Senate Bill sb1102
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2004 SB 1102
By Senator Geller
31-265A-04
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; limiting the amount of annual
12 coverage; providing that the act does not
13 affect the licensure of a health care
14 professional or impair the right to
15 reimbursement of a health care provider; making
16 a legislative finding that the act fulfills an
17 important state interest; providing an
18 effective date.
19
20 Be It Enacted by the Legislature of the State of Florida:
21
22 Section 1. Health insurance coverage for autism
23 spectrum disorder.--
24 (1)(a) As used in this section, the term "autism
25 spectrum disorder" means a neurobiological condition that
26 includes autism, Asperger syndrome, and Rett's syndrome.
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
1
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2004 SB 1102
31-265A-04
1 therapeutic evaluations and interventions, speech therapy,
2 occupational therapy, physical therapy, intensive early
3 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) The total annual payments by a health insurer or
14 health maintenance organization for coverage under this
15 section may not exceed $6,000.
16 (4) This section does not affect the scope of
17 licensure of any health care professional and does not impair
18 any right to reimbursement which is otherwise guaranteed to a
19 health care provider.
20 Section 2. The Legislature finds that the provisions
21 of this act fulfill an important state interest.
22 Section 3. This act shall take effect July 1, 2004.
23
24 *****************************************
25 SENATE SUMMARY
26 Requires that a health insurer or health maintenance
organization include coverage for autism spectrum
27 disorder as part of the coverage for major medical
expenses. Requires that such coverage include coverage
28 for certain types of evaluations and interventions.
Provides that the insurer or health maintenance
29 organization may confirm a diagnosis or review the
appropriateness of treatment. Limits the coverage to
30 $6,000 per year. Provides that the act does not affect
the scope of a health care professional's licensure or
31 impair a health care provider's right to reimbursement.
2
CODING: Words stricken are deletions; words underlined are additions.