February 26, 2009, Introduced by Reps. Angerer, Switalski, Liss, Sheltrown and Melton and referred to the Committee on Health Policy.
A bill to amend 1980 PA 350, entitled
"The nonprofit health care corporation reform act,"
(MCL 550.1101 to 550.1704) by adding section 416e.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 416e. (1) A health care corporation group or nongroup
certificate shall provide coverage for the screening, diagnosis,
and treatment of autism spectrum disorder, including, but not
limited to, coverage for speech therapy, occupational therapy,
physical therapy, psychological services, psychiatric services, and
applied behavior analysis, as prescribed or ordered by the member's
treating physician or psychologist.
(2) Coverage for autism spectrum disorder under this section
is subject to the same terms and conditions that the health care
corporation applies to the treatment of other disorders, except as
follows:
(a) Treatment shall not be limited or denied on the basis that
it is habilitative in nature.
(b) Treatment shall not be subject to visit limits.
(3) If a member is receiving treatment for autism spectrum
disorder, a health care corporation may request a review of that
treatment not more than once every 6 months unless the health care
corporation and the member's treating physician or psychologist
agree that a more frequent review is necessary. The cost of
obtaining this review shall be borne by the health care
corporation.
(4) This section shall not be construed as limiting benefits
that are otherwise available to a member with autism spectrum
disorder.
(5) As used in this section:
(a) "Applied behavior analysis" means the design,
implementation, and evaluation of environmental modifications,
using behavioral stimuli and consequences, to produce socially
significant improvement in human behavior, including the use of
direct observation, measurement, and functional analysis of the
relations between environment and behavior.
(b) "Autism spectrum disorder" means any of the pervasive
developmental disorders as defined by the most recent edition of
the diagnostic and statistical manual of mental disorders (DSM),
including autistic disorder, Asperger's disorder, and pervasive
developmental disorder not otherwise specified.