Missouri Legislation

HB 904 amends chapter 191 of the RSMo by adding new sections to expand access to SUD treatment. Among other things, the bill defines MAT to include both pharmacologic and behavioral therapies and defines “urgent health care service” to include services for the treatment of SUD. The bill requires formularies at the minimum for purposes of an OTP, to include all current and new FDA-approved medications and formulations and to place such medications on the lowest tier. The bill mandates all MAT services be covered in a manner compliant with the Federal Parity Law and places certain limitations and prohibitions on the manner in which these benefits can be limited or subject to medical management processes such as step therapy or prior authorization. Additionally, the bill sets time limits in which insurers must notify beneficiaries concerning coverage determinations for MAT services from outpatient providers and urgent care services. The bill also sets network adequacy requirements and expectations. Furthermore, the bill establishes that the MO Health Net program shall cover MAT medications and services, place such medications on its preferred drug list for SUD treatment and, and such list shall include all current and new FDA approved MAT formulations and medications. Finally, the bill requires insurers and payers to submit to the commissioner reports that describe compliance with the provisions of the bill as well as with parity requirements using specified guidelines. The Department must publicly disclose the findings and conclusions reached by the insurers, perform parity market conduct examinations, and promote and establish a mechanism for providers and beneficiaries to submit complaints when insurers are suspected of being noncompliant.

Among many other things this bill tried to change the state insurance law by adding a section that would expand health insurance coverage for lower income residents of Missouri. One of the subsections of this section would have required insurance plans to cover behavioral health services and forbid plans from having treatment limitations or financial requirements if similar ones are not used for other medical services.

This bill is identical to SB 145 from the same legislative session. That bill will change the state insurance law to require insurance plans to cover eating disorder treatment. It does not take effect until 1/2017. That bill adds a number of things into the law, including:

• Requires insurance plans to cover all medically necessary treatment, which is listed as medical care, psychiatric care, psychological care, nutritional care, therapy, pharmacy care
• Includes precise definitions of the treatment listed above
• Specifies in the definitions of treatments that inpatient care, partial hospitalization, residential care, intensive outpatient care, and outpatient care are included
• Defines eating disorders as anorexia, bulimia, binge eating disorder, pica, rumination disorder, avoidant/restrictive food intake disorder, other specified feeding eating disorder, or “any other eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Forbids insurance plans from making medical necessity determinations based only on the patient’s weight
• Requires insurance plans to follow the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders when making medical necessity determinations

 This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover medical, psychiatric, psychological, and nutritional services for inpatient care, residential treatment, partial hospitalization, intensive outpatient care, and outpatient care if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Requires insurance plans to cover all medically necessary treatment, which is listed as medical care, psychiatric care, psychological care, nutritional care, therapy, pharmacy care
• Includes precise definitions of the treatment listed above
• Specifies in the definitions of treatments that inpatient care, partial hospitalization, residential care, intensive outpatient care, and outpatient care are included
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Forbids insurance plans from making medical necessity determinations based only on the patient’s weight
• Requires insurance plans to follow the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders when making medical necessity determinations
• Forbids any annual limits or lifetime limits for eating disorder coverage
• Requires the Missouri’s Department of Insurance, Financial Institutions, and Professional Registration to submit an annual report to the General Assembly that includes:
  • Total number of insured people with eating disorders
  • The cost of all treatment coverage for the previous year
  • The cost of all treatment coverage per month
  • The average cost of treatment coverage per patient
• Requires insurance plans to give the Department of Insurance, Financial Institutions, and Professional Registration the information needed to submit its annual report

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried to change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried to require the Joint Committee on Legislative Research 60 conduct an actuarial analysis of the cost impact to health plans of covering diagnosis and treatment of eating disorders, including anorexia nervosa, bulimia, binge eating, and eating disorders non-specified. The analysis would have assumed that coverage included residential treatment, nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services
• Requires the Department of Social Services and the Department of Health and Senior Services to provide treatment of eating disorders for people without insurance or who needs financial assistance to pay for treatment

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried to change sections of the state insurance law about parity (these particular sections were repealed in 2014). It would have required insurance plans that provide long-term disability benefits to comply with these sections of the law.

This bill tried to change the state insurance law about autism coverage so that licensed psychologists could supervise line therapists. Currently only board-certified behavior analysts can do this.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services
• Requires the Department of Social Services and the Department of Health and Senior Services to provide treatment of eating disorders for people without insurance or who needs financial assistance to pay for treatment
• Create the Missouri Eating Disorder Council

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services
• Requires the Department of Social Services and the Department of Health and Senior Services to provide treatment of eating disorders for people without insurance or who needs financial assistance to pay for treatment
• Create the Missouri Eating Disorder Council

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services
• Requires the Department of Social Services and the Department of Health and Senior Services to provide treatment of eating disorders for people without insurance or who needs financial assistance to pay for treatment
• Create the Missouri Eating Disorder Council

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• Requires coverage for providers who are supervised by certified behavior analyst
• Includes very detailed definitions autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified, Rett’s disorder, and childhood disintegrative disorder
• Allows insurance plans to review treatment plans once every three months
• Requires insurance plans to set annual maximum for applied behavior analysis at $36,000
• Does not require coverage for services performed by line therapist
• No language exempting insurance plans from covering care that is part of a Part C program

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• Requires coverage for providers who are supervised by certified behavior analyst
• Includes very detailed definitions autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified, Rett’s disorder, and childhood disintegrative disorder
• Allows insurance plans to review treatment plans once every three months
• Requires insurance plans to set annual maximum for applied behavior analysis at $36,000
• Does not require coverage for services performed by line therapist
• No language exempting insurance plans from covering care that is part of a Part C program

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the state insurance law so that health plans would be required to cover habilitative services for children under nineteen years of age with certain illnesses, including autism. This bill specifically states that it does not apply to any mental health or substance use disorders besides autism.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services
• Requires the Department of Social Services and the Department of Health and Senior Services to provide treatment of eating disorders for people without insurance or who needs financial assistance to pay for treatment

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried change the state insurance law to require insurance plans to cover eating disorder treatment. The bill attempted to add a number of things into the law, including:

• Require insurance plans to cover residential treatment if it is medically necessary, as defined by the American Psychiatric Association’s Practice Guidelines for the Treatment of Patients with Eating Disorders
• Forbid insurance plans from reducing or limiting reimbursement for clinicians because they provide eating disorder services
• Forbid insurance plans from offering monetary incentives to patients or providers so that they will agree to a lesser form of treatment than what is medically necessary
• Forbids insurance plans from refusing to offer coverage to a person because he or she had been diagnosed with an eating disorder
• Requires insurance plans to cover nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring
• Defines eating disorders as anorexia, bulimia, binge eating, eating disorders nonspecified, or “any other severe eating disorders” in the Diagnostic Statistical Manual of Mental Disorders (DSM).
• Requires insurance plans to make deductibles and copayments the same for eating disorder services as they are for other medical services
• Requires the Department of Social Services and the Department of Health and Senior Services to provide treatment of eating disorders for people without insurance or who needs financial assistance to pay for treatment

This bill is similar to other bills from this and other legislative sessions about insurance coverage for eating disorders.

This bill tried to change the sections of the insurance law about parity. This bill tried to repeal all but one of the various sections about behavioral health coverage and consolidate everything into one section that would also address autism coverage. Some of the sections of the law it tried to repeal were subsequently repealed by other legislation.
Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about mental health and substance use disorder coverage and the ways the parts about autism coverage are different than what is currently in place:

• Add to the law many definitions of various treatments, providers, facilities, insurance practices
• Require insurance plans to cover applied behavior analysis through age 20
• Require insurance plans to set annual maximum for applied behavior analysis at $72,000
• Specifically states that applied behavior analysis is not an experimental treatment
• Establish that a violation of this section of the law would be a level 2 violation of Missouri insurance law
• Does not attempt to apply the law to large employer self-insured plans, self-insured state employee plans, and self-insured school district plans
• No language exempting insurance plans from covering care that is part of a Part C program
• No exemption for small employer plans if they demonstrate that the effect of this law has raised their plan premiums by 2.5% in one year
• Does not exempt the Missouri HealthNet plan
• Does not have any specific language about line therapists for autism treatment
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• Require insurance plans to cover applied behavior analysis through age 20
• Require insurance plans to set annual maximum for applied behavior analysis at $72,000
• Specifically states that applied behavior analysis is not an experimental treatment
• Establish that a violation of this section of the law would be a level 2 violation of Missouri insurance law
• Does not attempt to apply the law to large employer self-insured plans, self-insured state employee plans, and self-insured school district plans
• Does not exempt the Missouri HealthNet plan
• Does not have any specific language about line therapists for autism treatment
• No language exempting insurance plans from covering care that is part of a Part C program
• No exemption for small employer plans if they demonstrate that the effect of this law has raised their plan premiums by 2.5% in one year
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• No language about line therapists
• All treatment and diagnosis must take place in Missouri
• $36,000 Annual maximum for applied behavior analysis
• Only covers applied behavior analysis through age 14
• No language that forbids insurance plans from using outpatient visit limits
• No language exempting insurance plans from covering care that is part of a Part C program
• Has an exemption for all plans if they demonstrate that the effects of this law has raised their plan premiums by 5% over 2 years
• Does not exempt the Missouri HealthNet plan
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• No language about line therapists
• Defines medically necessary care
• Requires insurance plans to cover applied behavior analysis through age 20
• Requires insurance plans to set annual maximum for applied behavior analysis at $72,000
• Does not attempt to apply the law to large employer self-insured plans, self-insured state employee plans, and self-insured school district plans
• No language exempting insurance plans from covering care that is part of a Part C program
• No exemption for small employer plans if they demonstrate that the effect of this law has raised their plan premiums by 2.5% in one year
• Does not exempt the Missouri HealthNet plan
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• No language about line therapists
• Explicitly forbids insurance plans from denying care only because it is educational or habilitative
• Requires insurance plans to set annual maximum for applied behavior analysis at $45,000
• No language exempting insurance plans from covering care that is part of a Part C program
• No exemption for small employer plans if they demonstrate that the effect of this law has raised their plan premiums by 2.5% in one year
• Does not exempt the Missouri HealthNet plan
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• No language about applied behavior analysis
• No language about age
• No specified annual maximum for applied behavior analysis or any form of treatment
• More general definition of providers qualified to perform autism services
• Does not define pharmacy care, habilitative care, psychiatric care, psychological care, or therapeutic care
• Does not attempt to apply the law to large employer self-insured plans, self-insured state employee plans, and self-insured school district plans
• Does not exempt the Missouri HealthNet plan
• Does not have any specific language about line therapists for autism treatment
• No language exempting insurance plans from covering care that is part of a Part C program
• No exemption for small employer plans if they demonstrate that the effect of this law has raised their plan premiums by 2.5% in one year
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• Does not include Rett’s Disorder or Childhood Disintegrative Disorder in definition of autism spectrum disorder
• Requires insurance plans to cover applied behavior analysis through age 20
• Requires insurance plans to set annual maximum for applied behavior analysis at $75,000
• Does not list as many forms of treatment in its description of accepted treatments
• Makes coverage optional for small employer plans
• Does not attempt to apply the law to large employer self-insured plans, self-insured state employee plans, and self-insured school district plans
• Does not exempt the Missouri HealthNet plan
• Does not have any specific language about line therapists for autism treatment
• No language exempting insurance plans from covering care that is part of a Part C program
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

This bill tried to change a section of the insurance law so that it would also require insurance plans to cover autism services. Much of what is in this bill about autism coverage is similar to what is in the current section of the insurance law on autism coverage (summarized at the bottom of this page). Here are the ways this bill tried to change the law about autism coverage that are different than what is currently in the law:

• Does not include Rett’s Disorder or Childhood Disintegrative Disorder in definition of autism spectrum disorder
• Requires insurance plans to cover general autism treatment through age 15 (not just applied behavior analysis )
• Requires insurance plans to set annual maximum of $50,000 for behavioral therapy (does not specifically mention applied behavior analysis anywhere in the bill)
• Does not list as many forms of treatment in its description of accepted treatments
• Does not attempt to apply the law to large employer self-insured plans, self-insured state employee plans, and self-insured school district plans
• Does not exempt the Missouri HealthNet plan
• Does not have any specific language about line therapists for autism treatment
• No language exempting insurance plans from covering care that is part of a Part C program
• Does not require the Department of Insurance, Financial Institutions and Professional Registration to submit a report to the General Assembly about the costs of implementation

This bill is similar to different bills about autism coverage from this and other legislative sessions. It is also similar to bills HB 1311 and HB 1341 from the 2010 legislative session, which were signed into law.

Among other things, this bill changed a section of the state insurance law about parity so that insurance plans are required to cover mental health services provided by a licensed marital and family therapist. The part of the bill relevant to parity is identical to HB 326 from the same legislative session, which was signed into law and is detailed above.