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LB 505: Provide requirements for insurance coverage of Autism spectrum disorders (ASD)

As introduced: LB 505 requires insurance plans in this State (except disease-specific and self-funded employee plans) to provide coverage of behavioral health treatment administered by a board certified behavior analyst or licensed psychologist for the purpose screening for, diagnosing and treating autism. Required coverage amounts are as follows:

• A maximum of $70,000 per year for the first 3 years of treatment.

• A maximum of $20,000 per year for the remaining years of treatment until the patient is 21 years old.

For plans purchased on the Affordable Healthcare Act Exchange, these benefits shall not exceed those prescribed in such Exchange plan. In addition, a small employer with a group health plan may receive a waiver from such requirements if he/she can demonstrate to the Director of Insurance that such requirements have resulted in a 2.5% increase in the policy’s costs over a calendar year.

Introducing Senator(s): Coash (priority); Janssen; McGill; Ashford; Conrad; Bolz; Smith; Karpisek

Committee: Banking, Commerce and Insurance

Committee Hearing Date: February 26, 2013

Current Status: Not voted out of committee

Estimated Fiscal Impact: There are two aspects to this fiscal note. First, for our health plan it is difficult to provide a specific cost. The range of cost is dependent on the severity of each child’s form of autism. Based on our discussions with our Plan administrator we estimate the range to be from $480,000 to $970,000.

The second aspect will be the impact of additional insurance funding making these services in higher demand for UNMC. This will be offset for UNMC by the payments for the services provided.

Voices for Children’s Position: Support (see our testimony)

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