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 | * The following article was archived on 09/30/2010.
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Reminder: Mandated coverage for autism spectrum disorders (PA Only)
Posted: 08/07/2009 | |
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| On July 3, 2008, the Commonwealth of Pennsylvania passed a law that requires health insurers to cover the diagnosis and treatment of autism spectrum disorders (ASD) for members under 21 enrolled in commercial groups with 51 or more employees. ASD includes autistic disorder, Asperger’s Syndrome, Rett Syndrome, childhood disintegration disorder, and pervasive development disorder. Coverage for ASD in accordance with this mandate was effective July 1, 2009. We began to include coverage for eligible new members who begin coverage on or after July 1, 2009. We will also apply this coverage over the next year to eligible existing members on their contract anniversary date. Benefits will be provided for services set forth in a treatment plan, which we may request and review for approval.
For more detailed information about ASD coverage for eligible Pennsylvania group members, refer to the June issue of Partners in Health Update. You can also refer to Policy #07.03.07c: Evaluation and Management of Autistic Spectrum Disorders (ASD).
*This article was featured in the August 2009 edition of Partners in Health Update.
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