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2012 -- H 7165 | |
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LC00681 | |
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STATE OF RHODE ISLAND | |
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IN GENERAL ASSEMBLY | |
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JANUARY SESSION, A.D. 2012 | |
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A N A C T | |
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RELATING TO INSURANCE - AUTISM SPECTRUM DISORDERS | |
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Introduced By: Representatives Palumbo, Morrison, Corvese, Naughton, and E Coderre | |
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Date Introduced: January 18, 2012 | |
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Referred To: House Health, Education & Welfare | |
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It is enacted by the General Assembly as follows: | |
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SECTION 1. Sections 27-20.11-1, 27-20.11-3 and 27-20.11-7 of the General Laws in |
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Chapter 27-20.11 entitled "Autism Spectrum Disorders" are hereby amended to read as follows: |
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27-20.11-1. Mandatory coverage for Autism spectrum disorders. -- (a) Every group |
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health insurance contract, or every group hospital or medical expense insurance policy, plan, or |
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group policy delivered, issued for delivery, or renewed in this state, by any health insurance |
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carrier, on or after January 1, 2012, shall provide coverage for autism spectrum disorders; |
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provided, however, the provisions of this chapter shall not apply to contracts, plans or group |
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policies subject to the Small Employer Health Insurance Availability Act, chapter 50 of this title, |
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Medical Assistance, Chapter 40-8, or subject to the Individual Health Insurance Coverage Act, |
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chapter 18.5 of this title. |
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27-20.11-3. Scope of coverage. -- (a) Benefits under this section shall include coverage |
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for pharmaceuticals applied behavior analysis, physical therapy, speech therapy, psychology, |
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psychiatric and occupational therapy services for the treatment of Autism spectrum disorders, as |
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defined in the most recent edition of the DSM. Provided, however: (1) Coverage for physical |
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therapy, speech therapy and occupational therapy and psychology, psychiatry and pharmaceutical |
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services shall be to the extent such services are a covered benefit for other diseases and conditions |
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under such policy; and (2) Applied behavior analysis shall be limited to thirty-two thousand |
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dollars ($32,000) per person per year. |
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(b) Benefits under this section shall continue until the covered individual reaches age |
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fifteen (15). |
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(c) The health care benefits outlined in this chapter apply only to services delivered |
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within the State of Rhode Island; provided, that all health insurance carriers shall be required to |
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provide coverage for those benefits mandated by this chapter outside of the State of Rhode Island |
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where it can be established through a pre-authorization process that the required services are not |
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available in the State of Rhode Island from a provider in the health insurance carrier's network. |
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27-20.11-7. Credentialing and contracting practices. -- (a) Any individual providing or |
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supervising applied behavior analysis treatment under this section shall be: |
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(1) Individually licensed by the department of health as a |
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licensed behavior analyst or licensed assistant behavior analyst |
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credentialed by the insurer; or |
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(2) Individually |
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health as a psychologist |
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experience credentialed by the insurer. |
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(b) Nothing in this chapter shall be construed to require a change in the credentialing or |
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contracting practices of health insurers for mental health or substance abuse providers. |
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SECTION 2. This act shall take effect upon passage. |
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LC00681 | |
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EXPLANATION | |
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BY THE LEGISLATIVE COUNCIL | |
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OF | |
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A N A C T | |
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RELATING TO INSURANCE - AUTISM SPECTRUM DISORDERS | |
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This act would include coverage for psychology, psychiatry and pharmaceutical services. |
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This act would take effect upon passage. |
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LC00681 | |
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