Since the health law established a comprehensive set of “essential health benefits” that individual and small group plans must cover (unless they existed prior to passage of the law in 2010), it was hoped that mandates would no longer be much in demand, says Sabrina Corlette, project director at Georgetown University’s Center On Health Insurance Reforms.

Mandates are “not the most rational way to build a benefit package,” says Corlette.

The coverage includes 20 visits per year of speech and language therapy. 36 §6060.21 [PDF] Requires health benefit plans to cover for a child enrolled in the plan who is under 18 years of age and who has been diagnosed with a pervasive developmental disorder (including autism) all medical services, including rehabilitation services, that are medically necessary and are otherwise covered under the plan. Requires a health insurance policy or government program to provide coverage for individuals less than 21 years of age for the diagnostic assessment and treatment of autism spectrum disorder. These provisions are not subject to the Small Employer Health Insurance Availability Act, or the Individual Health Insurance Coverage Act. Laws §20.11 Requires a health insurance plan to provide coverage for the treatment of autism spectrum disorder.

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Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services.

Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six.

301 (2009) Requires all health benefit plans to provide coverage for the screening and diagnosis of autism spectrum disorders and the treatment of autism spectrum disorders in individuals less than 21 years of age. Coverage is determined in consultation with the autism services provider and the patient. Coverage under this section shall be subject to a maximum annual benefit per covered individual as follows: for individuals between the ages of one (1) through their seventh birthday, the maximum annual benefit shall be $50,000 per individual; for individuals between the ages of seven (7) through 21, the maximum benefit shall be $1,000, per month per individual. §304.17A-142 [PDF], 304.17A-143 [PDF] Requires any health coverage plan to provide coverage for the diagnosis and treatment of autism spectrum disorders in individuals less than . §22-1050 Requires all individual and group health insurance policies and contracts must provide coverage for autism spectrum disorders for an individual covered under a policy or contract who is 5 years of age or under in accordance with the following.

Citation: Iowa Code §514C.28 Effective January 1, 2011, requires the state employees' health care commission to provide for the coverage of services for the diagnosis and treatment of autism spectrum disorder in any covered individual whose age is less than 19 years. Treatment includes: medical care; habilitative or rehabilitative care; pharmacy care, if covered by the plan; psychiatric care; psychological care; therapeutic care (includes services provided by licensed speech therapists, occupational therapists, or physical therapists); and applied behavior analysis prescribed or ordered by a licensed health or allied health professional.

§31-3171.01 [PDF] (as amended by Act 20-336 [2013]) Requires health insurance plans to provide coverage to an eligible individual for: Coverage for the services shall be limited to $36,000 annually and may not exceed $200,000 in total lifetime benefits for an individual under 18 years of age or an individual 18 years of age or older who is in high school who has been diagnosed as having a developmental disability at 8 years of age or younger. Coverage is "limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan." Citation: Ind. §27-8-14.2; §27-13-7-14.7 Requires a group plan established for employees of the state providing for third-party payment or prepayment of health, medical, and surgical coverage benefits shall provide coverage benefits to covered individuals under twenty-one years of age for the diagnostic assessment of autism spectrum disorders and for the treatment of autism spectrum disorders. Effective January 1, 2011, requires insurance coverage for autism.

Coverage includes therapy services provided by a licensed or certified speech therapist or speech-language pathologist. Coverage includes behavioral health treatment, pharmacy care, psychiatric care, psychological care and therapeutic care, including therapy services provided by a licensed speech pathologists. Coverage provided shall be subject to a maximum benefit of ,000 per year, but shall not be subject to any limits on the number of visits to a service provider. Note: Speech language services are not specifically defined in the statute.

Coverage under this section shall not be denied on the basis that the treatment is habilitative or nonrestorative in nature. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is at least seven years and less than 19 years shall not exceed ,000 per year. Coverage for autism spectrum disorders shall be subject to

Coverage includes therapy services provided by a licensed or certified speech therapist or speech-language pathologist. Coverage includes behavioral health treatment, pharmacy care, psychiatric care, psychological care and therapeutic care, including therapy services provided by a licensed speech pathologists. Coverage provided shall be subject to a maximum benefit of $36,000 per year, but shall not be subject to any limits on the number of visits to a service provider. Note: Speech language services are not specifically defined in the statute. Coverage under this section shall not be denied on the basis that the treatment is habilitative or nonrestorative in nature. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is at least seven years and less than 19 years shall not exceed $27,000 per year. Coverage for autism spectrum disorders shall be subject to $1,000 maximum benefit per month, per covered individual. Coverage shall be subject to a maximum benefit of $36,000 per year and a lifetime maximum benefit of $144,000. Treatment includes: behavioral health treatment; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by a speech, occupational, or physical therapists or an aide or assistant under their supervision); items and equipment necessary to provide, receive, or advance in the above listed services, including those necessary for applied behavioral analysis; and any care for individuals with autism spectrum disorders that is determined by the Secretary of the Department of Health and Social Services, based upon their review of best practices and/or evidence-based research, to be medically necessary. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is between birth and less than seven years shall not exceed $36,000 per year. All health benefit plans in the individual and small group market shall provide coverage for pharmacy care, if covered by the plan: psychiatric care; psychological care; therapeutic care (includes services provided by licensed speech therapists, occupational therapists, or physical therapists); applied behavior analysis; habilitative and rehabilitative care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by licensed or certified speech therapists, occupational therapists, or physical therapists licensed or certified in this state), provided the care prescribed, provided, or ordered for an individual diagnosed with one of the autism spectrum disorders by a physician or psychologist who shall be licensed in this state and who shall supervise provision of such care. Treatment includes: habilitative or rehabilitative services, including applied behavior analysis or other professional or counseling services; counseling services provided by a licensed psychiatrist, psychologist, clinical professional counselor or clinical social worker; and therapy services provided by a licensed or certified speech therapist, occupational therapist or physical therapist. For decades, states have set rules for health coverage through mandates, laws that require insurers to cover specific types of medical care or services.The health law contains provisions aimed at curbing this piecemeal approach to coverage.Covered treatment includes medically necessary pharmacy care, psychiatric care, psychological care, habilitative or rehabilitative care, and therapeutic care (which includes services provided by a licensed speech-language pathologist.) There is no limit on the number of visits an individual may make to an autism services provider. However, behavioral therapy is specifically defined as applied behavioral analysis and coverage limitations for behavioral therapy are set out.

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Coverage includes therapy services provided by a licensed or certified speech therapist or speech-language pathologist. Coverage includes behavioral health treatment, pharmacy care, psychiatric care, psychological care and therapeutic care, including therapy services provided by a licensed speech pathologists. Coverage provided shall be subject to a maximum benefit of $36,000 per year, but shall not be subject to any limits on the number of visits to a service provider. Note: Speech language services are not specifically defined in the statute.

Coverage under this section shall not be denied on the basis that the treatment is habilitative or nonrestorative in nature. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is at least seven years and less than 19 years shall not exceed $27,000 per year. Coverage for autism spectrum disorders shall be subject to $1,000 maximum benefit per month, per covered individual. Coverage shall be subject to a maximum benefit of $36,000 per year and a lifetime maximum benefit of $144,000.

Treatment includes: behavioral health treatment; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by a speech, occupational, or physical therapists or an aide or assistant under their supervision); items and equipment necessary to provide, receive, or advance in the above listed services, including those necessary for applied behavioral analysis; and any care for individuals with autism spectrum disorders that is determined by the Secretary of the Department of Health and Social Services, based upon their review of best practices and/or evidence-based research, to be medically necessary. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is between birth and less than seven years shall not exceed $36,000 per year. All health benefit plans in the individual and small group market shall provide coverage for pharmacy care, if covered by the plan: psychiatric care; psychological care; therapeutic care (includes services provided by licensed speech therapists, occupational therapists, or physical therapists); applied behavior analysis; habilitative and rehabilitative care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by licensed or certified speech therapists, occupational therapists, or physical therapists licensed or certified in this state), provided the care prescribed, provided, or ordered for an individual diagnosed with one of the autism spectrum disorders by a physician or psychologist who shall be licensed in this state and who shall supervise provision of such care. Treatment includes: habilitative or rehabilitative services, including applied behavior analysis or other professional or counseling services; counseling services provided by a licensed psychiatrist, psychologist, clinical professional counselor or clinical social worker; and therapy services provided by a licensed or certified speech therapist, occupational therapist or physical therapist.

For decades, states have set rules for health coverage through mandates, laws that require insurers to cover specific types of medical care or services.

The health law contains provisions aimed at curbing this piecemeal approach to coverage.

Covered treatment includes medically necessary pharmacy care, psychiatric care, psychological care, habilitative or rehabilitative care, and therapeutic care (which includes services provided by a licensed speech-language pathologist.) There is no limit on the number of visits an individual may make to an autism services provider. However, behavioral therapy is specifically defined as applied behavioral analysis and coverage limitations for behavioral therapy are set out.

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Coverage includes therapy services provided by a licensed or certified speech therapist or speech-language pathologist. Coverage includes behavioral health treatment, pharmacy care, psychiatric care, psychological care and therapeutic care, including therapy services provided by a licensed speech pathologists. Coverage provided shall be subject to a maximum benefit of $36,000 per year, but shall not be subject to any limits on the number of visits to a service provider. Note: Speech language services are not specifically defined in the statute.

Coverage under this section shall not be denied on the basis that the treatment is habilitative or nonrestorative in nature. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is at least seven years and less than 19 years shall not exceed $27,000 per year. Coverage for autism spectrum disorders shall be subject to $1,000 maximum benefit per month, per covered individual. Coverage shall be subject to a maximum benefit of $36,000 per year and a lifetime maximum benefit of $144,000.

Treatment includes: behavioral health treatment; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by a speech, occupational, or physical therapists or an aide or assistant under their supervision); items and equipment necessary to provide, receive, or advance in the above listed services, including those necessary for applied behavioral analysis; and any care for individuals with autism spectrum disorders that is determined by the Secretary of the Department of Health and Social Services, based upon their review of best practices and/or evidence-based research, to be medically necessary. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is between birth and less than seven years shall not exceed $36,000 per year. All health benefit plans in the individual and small group market shall provide coverage for pharmacy care, if covered by the plan: psychiatric care; psychological care; therapeutic care (includes services provided by licensed speech therapists, occupational therapists, or physical therapists); applied behavior analysis; habilitative and rehabilitative care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by licensed or certified speech therapists, occupational therapists, or physical therapists licensed or certified in this state), provided the care prescribed, provided, or ordered for an individual diagnosed with one of the autism spectrum disorders by a physician or psychologist who shall be licensed in this state and who shall supervise provision of such care. Treatment includes: habilitative or rehabilitative services, including applied behavior analysis or other professional or counseling services; counseling services provided by a licensed psychiatrist, psychologist, clinical professional counselor or clinical social worker; and therapy services provided by a licensed or certified speech therapist, occupational therapist or physical therapist.

For decades, states have set rules for health coverage through mandates, laws that require insurers to cover specific types of medical care or services.

,000 maximum benefit per month, per covered individual. Coverage shall be subject to a maximum benefit of ,000 per year and a lifetime maximum benefit of 4,000.

Treatment includes: behavioral health treatment; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by a speech, occupational, or physical therapists or an aide or assistant under their supervision); items and equipment necessary to provide, receive, or advance in the above listed services, including those necessary for applied behavioral analysis; and any care for individuals with autism spectrum disorders that is determined by the Secretary of the Department of Health and Social Services, based upon their review of best practices and/or evidence-based research, to be medically necessary. Coverage for benefits for any covered person diagnosed with one or more autism spectrum disorders and whose age is between birth and less than seven years shall not exceed ,000 per year. All health benefit plans in the individual and small group market shall provide coverage for pharmacy care, if covered by the plan: psychiatric care; psychological care; therapeutic care (includes services provided by licensed speech therapists, occupational therapists, or physical therapists); applied behavior analysis; habilitative and rehabilitative care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; therapeutic care (including services provided by licensed or certified speech therapists, occupational therapists, or physical therapists licensed or certified in this state), provided the care prescribed, provided, or ordered for an individual diagnosed with one of the autism spectrum disorders by a physician or psychologist who shall be licensed in this state and who shall supervise provision of such care. Treatment includes: habilitative or rehabilitative services, including applied behavior analysis or other professional or counseling services; counseling services provided by a licensed psychiatrist, psychologist, clinical professional counselor or clinical social worker; and therapy services provided by a licensed or certified speech therapist, occupational therapist or physical therapist.

For decades, states have set rules for health coverage through mandates, laws that require insurers to cover specific types of medical care or services.

The health law contains provisions aimed at curbing this piecemeal approach to coverage.

Covered treatment includes medically necessary pharmacy care, psychiatric care, psychological care, habilitative or rehabilitative care, and therapeutic care (which includes services provided by a licensed speech-language pathologist.) There is no limit on the number of visits an individual may make to an autism services provider. However, behavioral therapy is specifically defined as applied behavioral analysis and coverage limitations for behavioral therapy are set out.