Bill Text: MN SF314 | 2013-2014 | 88th Legislature | Engrossed
Bill Title: Autism spectrum disorders (ASD) health insurance coverage establishment
Sponsorship: Moderate Partisan Bill (Democrat 4-1)
Status: (Introduced - Dead) 2013-04-02 - Comm report: To pass as amended and re-refer to Finance [SF314 Detail]
Download: Minnesota-2013-SF314-Engrossed.html
1.2relating to insurance; providing coverage for autism spectrum disorders;
1.3proposing coding for new law in Minnesota Statutes, chapter 62A.
1.4BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.5 Section 1. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
1.6 Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
1.7paragraphs (b) and (c) have the meanings given.
1.8(b) "Autism spectrum disorders" means the conditions as determined by criteria
1.9set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental
1.10Disorders of the American Psychiatric Association.
1.11(c) "Medically necessary care" means health care services appropriate, in terms of
1.12type, frequency, level, setting, and duration, to the enrollee's condition, and diagnostic
1.13testing and preventative services. Medically necessary care must be consistent with
1.14generally accepted practice parameters as determined by physicians and licensed
1.15psychologists who typically manage patients who have autism spectrum disorders.
1.16 Subd. 2. Coverage required. (a) A health plan must provide coverage for the
1.17diagnosis, evaluation, assessment, and medically necessary care of autism spectrum
1.18disorders, including but not limited to the following:
1.19(1) intensive behavior therapy, including but not limited to applied behavior
1.20analysis, intensive early intervention behavior therapy, intensive behavior intervention,
1.21and Lovaas therapy;
1.22(2) neuro-developmental and behavioral health treatments and management;
1.23(3) speech therapy;
1.24(4) occupational therapy;
2.1(5) physical therapy; and
2.2(6) medications.
2.3(b) Coverage required under this section shall include treatment that is in accordance
2.4with an individualized treatment plan prescribed by the enrollee's treating physician.
2.5(c) A health carrier may not refuse to renew or reissue, or otherwise terminate or
2.6restrict, coverage of an individual solely because the individual is diagnosed with an
2.7autism spectrum disorder.
2.8(d) A health carrier may request an updated treatment plan only once every six
2.9months, unless the health carrier and the treating physician agree that a more frequent
2.10review is necessary due to emerging circumstances.
2.11 Subd. 3. No effect on other law. Nothing in this section limits in any way the
2.12coverage required under section 62Q.47.
2.13 Subd. 4. State health care programs. This section does not affect benefits available
2.14under the medical assistance and MinnesotaCare programs and does not limit, restrict, or
2.15otherwise reduce coverage under these programs.
2.16EFFECTIVE DATE.This section is effective August 1, 2013, and applies to
2.17coverage offered; issued; sold; renewed; or continued as defined in Minnesota Statutes,
2.18section 60A.02, subdivision 2a; on or after that date.
1.3proposing coding for new law in Minnesota Statutes, chapter 62A.
1.4BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.5 Section 1. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
1.6 Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
1.7paragraphs (b) and (c) have the meanings given.
1.8(b) "Autism spectrum disorders" means the conditions as determined by criteria
1.9set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental
1.10Disorders of the American Psychiatric Association.
1.11(c) "Medically necessary care" means health care services appropriate, in terms of
1.12type, frequency, level, setting, and duration, to the enrollee's condition, and diagnostic
1.13testing and preventative services. Medically necessary care must be consistent with
1.14generally accepted practice parameters as determined by physicians and licensed
1.15psychologists who typically manage patients who have autism spectrum disorders.
1.16 Subd. 2. Coverage required. (a) A health plan must provide coverage for the
1.17diagnosis, evaluation, assessment, and medically necessary care of autism spectrum
1.18disorders, including but not limited to the following:
1.19(1) intensive behavior therapy, including but not limited to applied behavior
1.20analysis, intensive early intervention behavior therapy, intensive behavior intervention,
1.21and Lovaas therapy;
1.22(2) neuro-developmental and behavioral health treatments and management;
1.23(3) speech therapy;
1.24(4) occupational therapy;
2.1(5) physical therapy; and
2.2(6) medications.
2.3(b) Coverage required under this section shall include treatment that is in accordance
2.4with an individualized treatment plan prescribed by the enrollee's treating physician.
2.5(c) A health carrier may not refuse to renew or reissue, or otherwise terminate or
2.6restrict, coverage of an individual solely because the individual is diagnosed with an
2.7autism spectrum disorder.
2.8(d) A health carrier may request an updated treatment plan only once every six
2.9months, unless the health carrier and the treating physician agree that a more frequent
2.10review is necessary due to emerging circumstances.
2.11 Subd. 3. No effect on other law. Nothing in this section limits in any way the
2.12coverage required under section 62Q.47.
2.13 Subd. 4. State health care programs. This section does not affect benefits available
2.14under the medical assistance and MinnesotaCare programs and does not limit, restrict, or
2.15otherwise reduce coverage under these programs.
2.16EFFECTIVE DATE.This section is effective August 1, 2013, and applies to
2.17coverage offered; issued; sold; renewed; or continued as defined in Minnesota Statutes,
2.18section 60A.02, subdivision 2a; on or after that date.
