This bill amends existing Iowa law regarding insurance coverage for the treatment of autism spectrum disorder (ASD). It updates the terminology from "autistic disorders" to "autism spectrum disorder" and aligns the definitions with the American Psychiatric Association's diagnostic manual. The bill removes the previous age limit of 21 years for coverage of diagnostic assessments and treatments for autism, as well as the maximum benefit amount of $36,000 per year. Additionally, it eliminates age restrictions for coverage of applied behavior analysis, which was previously limited to individuals under 19 years of age, and removes the annual maximum benefit amounts associated with different age categories.

Furthermore, the bill ensures that group policies cannot impose aggregate annual or lifetime limits on benefits for autism spectrum disorder and mandates 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 apply to relevant insurance plans that are delivered, issued for delivery, continued, or renewed in Iowa on or after January 1, 2026.

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