House Bill 0093

CODING: Words stricken are deletions; words underlined are additions.







    Florida House of Representatives - 2000                  HB 93

        By Representative Crow






  1                      A bill to be entitled

  2         An act relating to health insurance coverage

  3         for autism spectrum disorder; requiring a

  4         health insurer or health maintenance

  5         organization that offers major medical coverage

  6         to include coverage for treating autism

  7         spectrum disorder; defining the term "autism

  8         spectrum disorder"; authorizing an insurer or

  9         health maintenance organization to confirm a

10         diagnosis or review the appropriateness of a

11         treatment plan; providing that the act does not

12         affect the licensure of a health care

13         professional or impair the right to

14         reimbursement of a health care provider;

15         providing a legislative finding; providing an

16         effective date.

17

18  Be It Enacted by the Legislature of the State of Florida:

19

20         Section 1.  Health insurance coverage for autism

21  spectrum disorder.--

22         (1)(a)  As used in this section, the term "autism

23  spectrum disorder" is a neurobiological condition that

24  includes autism, Asperger syndrome, Rett's syndrome, or

25  pervasive developmental disorder, as those disorders occur in

26  various degrees of severity.

27         (b)  Any health insurer or health maintenance

28  organization that issues major medical expense coverage in

29  this state may not exclude coverage prescribed by the

30  referring physician for the treatment of autism spectrum

31  disorder, including, but not limited to, coverage for

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CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 2000                  HB 93

    568-153A-00






  1  therapeutic evaluations and interventions, such as speech

  2  therapy, occupational therapy, physical therapy, intensive

  3  early intervention, applied behavioral analysis, and Lovaas

  4  behavioral therapy.

  5         (2)  Coverage for autism spectrum disorder is subject

  6  to the same terms and conditions that the insurer or health

  7  maintenance organization applies to the treatment of other

  8  disorders. However, an insurer or health maintenance

  9  organization may confirm a diagnosis or review the

10  appropriateness of a specific treatment plan in order to

11  ensure that coverage under this section is limited to

12  diagnostic and treatment services.

13         (3)  This section does not affect the scope of

14  licensure of any health care professional and does not impair

15  any right to reimbursement which is otherwise guaranteed to a

16  health care provider.

17         Section 2.  The Legislature finds that the provisions

18  of this bill fulfill an important state interest.

19         Section 3.  This act shall take effect July 1, 2000.

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21            *****************************************

22                          HOUSE SUMMARY

23    Requires that a health insurer or health maintenance
      organization include coverage for autism spectrum
24    disorder as part of the coverage for major medical
      expenses. Requires that such coverage include coverage
25    for certain types of evaluations and interventions.
      Provides that the insurer or health maintenance
26    organization may confirm a diagnosis or review the
      appropriateness of treatment. Provides that the act does
27    not affect the scope of a health care professional's
      licensure or impair a health care provider's right to
28    reimbursement.

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