Vote Smart's Synopsis:

Vote to concur with House amendments and pass a bill that establishes a reimbursement program for insurance providers that cover autism.

Highlights:

• Requires the Department of Licensing and Regulatory Affairs to develop an application, approval and compliance process for providers that wish to receive reimbursement for the required coverage of autism diagnosis and treatment (Sec. 5).

• Establishes an autism coverage fund within the state treasury (Sec. 7).

• Requires the Department of Licensing and Regulatory Affairs to approve or deny an application within 30 days after its receipt (Sec. 5).

• Requires the Department of Licensing and Regulatory Affairs to reimburse the amount of paid claims after 180 days if the applicant is approved and has not exceeded the required coverage cap (Sec. 5).

• Requires the Department of Licensing and Regulatory Affairs to notify insurance providers and the legislature if they reasonably believe that within 60 days the funds in the program will be insufficient to reimburse paid claims (Sec. 7).

• Specifies that if a health care provider was not fully reimbursed for all paid claims due to a shortfall in the reimbursement fund in a fiscal year, and if the health care provider increases its rates the following year to cover the amount not provided by reimbursements, then the rate increase shall not be considered as a reimbursement for paid claims (Sec. 5).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that establishes a reimbursement program for insurance providers that cover autism.

Highlights:

• Requires the Department of Licensing and Regulatory Affairs to develop an application, approval and compliance process for providers that wish to receive reimbursement for the required coverage of autism diagnosis and treatment (Sec. 5).

• Establishes an autism coverage fund within the state treasury (Sec. 7).

• Requires the Department of Licensing and Regulatory Affairs to approve or deny an application within 30 days after its receipt (Sec. 5).

• Requires the Department of Licensing and Regulatory Affairs to reimburse the amount of paid claims after 180 days if the applicant is approved and has not exceeded the required coverage cap (Sec. 5).

• Requires the Department of Licensing and Regulatory Affairs to notify insurance providers and the legislature if they reasonably believe that within 60 days the funds in the program will be insufficient to reimburse paid claims (Sec. 7).

• Specifies that if a health care provider was not fully reimbursed for all paid claims due to a shortfall in the reimbursement fund in a fiscal year, and if the health care provider increases its rates the following year to cover the amount not provided by reimbursements, then the rate increase shall not be considered as a reimbursement for paid claims (Sec. 5).

Full Bill Text