H1150B2237A03010 AJM:CDM 07/12/07 #90 A03010 AMENDMENTS TO HOUSE BILL NO. 1150 Sponsor: REPRESENTATIVE D. O'BRIEN Printer's No. 2237 1 Amend Sec. 1 (Sec. 635.2), page 5, line 17, by inserting 2 after "DISORDERS." 3 To the extent that the diagnosis and treatment of autism 4 spectrum disorders are not already covered by the health 5 insurance policy or government program, coverage under this 6 section shall be included in health insurance policies and 7 contracts under a government program which are delivered, 8 executed, issued, amended, adjusted or renewed on or after one 9 hundred eighty days from the effective date of this section, 10 except that the applicability of this section to government 11 programs shall be contingent upon Federal approval if necessary. 12 Amend Sec. 1 (Sec. 635.2), page 5, lines 27 through 29, by 13 striking out "PRICE INDEX (MPI) COMPONENT OF THE U.S. DEPARTMENT 14 OF LABOR CONSUMER PRICE INDEX (CPI). and inserting 15 care component of the United States Department of Labor Consumer 16 Price Index For All Urban Consumers (CPI-U). 17 Amend Sec. 1 (Sec. 635.2), page 9, line 10, by striking out 18 "LICENSED PSYCHOLOGIST" and inserting 19 psychologist licensed 20 Amend Sec. 1 (Sec. 635.2), page 10, line 15, by inserting 21 after "LAW," 22 the 23 Amend Sec. 1 (Sec. 635.2), page 10, line 19, by inserting 24 after "ALL" 25 of 26 Amend Sec. 1, page 10, lines 29 and 30; page 11, lines 1 27 through 19, by striking out all of said lines on said pages and
1 inserting 2 Section 2116.1. Treatment of Autism Spectrum Disorders.--(a) 3 Except for inpatient services, if an enrollee has obtained 4 authorization through utilization review from a managed care 5 plan, government program or a licensed insurer to receive any 6 care, treatment, intervention, service or item for an autism 7 spectrum disorder, the authorization shall be valid for twelve 8 months, unless the enrollee's primary care provider determines 9 that an earlier re-evaluation is necessary in order to 10 adequately address the clinical needs of the enrollee. 11 (a.1) In applying subsection (a), if within the twelve-month 12 period following the effective date of this section a health 13 insurance policy is delivered, issued, executed or renewed and 14 at the time of such delivery, issuance, execution or renewal an 15 enrollee is receiving any inpatient or outpatient care, 16 treatment, intervention, service or item for an autism spectrum 17 disorder pursuant to an authorization obtained from a government 18 program, and the care, treatment, intervention, service or item 19 is covered under the health insurance policy being delivered, 20 issued, executed or renewed, the authorization from the 21 government program shall remain valid for the remainder of the 22 existing authorization period as to any managed care plan or 23 private insurer and such authorization shall be honored by any 24 managed care plan or private insurer providing coverage to the 25 enrollee. 26 Amend Sec. 2 (Sec. 2121), page 12, lines 24 through 30; page 27 13, line 1, by striking out all of said lines on said pages 28 Amend Sec. 3, page 13, line 30, by striking out all of said 29 line and inserting 30 Section 3. This act shall take effect as follows: 31 (1) The following provisions shall take effect in 90 32 days: 33 (i) The addition of section 635.2(f) and (g) of the 34 act. 35 (ii) The amendment of section 2121 of the act. 36 (iii) This section. 37 (2) The remainder of this act shall take effect in 210 38 days. G12L90AJM/HB1150A03010 - 2 -