An Act To Encourage the Diagnosis and Treatment of Autism Spectrum Disorders
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24 MRSA §2317-B, sub-§19, as enacted by PL 1999, c. 256, Pt. M, §10, is amended to read:
19. Title 24-A, chapter 67. Medicare supplement insurance policies, Title 24-A, chapter 67; and
Sec. 2. 24 MRSA §2317-B, sub-§20, as amended by PL 2003, c. 428, Pt. G, §1, is further amended to read:
20. Title 24-A, chapters 68 and 68-A. Long-term care insurance, nursing home care insurance and home health care insurance, Title 24-A, chapters 68 and 68-A . ; and
Sec. 3. 24 MRSA §2317-B, sub-§21 is enacted to read:
21. Title 24-A, sections 2765, 2847-Q and 4257. Coverage for diagnostic testing and screening of autism spectrum disorders, Title 24-A, sections 2765, 2847-Q and 4257.
Sec. 4. 24-A MRSA §2765 is enacted to read:
1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Autism spectrum disorders" means a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication as well as severely restricted interests and highly repetitive behavior.
B. "Diagnostic testing" means a medical test performed to aid in the diagnosis or detection of a disease or disorder.
2. Required coverage. All individual health insurance policies and contracts must provide coverage for diagnostic testing and screening for autism spectrum disorders.
3. Limits; coinsurances; deductibles. Except as otherwise provided in this section, any policy or contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
Sec. 5. 24-A MRSA §2847-Q is enacted to read:
1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Autism spectrum disorders" means a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication as well as severely restricted interests and highly repetitive behavior.
B. "Diagnostic testing" means a medical test performed to aid in the diagnosis or detection of a disease or disorder.
2. Required coverage. All group health insurance policies, contracts and certificates must provide coverage for diagnostic testing and screening for autism spectrum disorders.
3. Limits; coinsurances; deductibles. Except as otherwise provided in this section, any policy, contract or certificate that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
Sec. 6. 24-A MRSA §4257 is enacted to read:
1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Autism spectrum disorders" means a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication as well as severely restricted interests and highly repetitive behavior.
B. "Diagnostic testing" means a medical test performed to aid in the diagnosis or detection of a disease or disorder.
2. Required coverage. All health maintenance organization individual and group health insurance policies, contracts and certificates must provide coverage for diagnostic testing and screening for autism spectrum disorders.
3. Limits; coinsurances; deductibles. Except as otherwise provided in this section, any policy, contract or certificate that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
Sec. 7. Application. The requirements of this Act apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2010. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
summary
This bill requires health insurance policies, contracts and certificates to provide coverage for diagnostic testing and screening for autism spectrum disorders. The provisions of this bill apply to all policies, contracts and certificates issued or renewed on or after January 1, 2010.