American Speech-Language-Hearing Association

State Insurance Mandates for Autism Spectrum Disorder

States With Limited Autism Mandates

The following states have limited autism mandates: District of Columbia, Georgia, Maryland, Oklahoma, and Tennessee.

District of Columbia

Requires a health benefit plan to provide coverage of habilitative services for children under the age of 21 years for a "congenital or genetic birth defect," including autism spectrum disorder. Habilitative services include speech therapy.

Citation: D.C. Code Ann. §31-3271

Georgia

Requires that an insurer that provides benefits for neurological disorders, whether under a group or individual accident and sickness contract, policy, or benefit plan shall not deny providing benefits for neurological disorders because of a diagnosis of autism.

Citation: Ga. Code Ann. §33-24-59.10

Maryland

Requires insurers and nonprofit health service plans and health maintenance organizations to provide coverage for habilitative services to children under the age of 19 years coverage who have a congenital or genetic birth defect (including autism).

Habilitative services include occupational therapy, physical therapy, and speech therapy.

Citation: MD Insurance Code Ann §15-835

Oklahoma

Requires all individual and group health insurance policies that provide medical and surgical benefits to provide the same coverage and benefits to any individual under the age of eighteen (18) years who has been diagnosed with an autistic disorder as it would provide coverage and benefits to an individual under the age of eighteen (18) years who has not been diagnosed with an autistic disorder. Nothing in this section requires an insurer to provide any benefits for the diagnosis or treatment of any autistic disorder.

Note: Speech language services are not clearly defined in the statue, but may still apply.

Citation: Okla. Stat. tit. 36 §6060.20 as created by S.B. 2045 [RTF]

Tennessee

Requires a contract or policy of an insurer that provides benefits for neurological disorders, to provide benefits and coverage for treatment of autism spectrum disorders that are at least as comprehensive as those provided for other neurological disorders. These benefits and coverage for treatment shall be provided to any person less than twelve (12) years of age.

Note: Speech language services are not clearly defined in the statue, but may still apply.

Citation: Tenn. Code Ann. §56-7-2367

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