On Monday, April 19, 2010 Kansas Governor Mark Parkinson signed the Senate Substitute for HB 2160: An act concerning insurance; providing coverage for autism spectrum disorder; amending K.S.A. 2009 Supp. 75-6501 and repealing the existing section into law. The bill takes effect upon publication in the Kansas Statute Book. S.Sub HB 2160 passed in the legislature on April 2, 2010 March 30, 2010.
New law and amendment of existing law will require the Kansas State Employees Health Care Commission (administers the State health care benefits program for state employees and other qualified entities) to provide for the coverage of services for the diagnosis and treatment of autism spectrum disorder (ASD) in any covered individual whose age is less than 19 years. Coverage would be no greater than $36,000/year for children from birth to 7, and no greater than $27,000/year for those age 7 through 18, with certain conditions applying to prescription, and services as recognized in the peer reviewed literature as providing a medical benefit.
Applied behavior analysis must be included if prescribed by a licensed physician, licensed psychologist or licensed specialist clinical social worker.
Reimbursement would be allowed only for services by
a provider licensed, trained , and qualified to provide such services or
by an autism specialist [includes BCBAs with experience and other state conditions]
or an intensive individual service provider, [individuals who work under the direction of an autism specialist]
as such terms are defined by the department of social and rehabilitation services Kansas autism waiver as it exists on July 1, 2010. [See Kansas Early Autism Services for more information on the Kansas autism waiver.]
The bill also would require the Health Care Commission, pursuant to the requirements of the Insurance Code regarding mandated health insurance benefits, to submit on or before March 1, 2012, a report to the Senate President and the Speaker of the House of Representatives. The report is to include information pertaining to the mandated ASD benefit coverage provided during the 2011 Plan Year. The information
is to include:
The impact that the mandated coverage has had on the State health care benefits program;
Data on the utilization of coverage for autism spectrum disorder by covered individuals and the cost of providing such coverage; and,
A recommendation on whether such mandated coverage should continue for the State health care benefits program.
The Legislature is permitted to consider (in the next session following the receipt of the report) whether or not to require the coverage for autism spectrum disorder to be included in any individual or group health insurance policy, medical service plan, HMO, or other contract which provides for accident and health services and which is delivered, issued for delivery, amended, or renewed on or after July 1, 2013.
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