Indiana § 27-13-7-14.7 Coverage for autism spectrum disorders

Indiana Statutes

§ 27-13-7-14.7 — Coverage for autism spectrum disorders

Indiana § 27-13-7-14.7

Title 27INSURANCE

Art. 13HEALTH MAINTENANCE ORGANIZATIONS

Ch. 7Requirements for Group Contracts, Individual Contracts,

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Bluebook

Ind. Code § 27-13-7-14.7 (2026).

Text

7.

(a)As used in this section, "autism spectrum disorder" means a neurological condition, including Asperger's syndrome and autism, as defined in the Diagnostic and Statistical Manual of Mental Disorders.

(b)A group contract with a health maintenance organization that provides basic health care services must provide services for the treatment of an autism spectrum disorder of an enrollee. Services provided to an enrollee under this subsection are limited to services that are prescribed by the enrollee's treating physician in accordance with a treatment plan. A health maintenance organization may not deny or refuse to provide services to, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage under a group contract to services to an individual solely because th

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7. (a) As used in this section, "autism
spectrum disorder" means a neurological condition, including
Asperger's syndrome and autism, as defined in the Diagnostic and
Statistical Manual of Mental Disorders.
(b) A group contract with a health maintenance organization that
provides basic health care services must provide services for the
treatment of an autism spectrum disorder of an enrollee. Services
provided to an enrollee under this subsection are limited to services
that are prescribed by the enrollee's treating physician in accordance
with a treatment plan. A health maintenance organization may not deny
or refuse to provide services to, or refuse to renew, refuse to reissue, or
otherwise terminate or restrict coverage under a group contract to
services to an individual solely because the individual is diagnosed
with an autism spectrum disorder.
(c) The services required under subsection (b) may not be subject
to dollar limits, deductibles, copayments, or coinsurance provisions
that are less favorable to an enrollee than the dollar limits, deductibles,
copayments, or coinsurance provisions that apply to physical illness
generally under the contract with the health maintenance organization.
(d) A health maintenance organization that enters into an individual
contract that provides basic health care services must offer to provide
services for the treatment of an autism spectrum disorder of an
enrollee. Services provided to an enrollee under this subsection are
limited to services that are prescribed by the enrollee's treating
physician in accordance with a treatment plan. A health maintenance
organization may not deny or refuse to provide services to, or refuse to
renew, refuse to reissue, or otherwise terminate or restrict coverage
under an individual contract to services to an individual solely because
the individual is diagnosed with an autism spectrum disorder.
(e) The services that must be offered under subsection (d) may not
be subject to dollar limits, deductibles, copayments, or coinsurance
provisions that are less favorable to an enrollee than the dollar limits,
deductibles, copayments, or coinsurance provisions that apply to
physical illness generally under the contract with the health
maintenance organization.