Kansas Legislation

This bill tried to change the state insurance law so that insurance plans would have to cover telemedicine for mental health services. The bill would have required deductibles and coinsurance to be similar to those used for other medical services. The bill also would have required insurance plans to notify their enrollees that the plan would now cover telemedicine for mental health services.

1. Coverage for anyone under 19 years of age. The current law applies to children under 12
2. A $36,000 dollar annual maximum for applied behavior analysis for children under 7 and a $27,000 annual maximum for children age 7-18. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
3. Defines autism spectrum disorder as any pervasive developmental disorder or autism spectrum disorder that is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.

1. Coverage for anyone under 19 years of age. The current law applies to children under 12.
2. A $36,000 dollar annual maximum for children under 7 and a $27,000 annual maximum for applied behavior analysis for children age 7-18. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
3. Defines autism spectrum disorder as any pervasive developmental disorder or autism spectrum disorder that is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.
4. The Commissioner of the Insurance Department would collect data in 2016 and 2017 from insurance plans about the costs of covering autism and then calculate an autism premium rate

1. This bill only allows 520 hours for applied behavior analysis for all children under 9 and no coverage for applied behavior analysis for children 9 through 11. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
2. This bill does not have any language stating that the limits for applied behavior analysis can be exceeded if it is medically necessary. The current law does allow this.
3. This bill does not have language stating that a child who has already received a diagnosis of pervasive developmental disorder will still be covered even if criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) change and the child does not meet the new criteria. The current law does allow this.
4. This bill has specific language about reimbursement for line therapists. This language is not in the current law.
5. This bill does not allow reimbursement for any a Part C early intervention program as part of the Individuals with Disabilities Education Act (IDEA). It also does not allow reimbursement to a school district for applied behavior analysis. This is not in the current law.

1. Coverage for anyone under 19 years of age. The current law applies to children under 12.
2. A $36,000 dollar annual maximum for children under 7 and a $27,000 annual maximum for applied behavior analysis for children age 7-18. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
3. Defines autism spectrum disorder as any pervasive developmental disorder or autism spectrum disorder that is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.
4. Insurance plans are only allowed to review a child’s autism treatment plan once a year. The current law allows reviews once every 6 months.

1. Coverage for anyone under 19 years of age. The current law applies to children under 12.
2. A $36,000 dollar annual maximum for children under 7 and a $27,000 annual maximum for applied behavior analysis for children age 7-18. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
3. Defines autism spectrum disorder as any pervasive developmental disorder or autism spectrum disorder that is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.
4. There is a section that allows coverage for telehealth autism services. The current law does not include anything about telehealth.
5. Insurance plans are only allowed to review a child’s autism treatment plan once a year. The current law allows reviews once every 6 months.

1. Coverage for anyone under 19 years of age. The current law applies to children under 12.
2. It specifically exempts non-grandfathered small employer plans and non-grandfathered individual plans .
3. It allows for 40 hours a week of applied behavior analysis for everyone under 19 years of age (2080 hours a year). The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
4. Defines autism spectrum disorder as any pervasive developmental disorder or autism spectrum disorder that is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.
5. There is a section that allows coverage for telehealth autism services. The current law does not include anything about telehealth.

1. Coverage for anyone under 19 years of age. The current law applies to children under 12.
2. A $36,000 dollar annual maximum for children under 7 and a $27,000 annual maximum for applied behavior analysis for children age 7-18. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
3. Defines autism spectrum disorder as Autistic disorder, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.
4. The Commissioner of the Insurance Department would collect data in 2013 and 2014 from insurance plans about the costs of covering autism and then calculate an autism premium rate
5. This bill would have applied the law to Medicaid plans.
6. The Secretary of the Department of Social and Rehabilitation Services would have been required to file a report on how many people need autism coverage and how much it would cost to cover them as required by this bill.

1. It only would have required coverage for large employer plans . Small employer plans and individual plans would not have been required to cover autism services if the small employer or the individual did not want the coverage as part of the plan.
2. It would have required coverage through age 21. The current law only applies to children under age 12.
3. $75,000 annual maximum for applied behavior analysis for anyone through age 21. The current law has a 1300 hour limit for children under 5 and 420 hour limit for children under 12.
4. Defines autism spectrum disorder as Autistic disorder, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current law goes into much greater detail about which conditions are covered.
5. This defined “treatment for autism spectrum disorder as habilitative and rehabilitative care, pharmacy care, psychiatric care, psychological care, and therapeutic care. The current law does not define it in this level of detail.
6. Insurance plans would only be allowed to review a child’s treatment plan once a year. The current law allows reviews once every 6 months.
7. It would required insurance plans give parents the right to expedited appeals process , an expedited external review process , and the right to further appeal in a court. There is nothing in the current law about these or the appeals process in general.