This bill amends existing Iowa law regarding insurance coverage for the treatment of autism spectrum disorder (ASD). It removes the age limit of 21 years for coverage of diagnostic assessments and treatment, as well as the maximum annual benefit cap of $36,000. Additionally, the bill eliminates the age restrictions for applied behavior analysis coverage, which previously applied to individuals under 19 years of age, and removes the tiered maximum benefit amounts based on age. The bill also specifies that group policies cannot impose annual or lifetime limits on benefits for autism spectrum disorder.

Furthermore, the bill updates the definitions related to autism spectrum disorder and mandates that group policies provide a minimum of thirty inpatient days and fifty-two outpatient visits annually, without limiting the number of outpatient visits for applied behavior analysis. The changes will take effect for policies delivered, issued for delivery, continued, or renewed in Iowa on or after January 1, 2026.

Statutes affected:
Introduced: 514C.22, 514C.28, 514C.31, 514C.6