HB569 (2009) Detail

Requiring insurance coverage for diagnosis and treatment of autism spectrum disorders.


HB 569-FN – AS INTRODUCED

2009 SESSION

09-0706

01/05

HOUSE BILL 569-FN

AN ACT requiring insurance coverage for diagnosis and treatment of autism spectrum disorders.

SPONSORS: Rep. Butcher, Ches 3; Rep. Hammond, Hills 3; Sen. Hassan, Dist 23; Sen. Fuller Clark, Dist 24; Sen. Kelly, Dist 10; Sen. Sgambati, Dist 4; Sen. Lasky, Dist 13

COMMITTEE: Commerce and Consumer Affairs

ANALYSIS

This bill requires insurance coverage for diagnosis and treatment of autism spectrum disorders.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

09-0706

01/05

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Nine

AN ACT requiring insurance coverage for diagnosis and treatment of autism spectrum disorders.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Section; Coverage for Diagnosis and Treatment of Autism Spectrum Disorders. Amend RSA 415 by inserting after section 6-o the following new section:

415:6-p Coverage for Diagnosis and Treatment of Autism Spectrum Disorders. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for the diagnosis and treatment of autism spectrum disorders. The benefits included in this section shall not be subject to any greater deductible or other limitations than any other benefits provided by the insurer. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:

I. “Autism spectrum disorders” means the neurological condition of autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.

II. “Treatment of autism spectrum disorders” means the following care prescribed, provided, or ordered for an individual diagnosed with a pervasive developmental disorder by a licensed physician or a licensed psychologist who determines the care to be medically necessary:

(a) Habilitative or rehabilitative care.

(b) Pharmacy care.

(c) Psychiatric care.

(d) Psychological care.

(e) Therapeutic care.

2 New Section; Coverage for Diagnosis and Treatment of Autism Spectrum Disorders. Amend RSA 415 by inserting after section 18-t the following new section:

415:18-u Coverage for Diagnosis and Treatment of Autism Spectrum Disorders. Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the diagnosis and treatment of autism spectrum disorders. The benefits included in this section shall not be subject to any greater deductible or other limitations than any other benefits provided by the insurer. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:

I. “Autism spectrum disorders” means the neurological condition of autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.

II. “Treatment of autism spectrum disorders” means the following care prescribed, provided, or ordered for an individual diagnosed with a pervasive developmental disorder by a licensed physician or a licensed psychologist who determines the care to be medically necessary:

(a) Habilitative or rehabilitative care.

(b) Pharmacy care.

(c) Psychiatric care.

(d) Psychological care.

(e) Therapeutic care.

3 Coverage for Diagnosis and Treatment of Autism Spectrum Disorders. Amend RSA 420-A:2 to read as follows:

420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:18, V, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-u, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

4 Coverage for Diagnosis and Treatment of Autism Spectrum Disorders. Amend RSA 420-B:20, III to read as follows:

III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA 415:18-j, RSA 415:18-u, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

5 Effective Date. This act shall take effect 60 days after its passage.

LBAO

09-0706

01/21/09

HB 569-FN - FISCAL NOTE

AN ACT requiring insurance coverage for diagnosis and treatment of autism spectrum disorders.

FISCAL IMPACT:

    The New Hampshire Association of Counties and New Hampshire Municipal Association state this bill may increase county and local expenditures by an indeterminable amount in FY 2010 and each year thereafter. There will be no fiscal impact on state expenditures or state, county, and local revenues.

METHODOLOGY:

    The New Hampshire Insurance Department states this bill requires insurance coverage for diagnosis and treatment of autism spectrum disorders. The Department states current RSA 417-E:1, III (h) already requires coverage for biologically based mental illness categorized by the American Psychiatric Association within the category of pervasive developmental disorders or autism. Therefore, the proposed legislation creates no new coverage requirements, and the Department anticipates no fiscal impact.

    The Department of Administrative Services states this coverage is already provided under the state’s self-funded health coverage. Therefore, Department anticipates no fiscal impact on state expenditures.

    The New Hampshire Association of Counties states to the extent any health insurance provided to county employees does not currently provide this coverage, insurance premiums may increase, resulting in increased county expenditures. However, because the Association does not have information on the number of counties impacted, the fiscal impact cannot be determined at this time.

    The New Hampshire Municipal Association states this bill will have no impact on municipalities participating in pooled insurance programs. To the extent municipalities’ employee health insurance is not provided by pooled insurance programs and does not currently provide this coverage, municipal insurance premiums may increase. However, because the Association does not have information on the number of municipalities impacted, the fiscal impact cannot be determined at this time.

Links

HB569 at GenCourtMobile

Action Dates

Date Body Type

Bill Text Revisions

HB569 Revision: 13604 Date: Jan. 23, 2009, midnight

Docket