SB 267-1_ Filed 03/18/2013, 11:11 Clere
Adopted 3/18/2013


Text Box


    PREVAILED      Roll Call No. _______
    FAILED        Ayes _______
    WITHDRAWN        Noes _______
    RULED OUT OF ORDER


[

HOUSE MOTION ____

]

MR. SPEAKER:

    I move that Engrossed Senate Bill 267 be amended to read as follows:

SOURCE: Page 1, line 16; (13)MO026702.1. -->     Page 1, between lines 16 and 17, begin a new paragraph and insert:
SOURCE: IC 5-10-8-7.1; (13)MO026702.2. -->     "SECTION 2. IC 5-10-8-7.1 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 7.1. (a) As used in this section, "covered individual" means an individual who is:
        (1) covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or
        (2) entitled to health services under a contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter.
    (b) As used in this section, "pervasive developmental "autism spectrum 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.
    (c) A self-insurance program established under section 7(b) of this chapter to provide health care coverage must provide a covered individual with coverage for the treatment of a pervasive developmental an autism spectrum disorder. Coverage provided under this section is limited to treatment that is prescribed by the covered individual's treating physician in accordance with a treatment plan. A self-insurance program may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on, an individual under an insurance policy or health plan solely because the individual

is diagnosed with a pervasive developmental an autism spectrum disorder.
    (d) A contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter must provide a covered individual with services for the treatment of a pervasive developmental an autism spectrum disorder. Services provided under this section are limited to treatment that is prescribed by the covered individual's treating physician in accordance with a treatment plan. A prepaid health care delivery plan may not deny or refuse to provide services to, or refuse to renew, refuse to reissue, or otherwise terminate or restrict services to, an individual solely because the individual is diagnosed with a pervasive developmental an autism spectrum disorder.
    (e) The coverage required by subsection (c) and services required by subsection (d) may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to a covered individual than the dollar limits, deductibles, copayments, or coinsurance provisions that apply to physical illness generally under the self-insurance program or contract with a prepaid health care delivery plan.

SOURCE: IC 12-7-2-19; (13)MO026702.3. -->     SECTION 3. IC 12-7-2-19, AS AMENDED BY P.L.99-2007, SECTION 41, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 19. (a) "Autism", for purposes of IC 12-11-8, has the meaning set forth in IC 12-11-8-1.
    (b) "Autism", for purposes of IC 12-11-1.1-6 and IC 12-28-4-13, refers to the characteristics of a neurological disorder that is described in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Washington, of the American Psychiatric Association. 1994, pages 70 and 71.".
SOURCE: Page 6, line 26; (13)MO026702.6. -->     Page 6, between lines 26 and 27, begin a new paragraph and insert:
SOURCE: IC 16-38-4-1; (13)MO026702.18. -->     "SECTION 18. IC 16-38-4-1 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 1. As used in this chapter, "birth problems" means one (1) or more of the following conditions:
        (1) A structural deformation.
        (2) A developmental malformation.
        (3) A genetic, inherited, or biochemical disease.
        (4) A condition of a chronic nature, including central nervous system hemorrhage or infection of the central nervous system, that may result in a need for long term health care.
        (5) A pervasive developmental An autism spectrum disorder that is recognized in a child before the child becomes five (5) years of age.
        (6) A fetal alcohol spectrum disorder that is recognized before a child becomes five (5) years of age.
        (7) Any other severe disability that is:
            (A) designated in a rule adopted by the state department; and
            (B) recognized in a child after birth and before the child becomes three (3) years of age.
SOURCE: IC 16-38-4-8; (13)MO026702.19. -->     SECTION 19. IC 16-38-4-8, AS AMENDED BY P.L.93-2006, SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 8. (a) The state department shall establish a birth problems registry for the purpose of recording all cases of birth problems that occur in Indiana residents and compiling necessary and appropriate information concerning those cases, as determined by the state department, in order to:
        (1) conduct epidemiologic and environmental studies and to apply appropriate preventive and control measures;
        (2) inform the parents of children with birth problems:
            (A) at the time of discharge from the hospital; or
            (B) if a birth problem is diagnosed during a physician or hospital visit that occurs before the child is:
                (i) except as provided in item (ii), three (3) years of age at the time of diagnosis; or
                (ii) five (5) years of age at the time of diagnosis if the disorder is a pervasive developmental an autism spectrum disorder or a fetal alcohol spectrum disorder;
        about physicians, care facilities, and appropriate community resources, including local step ahead agencies and the infants and toddlers with disabilities program (IC 12-12.7-2); or
        (3) inform citizens regarding programs designed to prevent or reduce birth problems.
    (b) The state department shall record in the birth problems registry:
        (1) all data concerning birth problems of children that are provided from the certificate of live birth; and
        (2) any additional information that may be provided by an individual or entity described in section 7(a)(2) of this chapter concerning a birth problem that is:
            (A) designated in a rule adopted by the state department; and
            (B) recognized:
                (i) after the child is discharged from the hospital as a newborn;
                (ii) before the child is five (5) years of age if the child is diagnosed with a pervasive developmental an autism spectrum disorder or a fetal alcohol spectrum disorder; and
                (iii) before the child is three (3) years of age for any diagnosis not specified in item (ii).
    (c) The state department shall:
        (1) provide a physician and a local health department with necessary forms for reporting under this chapter; and
        (2) report in an electronic format under IC 5-14-6 to the legislative council any birth problem trends that are identified

through the data collected under this chapter.

SOURCE: IC 27-8-14.2-3; (13)MO026702.20. -->     SECTION 20. IC 27-8-14.2-3 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 3. As used in this chapter, "pervasive developmental "autism spectrum 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.
SOURCE: IC 27-8-14.2-4; (13)MO026702.21. -->     SECTION 21. IC 27-8-14.2-4 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 4. (a) An accident and sickness insurance policy that is issued on a group basis must provide coverage for the treatment of a pervasive developmental an autism spectrum disorder of an insured. Coverage provided under this section is limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan. An insurer may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy solely because the individual is diagnosed with a pervasive developmental an autism spectrum disorder.
    (b) The coverage required under this section 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 that apply to physical illness generally under the accident and sickness insurance policy.
SOURCE: IC 27-8-14.2-5; (13)MO026702.22. -->     SECTION 22. IC 27-8-14.2-5 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 5. (a) An insurer that issues an accident and sickness insurance policy on an individual basis must offer to provide coverage for the treatment of a pervasive developmental an autism spectrum disorder of an insured. Coverage provided under this section is limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan. An insurer may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy solely because the individual is diagnosed with a pervasive developmental an autism spectrum disorder.
    (b) The coverage that must be offered under this section 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 that apply to physical illness generally under the accident and sickness insurance policy.
SOURCE: IC 27-13-7-14.7; (13)MO026702.23. -->     SECTION 23. IC 27-13-7-14.7 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 14.7. (a) As used in this section, "pervasive developmental "autism spectrum 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 group contract with a health maintenance organization that provides basic health care services must provide services for the treatment of a pervasive developmental an autism spectrum disorder of an enrollee. Services provided to an enrollee under this subsection are limited to services that are prescribed by the enrollee's treating physician in accordance with a treatment plan. A health maintenance organization may not deny or refuse to provide services to, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage under a group contract to services to an individual solely because the individual is diagnosed with a pervasive developmental an autism spectrum disorder.
    (c) The services required under subsection (b) 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 that apply to physical illness generally under the contract with the health maintenance organization.
    (d) A health maintenance organization that enters into an individual contract that provides basic health care services must offer to provide services for the treatment of a pervasive developmental an autism spectrum disorder of an enrollee. Services provided to an enrollee under this subsection are limited to services that are prescribed by the enrollee's treating physician in accordance with a treatment plan. A health maintenance organization may not deny or refuse to provide services to, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage under an individual contract to services to an individual solely because the individual is diagnosed with a pervasive developmental an autism spectrum disorder.
    (e) The services that must be offered under subsection (d) 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 that apply to physical illness generally under the contract with the health maintenance organization.".
    Renumber all SECTIONS consecutively.
    (Reference is to ESB 267 as printed March 15, 2013.)

________________________________________

Representative Clere


MO026702/DI 97     2013