The bill amends Section 27-20.11-3 of the General Laws regarding coverage for autism spectrum disorders. It introduces a provision that removes the age limit for benefits coverage, stating that, starting January 1, 2026, no benefits shall be limited by the age of the covered individual. Additionally, it mandates that health insurance policies issued or renewed on or after this date must reimburse certified applied behavior analysis providers at rates equal to or greater than the prevailing integrated state Medicaid rate for such services.

Furthermore, the bill adds a new section, 27-20.11-9, which outlines the reimbursement requirements for applied behavior analysis services. It specifies that every group health insurance contract, or every group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by any health insurance carrier on or after January 1, 2026, shall comply with these reimbursement rates. The provisions of this section shall not apply to contracts, plans, or group policies subject to the small employer health insurance availability act, medical assistance, or the individual health insurance coverage act. Overall, the bill aims to enhance coverage and ensure fair reimbursement for services related to autism spectrum disorders.

Statutes affected:
5253: 27-20.11-3