Mississippi: Enacts Code 83-9-26 Autism Coverage Mandate

• Mississippi Code Ann. §83-9-26 mandates health insurance coverage for the screening, diagnosis, and treatment of autism spectrum disorder, effective January 1, 2016.
• The law, originating from HB 885, applies to policies issued or renewed in Mississippi or for its residents, prohibiting discrimination based on an autism diagnosis.
• Covered treatments include behavioral health (like ABA therapy), psychological care, and therapeutic services from licensed speech, occupational, or physical therapists.
• The Mississippi Insurance Department enforces these provisions and provides consumer assistance for questions or concerns regarding autism coverage, reachable by phone at 1-800-562-2957 or via email at consumer@mid.ms.gov.
• Some insurers have voluntarily removed age restrictions for Applied Behavior Analysis treatment, as noted in a MID survey.

The statute, Miss. Code Ann. §83-9-26, explicitly mandates that health insurance policies must provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder.

In a significant legislative move, Mississippi enacted a comprehensive mandate for health insurance coverage of autism spectrum disorder treatments, codified under Mississippi Code 83-9-26 autism coverage. This critical legislation originated as House Bill 885 during the 2015 legislative session, establishing a framework for insurers to cover various therapies and services for individuals diagnosed with autism. Beyond just mandating coverage, Mississippi HB 885 autism coverage also introduced a licensure process for specific providers offering autism services, aiming to ensure quality and accessibility of care across the state.

The Mississippi Insurance Department (MID) is the primary regulatory body tasked with enforcing all insurance-related statutes within the state, particularly those found in Title 83 of the Mississippi Code. This includes overseeing compliance with the autism spectrum disorder insurance Mississippi mandate. The MID plays a crucial role in ensuring that health insurance policies adhere to the requirements set forth by the law, protecting consumers and ensuring access to necessary treatments for autism spectrum disorder.

The statute, Miss. Code Ann. §83-9-26, explicitly mandates that health insurance policies must provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. This requirement applies to policies delivered, executed, issued, amended, adjusted, or renewed within Mississippi, or even outside the state if they insure Mississippi residents, with an effective date of January 1, 2016, or later. A key provision of this Mississippi health insurance autism mandate is its broad definition of autism spectrum disorder, which encompasses all pervasive developmental disorders as defined by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Furthermore, the law prohibits insurers from terminating coverage or refusing to deliver, execute, issue, amend, adjust, or renew a policy solely because an individual has been diagnosed with or has received treatment for an autism spectrum disorder. The required treatments under this mandate are extensive, including behavioral health treatment, such as ABA therapy insurance Mississippi, psychological care, and therapeutic care. Therapeutic care specifically covers services provided by licensed speech-language pathologists, occupational therapists, and physical therapists, provided these services are already covered by the health insurance policy.

The Mississippi Insurance Department autism division actively monitors compliance with these regulations. The MID conducted a survey of major fully insured health plans operating in Mississippi, inquiring about billing practices and other aspects related to benefits for autism spectrum disorder treatment. Notably, several companies have voluntarily eliminated all age restrictions for Applied Behavior Analysis (ABA) treatment, demonstrating a commitment beyond the statutory minimums in some cases.

Consumers who have questions about their coverage under Mississippi Code 83-9-26 autism coverage, or who believe their rights are being violated, are encouraged to contact the Mississippi Insurance Department. Consumer representatives are available to assist from 8:00 am to 5:00 pm Central Time, reachable by phone at 1-800-562-2957 or via email at consumer@mid.ms.gov. This direct line of communication underscores the state's commitment to ensuring the mandate is effectively implemented and that individuals receive the autism spectrum disorder insurance Mississippi coverage they are entitled to.

Lawyers and compliance officers in Mississippi must ensure health insurance policies comply with Miss. Code Ann. §83-9-26, which mandates coverage for autism spectrum disorder treatments, including ABA therapy, and prohibits discrimination based on diagnosis. This requires reviewing policy language for adherence to required coverage and the absence of unlawful age restrictions, particularly for plans issued or renewed after January 1, 2016.

Source: Original reporting via Mississippi Insurance Department