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
    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.

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