Introduced Version






HOUSE BILL No. 1091

_____


DIGEST OF INTRODUCED BILL



Citations Affected: IC 27-8-14.2 ; IC 27-13-7-14.7.

Synopsis: Insurance coverage for autism. Defines pervasive developmental disorders, including Asperger's syndrome and autism, as neurological conditions for purposes of coverage under group health insurance and group health maintenance organization contracts. Requires group health insurers and group health maintenance organization contracts that provide basic health care services to offer to provide coverage for treatment of a pervasive developmental disorder of an individual covered under the plan. (The introduced version of this bill was prepared by the Indiana commission on autism.)

Effective: July 1, 2001.





Duncan, Summers




    January 8, 2001, read first time and referred to Committee on Human Affairs.







Introduced

First Regular Session 112th General Assembly (2001)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
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HOUSE BILL No. 1091



    A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Be it enacted by the General Assembly of the State of Indiana:

SOURCE: IC 27-8-14.2; (01)IN1091.1.1. -->     SECTION 1. IC 27-8-14.2 IS ADDED TO THE INDIANA CODE AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2001]:
    Chapter 14.2. Insurance Coverage for Pervasive Developmental Disorders
    Sec. 1. As used in this chapter, "accident and sickness insurance policy" means an insurance policy that:
        (1) provides one (1) or more of the types of insurance described in IC  27-1-5-1, classes 1(b) and 2(a); and
        (2) is issued on a group basis.
    Sec. 2. As used in this chapter, "insured" means an individual who is entitled to coverage under an accident and sickness insurance policy.
    Sec. 3. As used in this chapter, "insurer" means a person that provides coverage under an accident and sickness insurance policy.
    Sec. 4. As used in this chapter, "pervasive developmental disorder" means a neurological condition, including Asperger's

syndrome and autism, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.
    Sec. 5. An insurer shall offer to provide coverage for the treatment of a pervasive developmental disorder of an insured in each accident and sickness insurance policy.
    Sec. 6. The coverage required under this chapter may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles, or coinsurance provisions applying to physical illness generally under the accident and sickness insurance policy.

SOURCE: IC 27-13-7-14.7; (01)IN1091.1.2. -->     SECTION 2. IC 27-13-7-14.7 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2001]: Sec. 14.7. (a) As used in this chapter, "pervasive developmental disorder" means a neurological condition, including Asperger's syndrome and autism, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.
    (b) A health maintenance organization shall offer to provide services for the treatment of a pervasive developmental disorder of an enrollee in any group contract that provides basic health care services.
    (c) The services required under this section may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to an enrollee than the dollar limits, deductibles, copayments, or coinsurance provisions applying to physical illness generally under the contract with the health maintenance organization.

SOURCE: ; (01)IN1091.1.3. -->     SECTION 3. [EFFECTIVE JULY 1, 2001] (a) IC 27-8-14.2 , as added by this act, applies to all accident and sickness insurance policies issued, renewed, delivered, or entered into after June 30, 2001.
    (b) IC 27-13-7-14.7 , as added by this act, applies to all group contracts with health maintenance organizations entered into, renewed, delivered, or issued after June 30, 2001.
    (c) This SECTION expires June 30, 2005.