HB 2184 -- Health Insurance Coverage for Habilitative Services

Sponsor:  Lampe

This bill requires all health benefit plans that are delivered,
continued, or renewed on or after January 1, 2011, to provide
coverage for habilitative services for children younger than 19
years of age with a congenital, genetic, or early acquired
disorder if a licensed physician has diagnosed the disorder,
treatment is administered by a specified licensed practitioner,
and the treatment is medically necessary and therapeutic and not
considered experimental.  The coverage will be subject to other
general exclusions and limitations in the policy of the health
benefit plan.  Habilitative services that are solely educational
are not eligible for reimbursement.  The coverage cannot apply to
any treatment of a mental or emotional disorder or illness that
is considered a mental health diagnosis by law.  Denial of
coverage is subject to appeal and external independent review
procedures.  A health carrier or health benefit plan can request
medical records to substantiate medical necessity for initial or
continued treatment provided under the coverage and request a
treatment plan from the treating provider.  Certain supplemental
insurance policies are exempt from the provisions of the bill.

Missouri House of Representatives
95th General Assembly, 2nd Regular Session
Last Updated September 14, 2010 at 3:13 pm