BILL ANALYSIS

H.B. 1744

By: Allen

Insurance

Committee Report (Unamended)

BACKGROUND AND PURPOSE

Currently, a group health benefit plan provides coverage to an enrollee diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes a certain age for all generally recognized services, which the law lists, that are prescribed in relation to autism spectrum disorder by the enrollee's primary care physician in the treatment plan recommended by that physician.  While this list suggests several therapies that may be categorized as these services, it has been reported that health benefit providers often limit autism coverage to the services in that list.

Due to the complex nature of the symptoms of autism spectrum disorder, which are often behavioral and emotional, H.B. 1744 seeks to expand the list of therapies that may be used in providing services to enrollees with the disorder and to provide more parent input in such an enrollee's treatment plan. 

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

H.B. 1744 amends the Insurance Code, in a provision of law requiring a group health benefit plan to provide to an enrollee who is diagnosed with autism spectrum disorder coverage for all services prescribed by the enrollee's treatment plan, to require the treatment plan to be developed by the enrollee's primary care physician in consultation with the enrollee's parent or guardian, rather than only recommended by the physician. The bill adds to the list of services included in the definition of "generally recognized services," for purposes of that provision of law, therapy to develop appropriate social, emotional, and interpersonal skills.

EFFECTIVE DATE

September 1, 2011.