Bill > S522

This bill mandates that various types of insurance policies, including those from the Group Insurance Commission, individual and group accident and sickness insurance, nonprofit hospital service plans, medical service agreements, and health maintenance contracts, must provide coverage for the diagnosis and treatment of specific pervasive developmental disorders, such as autistic disorder and Asperger's disorder, as defined in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM IV). This coverage must be provided on a nondiscriminatory basis, meaning it cannot have limitations on dollar amounts or units of service that are less than those applied to physical conditions. The bill also requires coverage for children and adolescents under 19 whose pervasive developmental disorders significantly impact their functioning and social interactions, with provisions for continuing treatment beyond age 19 if a course of treatment is ongoing. Furthermore, it mandates medically necessary coverage for other pervasive developmental disorders and specifies that treatment should occur in the least restrictive clinically appropriate setting, with denials of service only permissible by licensed health professionals. The bill also clarifies that this coverage does not apply to services already provided by other state agencies or educational institutions.