American Speech-Language-Hearing Association

State Insurance Mandates for Autism Spectrum Disorder

States with Mental Health Parity

The following state have a mental health parity law that may include autism spectrum disorder as a covered mental illness: Hawaii, Minnesota, Mississippi, Nebraska, North Carolina, North Dakota, Ohio, Utah, and Washington.

Hawaii

Requires insurers to include within their hospital and medical coverage the benefits for mental illness treatment services. Developmental disabilities do not in and of themselves constitute a mental disorder.

Citation: Haw. Rev. Stat. §431M-2.

Minnesota

Requires all group policies and all group subscriber contracts providing benefits for mental or nervous disorder treatments in a hospital to also provide coverage for treatment performed while enrollee is not in a hospital.

Also requires insurers who provide coverage of or reimbursement for inpatient hospital and medical expenses to provide health service for the treatment of emotionally disabled children in a residential treatment facility licensed by the commissioner of human services.

Citation: Minn. Stat. §62A.151; §62A-152.

Mississippi

Requires all group health insurance policies, plans or programs regulated by the State of Mississippi to provide covered benefits for the treatment of mental illness. Mental illness is defined as any psychiatric disease identified in the current edition of the International Classification of Diseases or the American Psychiatric Association Diagnostic and Statistical Manual.

Citation: Miss. Code Ann. §83-9-39.

Nebraska

Requires, that if a health insurance plan provides coverage for serious mental illness, it shall provide coverage by (a) by a mental health professional, (b) by a person authorized by the rules and regulations of the Department of Health and Human Services to provide treatment for mental illness, (c) in a mental health center, or (d) in any other health care facility licensed under the Health Care Facility Licensure Act that provides a program for the treatment of a mental health condition pursuant to a written plan. Mental health condition means any condition or disorder involving mental illness that falls under any of the diagnostic categories listed in the Mental Disorders Section of the International Classification of Disease.

Citation: Neb. Rev. Stat. §44-792.

North Carolina

Requires an insurer to provide in each group health benefit plan benefits for the necessary care and treatment of mental illnesses that are no less favorable than benefits for physical illness generally, including application of the same limits. Mental illnesses are as diagnosed and defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM IV, or a subsequent edition published by the American Psychiatric Association.

Citation: N.C. Gen. Stat. §58-3-220.

North Dakota

Requires an insurance company, nonprofit health service corporation, or health maintenance organization to deliver, issue, execute, or renew any health insurance policy or health service contract on a group or blanket or franchise or association basis to provide policy or contract provides benefits, of the same type offered under the policy or contract for other illnesses, for health services to any person covered under the policy or contract, for the diagnosis, evaluation, and treatment of mental disorder and other related illness.

Citation: N.D. Cent. Code §26.1-36-09 [PDF]

Ohio

Requires every policy of group sickness and accident insurance providing hospital, surgical, or medical expense coverage, and delivered, issued for delivery, or renewed in this state, and that provides coverage for mental or emotional disorders, shall provide benefits for services on an outpatient basis for each eligible person under the policy who resides in this state for mental or emotional disorders, or for evaluations, that are at least equal to five hundred fifty dollars in any calendar year or twelve-month period.

Citation: Ohio Rev. Code Ann. §3923.27; §3923.28; §3923.30.

Utah

Requires some limited coverage for catastrophic mental health conditions. Mental health conditions are defined as those listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The law specifies that specific developmental disorders are not covered when they are the primary reason for treatment.

Citation: Utah Code Ann. § 31A-22-625.

Washington

Requires each health insurance policy issued by the pool to provide coverage for mental health services. Mental health conditions are defined as those listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Citation: Wash. Rev. Code §48.41.220.

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