Tennessee Legislation

This bill would change the sections of the state insurance law about behavioral health coverage by doing the following:

• Specifies that plans must comply with all sections of federal law about parity and their implementing regulations
• Defines non-quantitative treatment limitations (NQTLs) identically to how they are defined the the final regulations of the Federal Parity Law
• Requires plans to use the criteria of the American Society of Addiction Medicine when making medical necessity determinations for substance use disorders
• Requires all insurance plans and subject to state jurisdiction and Medicaid managed care organizations to submit annual reports that demonstrate their compliance with the Federal Parity Law, including information that shows that NQTLs for behavioral health services are applied no more restrictively than those used for other medical services
• Requires the Department of Commerce and Insurance to monitor plans for compliance with the Federal Parity Law and submit annual reports describing how they are doing so

This bill would require all insurance plans and subject to state jurisdiction to submit annual reports that demonstrate their compliance with the Federal Parity Law, including information that shows that NQTLs for behavioral health services are applied no more restrictively than those used for other medical services.

This bill tries to change the section of state insurance law about autism so that autism includes autistic disorder, Asperger’s disorder, and pervasive development disorder. The bill also tries to require coverage for autism for children through age 15. Currently the law only requires coverage up through age 11. The bill also calls for annual maximum for medically necessary behavioral therapy services of $50,000 up to age 8 and an annual maximum of $25,000 from age 9 through age 15. This bill is nearly identical to HB 2105/SB 1789 from the 2009-2010 legislative session and HB 1137/SB 1298 from the 2013-2014 legislative session.

This bill tried to change the section of state insurance law about autism so that autism includes autistic disorder, asperger’s disorder, and pervasive development disorder. The bill also tried to require coverage for autism for children through age 15. Currently the law only requires coverage through age 11. The bill also called for annual maximum for medically necessary behavioral therapy services of $50,000 up to age 8 and an annual maximum of $25,000 from age 9 through age 15. This bill is nearly identical to HB 2105/SB 1789 from the 2009-2010 legislative session and HB 1017/SB 0916 from the 2015-2016 legislative session.

This bill tried to amend the section of state law that applies to services for autism (Title 56 Chapter 7 Part 2367). Among other terms, the bill changes the definition of autism spectrum disorder to the definition within the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The bill also requires that all health insurance policies cover screening, diagnosis, and treatment services for autism spectrum disorder.

This bill tried to change the section of state insurance law about autism so that insurance plans would be required to cover autism services for children through age 15. At the time and currently the law only requires coverage through age 11. The bill also tried to change the law so that insurance plans would have to cover an annual maximum of $50,000 for autism services that could be adjusted for inflation every year. At the time and now there is no language in the law about an annual maximum. Small employer plans were exempted in this bill.

This bill tried to change the section of state insurance law about autism so that insurance plans would be required to cover autism services for people through age 20. The law only requires coverage through age 11. The bill also tried to change the law so that insurance plans would have to cover an annual maximum of $36,000 for autism services that could be adjusted for inflation every year. Currently, there is no language in the law about an annual maximum.
It also would have expanded the definition of autism to specifically include autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified. The bill also included a thorough description of medically necessary care for autism and stated that for medical necessity reviews, insurance plans must use a medical professional with expertise in treating autism.

This bill tried to change the section of state insurance law about autism so that autism includes autistic disorder, asperger’s disorder, and pervasive development disorder. The bill also tried to require coverage for autism for children through age 15. Currently the law only requires coverage up through age 11. The bill also calls for annual maximum for medically necessary behavioral therapy services of $50,000 up to age 8 and an annual maximum of $25,000 from age 9 through age 15. This bill is nearly identical to HB 1017/SB 0916 from the 2015-2016 legislative session.

This bill tried to change the section of the state insurance law about autism. The only way this bill is significantly different than the other autism bills from this legislative session is that it would have prevented insurance plans from performing medical necessity review more than once every 6 months.

This bill tried to change the section of the state insurance law about autism. This bill only way this bill is significantly different than the other autism bills from this legislative session is that it would have prevented insurance plans from performing medical necessity review more than once every 6 months.