HB 0031

1	A bill to be entitled
2	An act relating to health insurance coverage for autism
3	spectrum disorder; requiring a health insurer or health
4	maintenance organization that offers major medical
5	coverage to include coverage for treating autism spectrum
6	disorder; defining the term "autism spectrum disorder";
7	authorizing an insurer or health maintenance organization
8	to confirm a diagnosis or review the appropriateness of a
9	treatment plan; limiting the amount of annual coverage;
10	providing that the act does not affect the licensure of a
11	health care professional or impair the right to
12	reimbursement of a health care provider; making a
13	legislative finding that the act fulfills an important
14	state interest; providing an effective date.
15
16	Be It Enacted by the Legislature of the State of Florida:
17
18	Section 1.  Health insurance coverage for autism spectrum
19	disorder.--
20	(1)(a)  As used in this section, the term "autism spectrum
21	disorder" means a neurobiological condition that includes
22	autism, Asperger syndrome, and Rett's syndrome.
23	(b)  Any health insurer or health maintenance organization
24	that issues major medical expense coverage in this state may not
25	exclude coverage prescribed by the referring physician for the
26	treatment of autism spectrum disorder, including, but not
27	limited to, coverage for therapeutic evaluations and
28	interventions, speech therapy, occupational therapy, physical
29	therapy, intensive early intervention, applied behavioral
30	analysis, and Lovaas behavioral therapy.
31	(2)  Coverage for autism spectrum disorder is subject to
32	the same terms and conditions that the insurer or health
33	maintenance organization applies to the treatment of other
34	disorders. However, an insurer or health maintenance
35	organization may confirm a diagnosis or review the
36	appropriateness of a specific treatment plan in order to ensure
37	that coverage under this section is limited to diagnostic and
38	treatment services.
39	(3)  The total annual payments by a health insurer or
40	health maintenance organization for coverage under this section
41	may not exceed $6,000.
42	(4)  This section does not affect the scope of licensure of
43	any health care professional and does not impair any right to
44	reimbursement which is otherwise guaranteed to a health care
45	provider.
46	Section 2.  The Legislature finds that the provisions of
47	this act fulfill an important state interest.
48	Section 3.  This act shall take effect July 1, 2005.

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