This bill mandates that health insurance providers, including health, hospital, and medical service corporations, as well as the State Medicaid program, cover medical expenses related to the treatment of stuttering. This includes both habilitative and rehabilitative speech therapy, which must be deemed medically necessary by the subscriber's medical doctor. The coverage applies to services delivered in-person or via telemedicine or telehealth, and it prohibits any prior authorization or other utilization management requirements. Additionally, no cost-sharing measures such as deductibles, coinsurance, or copayments can be imposed on these services.
The bill defines "habilitative speech therapy" as therapy that helps individuals maintain, learn, or improve daily living skills, while "rehabilitative speech therapy" is described as therapy aimed at restoring or improving skills that have been lost or impaired. The provisions of this act will take effect 90 days after enactment and will apply to all relevant policies, plans, and contracts issued or renewed after that date.