Bill > SB562

This bill updates Texas insurance regulations regarding health benefit plan coverage for autism spectrum disorder (ASD) by expanding and clarifying the definition of ASD to include diagnoses from the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and previous editions, and removing age-based restrictions on treatment coverage. Specifically, the bill eliminates the previous limitation that required an ASD diagnosis to be made before a child's 10th birthday and removes the annual $36,000 cap on applied behavior analysis benefits. The bill also modifies language to indicate that health benefit plans may provide coverage rather than being strictly required to do so. These changes will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, giving insurance providers time to adapt to the new requirements. The bill takes effect on September 1, 2025, and aims to provide more comprehensive and flexible insurance coverage for individuals diagnosed with autism spectrum disorder.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB562