Bill > HB4740

This bill modifies Michigan insurance law to enhance coverage requirements for individuals with autism spectrum disorders (ASD). The bill mandates that health insurers cannot deny, limit, or terminate coverage based on an ASD diagnosis, and removes previous age-based annual benefit caps for treatment. Insurers are prohibited from imposing financial limitations on ASD treatments that would not apply to other physical illnesses. The bill defines ASD as including autistic disorder, Asperger's disorder, and pervasive developmental disorder, and specifies that coverage must include evidence-based treatments such as behavioral health treatment, pharmacy care, psychiatric care, psychological care, and therapeutic care. Insurers can request treatment reviews and require specific diagnostic assessments like the autism diagnostic observation schedule, but cannot unreasonably restrict access to care. The bill ensures that individuals with ASD receive comprehensive, medically necessary treatments across various care types, with provisions allowing insurers to use standard managed care practices to control costs while maintaining quality of care. Notably, the bill applies to most health insurance policies but excludes short-term policies and does not require coverage under multiple policies for the same individual.

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https://legislature.mi.gov/Bills/Bill?ObjectName=2025-HB-4740