HB 760 -- Insurance Coverage for Autism Spectrum Disorder

Sponsor:  Grill

This bill requires all health insurance carriers offering health
benefit plans which are delivered, issued, continued, or renewed
on or after January 1, 2010, to provide coverage to their members
for autism spectrum disorder (ASD) diagnosis and treatments.
Insurers are prohibited from denying coverage for individuals
solely because they are diagnosed with ASD.  Deductibles,
co-insurance, and benefit limits for the disorder cannot exceed
those assessed for a general physical illness under the health
insurance plan.

Coverage for ASD:

(1)  Can be subject to exclusions and limitations such as
coordination of benefits, provider requirements, restrictions for
services provided by family members, and reviews of necessity for
services being utilized;

(2)  Will be limited to the treatment plan prescribed by the
treating physician, and insurers can request a copy of the
treatment plan every six months;

(3)  Will be provided for individuals that are diagnosed with ASD
prior to turning nine years of age, and eligible individuals can
receive plan benefits and coverage up to 21 years of age;

(4)  Will include applied behavioral analysis therapies with a
$75,000 per year maximum benefit; and

(5)  Is not required to be offered by employers with 50 or fewer
employees.

Certain other supplemental insurance policies are not subject to
the ASD coverage requirements.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:25 am