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 also removes previous age and benefit limits for coverage, ensuring that individuals of all ages diagnosed with autism spectrum disorders receive necessary treatment.

Furthermore, the bill outlines the conditions under which insurers may require treatment reviews and evaluations, including the use of standardized diagnostic measures. It clarifies that coverage does not extend to short-term policies or require prescription drug coverage unless the insured is part of a prescription drug plan. The bill also defines key terms related to autism spectrum disorders and 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 ensuring that insurers adhere to evidence-based care practices.

Statutes affected:
House Introduced Bill: 500.3406