification
board
or
shall
be
a
health
professional
licensed
under
chapter
147
.
c.
“Autism
spectrum
disorders
disorder
”
means
any
of
the
pervasive
developmental
disorders
including
autistic
disorder,
House
File
2167,
p.
3
Asperger’s
disorder,
and
pervasive
developmental
disorders
not
otherwise
specified.
The
commissioner,
by
rule,
shall
define
“autism
spectrum
disorders”
consistent
with
definitions
provided
in
the
most
recent
edition
of
the
American
psychiatric
association’s
diagnostic
and
statistical
manual
of
mental
disorders,
as
such
definitions
may
be
amended
from
time
to
time.
The
commissioner
may
adopt
the
definitions
provided
in
such
manual
by
reference
a
mental
health
condition
that
meets
the
diagnostic
criteria
for
such
disorder
as
published
in
the
most
recent
edition
of
the
diagnostic
and
statistical
manual
of
mental
disorders
as
published
by
the
American
psychiatric
association
.
d.
“Diagnostic
assessment
of
autism
spectrum
disorders
disorder
”
means
medically
necessary
assessment,
evaluations,
or
tests
performed
by
a
licensed
physician,
licensed
physician
assistant,
licensed
psychologist,
or
licensed
registered
nurse
practitioner
to
diagnose
whether
an
individual
has
an
autism
spectrum
disorder.
j.
“Treatment
of
autism
spectrum
disorders
disorder
”
means
treatment
that
is
identified
in
a
treatment
plan
and
includes
medically
necessary
pharmacy
care,
psychiatric
care,
psychological
care,
rehabilitative
care,
and
therapeutic
care
that
is
one
of
the
following:
(1)
Prescribed,
ordered,
or
provided
by
a
licensed
physician,
licensed
physician
assistant,
licensed
psychologist,
licensed
social
worker,
or
licensed
registered
nurse
practitioner.
(2)
Provided
by
an
autism
service
provider.
(3)
Provided
by
a
person,
entity,
or
group
that
works
under
the
direction
of
an
autism
service
provider.
k.
“Treatment
plan”
means
a
plan
for
the
treatment
of
autism
spectrum
disorders
disorder
developed
by
a
licensed
physician
or
licensed
psychologist
pursuant
to
a
comprehensive
evaluation
or
reevaluation
performed
in
consultation
with
the
patient
and
the
patient’s
representative.
Sec.
6.
Section
514C.28,
subsections
3,
7,
and
10,
Code
2022,
are
amended
to
read
as
follows:
3.
Coverage
is
required
pursuant
to
this
section
in
a
maximum
benefit
amount
of
not
more
than
thirty-six
thousand
House
File
2167,
p.
4
dollars
per
year
but
shall
not
be
subject
to
any
limits
on
the
number
of
visits
to
an
autism
service
provider
for
treatment
of
autism
spectrum
disorders
disorder
.
Beginning
in
2014,
the
The
commissioner
shall,
on
or
before
April
1
of
each
calendar
year,
publish
an
adjustment
to
the
maximum
benefit
required
equal
to
the
percentage
change
in
the
United
States
department
of
labor
consumer
price
index
for
all
urban
consumers
in
the
preceding
year,
and
the
published
adjusted
maximum
benefit
shall
be
applicable
to
group
policies,
contracts,
or
plans
subject
to
this
section
that
are
issued
or
renewed
on
or
after
January
1
of
the
following
calendar
year.
Payments
made
under
a
group
plan
subject
to
this
section
on
behalf
of
a
covered
individual
for
treatment
of
a
health
condition
unrelated
to
or
distinguishable
from
the
individual’s
autism
spectrum
disorder
shall
not
be
applied
toward
any
maximum
benefit
established
under
this
subsection
.
7.
This
section
shall
not
be
construed
to
require
coverage
by
a
group
plan
of
any
service
solely
based
on
inclusion
of
the
service
in
an
individualized
education
program.
Consistent
with
federal
or
state
law
and
upon
consent
of
the
parent
or
guardian
of
a
covered
individual,
the
treatment
of
autism
spectrum
disorders
disorder
may
be
coordinated
with
any
services
included
in
an
individualized
education
program.
However,
coverage
for
the
treatment
of
autism
spectrum
disorders
disorder
shall
not
be
contingent
upon
coordination
of
services
with
an
individualized
education
program.
10.
An
insurer
may
review
a
treatment
plan
for
treatment
of
autism
spectrum
disorders
disorder
once
every
six
months,
subject
to
its
utilization
review
requirements,
including
case
management,
concurrent
review,
and
other
managed
care
provisions.
A
more
or
less
frequent
review
may
be
agreed
upon
by
the
insured
and
the
licensed
physician
or
licensed
psychologist
developing
the
treatment
plan.
Sec.
7.
Section
514C.31,
subsection
2,
paragraphs
b
and
d,
Code
2022,
are
amended
to
read
as
follows:
b.
“Autism
spectrum
disorder”
means
a
complex
neurodevelopmental
medical
disorder
characterized
by
social
impairment,
communication
difficulties,
and
restricted,
House
File
2167,
p.
5
repetitive,
and
stereotyped
patterns
of
behavior
the
same
as
defined
in
section
514C.28,
subsection
2
.
d.
“Treatment
plan”
means
a
plan
for
the
treatment
of
an
autism
spectrum
disorder
developed
by
a
licensed
physician
or
licensed
psychologist
after
a
comprehensive
evaluation
or
reevaluation
performed
in
a
manner
consistent
with
the
most
recent
clinical
report
or
recommendations
of
the
American
academy
of
pediatrics.
“Treatment
plan”
includes
supervisory
services,
subject
to
the
provisions
of
subsection
5
.
Sec.
8.
APPLICABILITY.
1.
The
sections
of
this
Act
amending
section
514C.28
apply
to
plans
established
pursuant
to
chapter
509A
for
employees
of
the
state
that
are
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
state
on
or
after
January
1,
2023.
2.
The
section
of
this
Act
amending
section
514C.31
applies
to
third-party
provider
payment
contracts,
policies,
or
plans
specified
in
section
514C.31,
subsection
1,
paragraph
“a”,
or
to
plans
established
pursuant
to
chapter
509A
for
public
employees
other
than
employees
of
the
state,
that
are
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
state
on
or
after
January
1,
2023.
______________________________
PAT
GRASSLEY
Speaker
of
the
House
______________________________
JAKE
CHAPMAN
President
of
the
Senate
I
hereby
certify
that
this
bill
originated
in
the
House
and
is
known
as
House
File
2167,
Eighty-ninth
General
Assembly.
______________________________
MEGHAN
NELSON
Chief
Clerk
of
the
House
Approved
_______________,
2022
______________________________
KIM
REYNOLDS
Governor
