Arizona § 20-826.04 Subscription contracts; autism spectrum disorder; coverage; exceptions; definitions

Arizona Statutes

§ 20-826.04 — Subscription contracts; autism spectrum disorder; coverage; exceptions; definitions

Arizona § 20-826.04

Title 20Arizona Revised Statutes

Ch. 4PARTICULAR TYPES OF INSURERS

Art. 3Hospital, Medical, Dental and Optometric Service Corporations

This text of Arizona § 20-826.04 (Subscription contracts; autism spectrum disorder; coverage; exceptions; definitions) is published on Counsel Stack Legal Research, covering Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ariz. Rev. Stat. Ann. § 20-826.04 (2026).

Text

A.A hospital service corporation or medical service corporation shall not:

1.Exclude or deny coverage for a treatment or impose dollar limits, deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder. For the purposes of this paragraph, "treatment" includes diagnosis, assessment and services.

2.Exclude or deny coverage for medically necessary behavioral therapy services. To be eligible for coverage, behavioral therapy services shall be provided or supervised by a licensed or certified provider.

B.This section does not:

1.Apply to a subscription contract that is issued to an individual or a small employer.

2.Apply to limited benefit coverage as defined in section 20-1137.

3.Require coverage for services provided outside of this state. C.

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A. A hospital service corporation or medical service corporation shall not:

1. Exclude or deny coverage for a treatment or impose dollar limits, deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder. For the purposes of this paragraph, "treatment" includes diagnosis, assessment and services.

2. Exclude or deny coverage for medically necessary behavioral therapy services. To be eligible for coverage, behavioral therapy services shall be provided or supervised by a licensed or certified provider.

B. This section does not:

1. Apply to a subscription contract that is issued to an individual or a small employer.

2. Apply to limited benefit coverage as defined in section 20-1137.

3. Require coverage for services provided outside of this state.

C. The coverage required by this section is subject to all the terms and conditions of the subscription contract. This section does not prevent a corporation from imposing deductibles, coinsurance or other cost sharing in relation to the coverage required by this section.

D. For the purposes of this section:

1. "Autism spectrum disorder" means a pervasive, developmental disorder that meets the criteria for autism spectrum disorder as defined in the most recent edition of the diagnostic and statistical manual of mental disorders of the American psychiatric association.

2. "Behavioral therapy" means interactive therapies derived from evidence based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs and early intensive behavioral intervention.

3. "Small employer" has the same meaning prescribed in section 20-2301.