Bill > HB813

This bill expands health insurance coverage for individuals with autism spectrum disorder (ASD) by updating the definition of ASD and removing previous age and coverage limitations. The bill broadens the definition of autism spectrum disorder to include both current diagnostic criteria from the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and diagnoses made under previous editions, ensuring a more comprehensive understanding of the condition. It eliminates the previous restriction that limited coverage only for children diagnosed before their 10th birthday, now requiring health benefit plans to provide coverage for ASD treatment from the date of diagnosis, regardless of the patient's age. Additionally, the bill removes the previous $36,000 annual cap on applied behavior analysis treatment and gives health benefit plans more flexibility in determining coverage. These changes will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, with the Act taking effect on September 1, 2025, thereby providing expanded and more inclusive autism treatment coverage for individuals in Texas.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB813