Signed by Governor Jay Nixon

Vote Smart's Synopsis:

Vote to repass a bill after having adopted a conference report that requires certain health insurance plans to provide coverage for the diagnosis and treatment of autism spectrum disorders.

Highlights:

-Establishes the Behavior Analyst Advisory Board and requires it to meet at least quarterly to perform the following responsibilities (Sec. A, RSMo 337.305, 337.310):

-Review applications for licensure for behavior analysts and assistants; -Review applications for line therapists; -Complaints made relating to the practice of behavior analysis; and -Entities responsible for certifying behavior analysts.

-Requires the board to make recommendations to the committee rules regarding, among other things, the application form, fees, roles of behavior analysts, and code of conduct (Sec. A, RSMo 337.310). -Specifies the requirements for license approvals and renewals and what may cause an inactive license issuance (Sec. A , RSMo 337.320). -Defines "autism spectrum disorders" as a neurobiological disorder, an illness of the nervous system, which includes the following disorders (Sec. A, RSMo 376.1224):

-Autistic Disorder; -Asperger's Disorder; -Pervasive Developmental Disorder Not Otherwise Specified; -Rett's Disorder; and -Childhood Disintegrative Disorder.

-Requires all group health benefit plans that are delivered, issued for delivery, continued, or renewed on or after January 1, 2011, if written inside the state of Missouri, or written outside the state of Missouri but insuring Missouri residents, to provide coverage for the diagnosis and treatment of autism spectrum disorders (Sec. A, RSMo 376.1224). -Prohibits a health carrier from denying or refusing to issue coverage on, refusing to contract with, or refusing to renew or refusing to issue or otherwise terminate or restrict coverage on an individual or their dependent because the individual is diagnosed with an autism spectrum disorder (Sec. A, RSMo 376.1224). -Specifies that the required coverage only apply to medically necessary treatment that is ordered by the insured's treating licensed physician or licensed psychologist (Sec. A, RSMo 376.1224). -Requires the health benefit plan or health carrier to include necessary elements to pay claims including, but not limited to, a diagnosis, proposed treatment by type, frequency and duration of treatment, and goals (Sec. A, RSMo 376.1224). -Specifies that the maximum coverage for applied behavior analysis is $40,000 per calendar year for individuals through 18 years of age (Sec. A, RSMo 376.1224). -Specifies that the required coverage apply to the following types of plans that are established, extended, modified, or renewed on or after January 1, 2011 (Sec. A, RSMo 376.1224):

-Self-insured governmental plans; -Self-insured group arrangements, to the extent not preempted by federal law; -Plans provided through a multiple employer welfare or other benefit arrangement; and -Self-insured school district health plans.

-Specifies that a waiver from the provisions may be provided to a small employer that demonstrates to the director by actual claims experience over any consecutive twelve month period that compliance with the provisions has increased the cost of the health insurance policy by an amount of 2.5 percent or greater over the period of a calendar year in premium costs to the small employer (Sec. A, RSMo 376.1224).

Full Bill Text

Vote Smart's Synopsis:

Vote to repass a bill after having adopted a conference report that requires certain health insurance plans to provide coverage for the diagnosis and treatment of autism spectrum disorders.

Highlights:

-Establishes the Behavior Analyst Advisory Board and requires it to meet at least quarterly to perform the following responsibilities (Sec. A, RSMo 337.305, 337.310):

-Review applications for licensure for behavior analysts and assistants; -Review applications for line therapists; -Complaints made relating to the practice of behavior analysis; and -Entities responsible for certifying behavior analysts.

-Requires the board to make recommendations to the committee rules regarding, among other things, the application form, fees, roles of behavior analysts, and code of conduct (Sec. A, RSMo 337.310). -Specifies the requirements for license approvals and renewals and what may cause an inactive license issuance (Sec. A , RSMo 337.320). -Defines "autism spectrum disorders" as a neurobiological disorder, an illness of the nervous system, which includes the following disorders (Sec. A, RSMo 376.1224):

-Autistic Disorder; -Asperger's Disorder; -Pervasive Developmental Disorder Not Otherwise Specified; -Rett's Disorder; and -Childhood Disintegrative Disorder.

-Requires all group health benefit plans that are delivered, issued for delivery, continued, or renewed on or after January 1, 2011, if written inside the state of Missouri, or written outside the state of Missouri but insuring Missouri residents, to provide coverage for the diagnosis and treatment of autism spectrum disorders (Sec. A, RSMo 376.1224). -Prohibits a health carrier from denying or refusing to issue coverage on, refusing to contract with, or refusing to renew or refusing to issue or otherwise terminate or restrict coverage on an individual or their dependent because the individual is diagnosed with an autism spectrum disorder (Sec. A, RSMo 376.1224). -Specifies that the required coverage only apply to medically necessary treatment that is ordered by the insured's treating licensed physician or licensed psychologist (Sec. A, RSMo 376.1224). -Requires the health benefit plan or health carrier to include necessary elements to pay claims including, but not limited to, a diagnosis, proposed treatment by type, frequency and duration of treatment, and goals (Sec. A, RSMo 376.1224). -Specifies that the maximum coverage for applied behavior analysis is $40,000 per calendar year for individuals through 18 years of age (Sec. A, RSMo 376.1224). -Specifies that the required coverage apply to the following types of plans that are established, extended, modified, or renewed on or after January 1, 2011 (Sec. A, RSMo 376.1224):

-Self-insured governmental plans; -Self-insured group arrangements, to the extent not preempted by federal law; -Plans provided through a multiple employer welfare or other benefit arrangement; and -Self-insured school district health plans.

-Specifies that a waiver from the provisions may be provided to a small employer that demonstrates to the director by actual claims experience over any consecutive twelve month period that compliance with the provisions has increased the cost of the health insurance policy by an amount of 2.5 percent or greater over the period of a calendar year in premium costs to the small employer (Sec. A, RSMo 376.1224).

Full Bill Text