The bill amends the Michigan Insurance Code to enhance coverage for the diagnosis and treatment of autism spectrum disorders by health insurance policies. 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 and does not mandate prescription drug coverage unless the individual is enrolled in a specific drug plan. The bill also defines key terms related to autism treatment, including "applied behavior analysis" and "behavioral health treatment," ensuring that the language aligns with current medical standards and practices. Overall, the amendments aim to provide comprehensive support for individuals with autism spectrum disorders while maintaining the integrity of insurance practices.

Statutes affected:
House Introduced Bill: 500.3406