House Bill hb0043

    Florida House of Representatives - 2002                  HB 43

        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; making

15         a legislative finding that the act fulfills an

16         important state interest; providing an

17         effective date.

18

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

20

21         Section 1.  Health insurance coverage for autism

22  spectrum disorder.--

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

24  spectrum disorder" means a neurobiological condition that

25  includes autism, Asperger syndrome, and Rett's syndrome.

26         (b)  Any health insurer or health maintenance

27  organization that issues major medical expense coverage in

28  this state may not exclude coverage prescribed by the

29  referring physician for the treatment of autism spectrum

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

31  therapeutic evaluations and interventions, such as speech

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






    Florida House of Representatives - 2002                  HB 43

    568-173A-02






  1  therapy, occupational therapy, physical therapy, intensive

  2  early intervention, applied behavioral analysis, and

  3  behavioral therapy.

  4         (2)  Coverage for autism spectrum disorder is subject

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

  6  maintenance organization applies to the treatment of other

  7  disorders. However, an insurer or health maintenance

  8  organization may confirm a diagnosis or review the

  9  appropriateness of a specific treatment plan in order to

10  ensure that coverage under this section is limited to

11  diagnostic and treatment services.

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

13  licensure of any health care professional and does not impair

14  any right to reimbursement which is otherwise guaranteed to a

15  health care provider.

16         Section 2.  The Legislature finds that the provisions

17  of this act fulfill an important state interest.

18         Section 3.  This act shall take effect July 1, 2002.

19

20            *****************************************

21                          HOUSE SUMMARY

22
      Requires that a health insurer or health maintenance
23    organization include coverage for autism spectrum
      disorder as part of the coverage for major medical
24    expenses. Requires that such coverage include coverage
      for certain types of evaluations and interventions.
25    Provides that the insurer or health maintenance
      organization may confirm a diagnosis or review the
26    appropriateness of treatment. Provides that the act does
      not affect the scope of a health care professional's
27    licensure or impair a health care provider's right to
      reimbursement.
28

29

30

31

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