§ 6060.21. Screening, diagnosis and treatment of autism spectrum disorder
Oklahoma Statutes AnnotatedTitle 36. InsuranceEffective: November 1, 2022
Effective: November 1, 2022
36 Okl.St.Ann. § 6060.21
§ 6060.21. Screening, diagnosis and treatment of autism spectrum disorder
A. For all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan shall provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals. No insurer shall 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.
C. Coverage under this section shall not be subject to dollar limits, deductibles or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles or coinsurance provisions that apply to substantially all medical and surgical benefits under the health benefit plan.
F. Except for inpatient services, if an insured is receiving treatment for an autism spectrum disorder, an insurer shall have the right to review the treatment plan annually, unless the insurer and the insured's treating physician or psychologist agree that a more frequent review is necessary. Any such agreement regarding the right to review a treatment plan more frequently shall apply only to a particular insured being treated for an autism spectrum disorder and shall not apply to all individuals being treated for autism spectrum disorder by a physician or psychologist. The cost of obtaining any review or treatment plan shall be borne by the insurer.
1. “Applied behavior analysis” means the design, implementation and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior including the use of direct observation, measurement and functional analysis of the relationship between environment and behavior;
11. “Treatment for autism spectrum disorder” means evidence-based care and related equipment prescribed or ordered for an individual diagnosed with an autism spectrum disorder by a licensed physician or a licensed doctoral-level psychologist who determines the care to be medically necessary including, but not limited to:
Credits
Laws 2016, c. 230, § 1, eff. Nov. 1, 2016; Laws 2019, c. 437, § 2, eff. Nov. 1, 2019; Laws 2022, c. 154, § 8, eff. Nov. 1, 2022.
36 Okl. St. Ann. § 6060.21, OK ST T. 36 § 6060.21
Current with emergency effective legislation through Chapter 257 of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
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