Mississippi Legislature Mandates Autism Coverage via HB 885, Codified §83-9-26

The Mississippi Insurance Department (MID) is charged with enforcing all laws that apply to the business of insurance in the state of Mississippi, specifically those provisions found in Title 83 of the Mississippi Code. During the 2015 legislative session, the Mississippi legislature enacted HB 885, which mandates insurance coverage for various treatments for autism and autism spectrum disorders, in addition to establishing a licensure process for certain providers of autism services. This bill has since been codified under Miss. Code Ann. §83-9-26 which states in part: “Except as otherwise provided herein, a health insurance policy shall provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. To the extent that the screening, diagnosis, and treatment of autism spectrum disorder are not already covered by a health insurance policy, coverage under this section will be included in health insurance policies that are delivered, executed, issued, amended, adjusted, or renewed in this state, or outside this state if insuring residents of this state, on or after January 1, 2016. No insurer can terminate coverage, or refuse to deliver, execute, issue, amend, adjust, or renew coverage to an individual solely because the individual is diagnosed with or has received treatment for an autism spectrum disorder.” If you have questions about the effect this law will have on your health insurance policy please refer to the materials below. If you have questions about your coverage or if you feel your rights are being violated, please contact us. Consumer representatives are available between the hours of 8:00 am and 5:00 pm central time at 1-833-488-6472 or via email at: consumer@mid.ms.gov . The Mississippi Insurance Department conducted a survey of the major fully insured health plans in Mississippi asking several key questions regarding billing and other matters related to benefits for treatment of Autism Spectrum Disorder. Below is a list of survey responses. The following companies have voluntarily removed all age restrictions for Applied Behavior Analysis Treatment. (For additional information please contact your insurance company to confirm that your specific plan offers ABA therapy.) What are the requirements under the law? The law states that a health insurance policy shall provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. To the extent that the screening, diagnosis, and treatment of autism spectrum disorder are not already covered by a health insurance policy, coverage under this section will be included in health insurance policies that are delivered, executed, issued, amended, adjusted, or renewed in this state, or outside this state if insuring residents of this state, on or after January 1, 2016. No insurer can terminate coverage, or refuse to deliver, execute, issue, amend, adjust, or renew coverage to an individual solely because the individual is diagnosed with or has received treatment for an autism spectrum disorder. Does the law apply only to autism? No. The new law requires coverage for any of the pervasive developmental disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (“DSM”). Which insurance plans are affected? The autism coverage mandate applies to: What treatments are required under this law? The new law requires carriers to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Treatment of ASD is defined broadly and includes all of the following: 1. Behavioral health treatment includes applied behavior analysis (“ABA”) therapy. 4. Psychological care 5. Therapeutic care – includes services provided by licensed speech-language pathologists, occupational therapists, or physical therapists as covered by the health insurance policy The law does not create a new mandate for plans to begin covering these services, but if a plan d