The bill amends the Michigan Insurance Code of 1956 to enhance coverage for the diagnosis and treatment of autism spectrum disorders by health insurance providers. It mandates that insurers cannot terminate coverage or refuse to issue policies based solely on an individual's autism diagnosis or treatment. Additionally, insurers are prohibited from limiting the number of treatment visits, denying coverage based on the educational nature of treatment, or imposing dollar limits and copays that differ from those applied to physical illnesses. The bill removes previous age and benefit limits for coverage, ensuring that individuals of all ages diagnosed with autism spectrum disorders receive necessary treatment without arbitrary financial restrictions.

Furthermore, the bill outlines the conditions under which insurers may require treatment reviews and evaluations for individuals receiving autism treatment. It clarifies that coverage does not extend to short-term policies or require prescription drug coverage unless the individual is enrolled in a specific drug plan. The bill also defines key terms related to autism spectrum disorders and treatment, ensuring clarity in the implementation of these provisions. Overall, the amendments aim to provide comprehensive support for individuals with autism while ensuring that insurers adhere to evidence-based practices in their coverage.

Statutes affected:
House Introduced Bill: 500.3406