Indiana § 5-10-8-7.1 Coverage for autism spectrum disorder

Indiana Statutes

§ 5-10-8-7.1 — Coverage for autism spectrum disorder

Indiana § 5-10-8-7.1

Title 5STATE AND LOCAL ADMINISTRATION

Art. 10PUBLIC EMPLOYEE BENEFITS

Ch. 8Group Insurance for Public Employees

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Bluebook

Ind. Code § 5-10-8-7.1 (2026).

Text

1.

(a)As used in this section, "covered individual" means an individual who is:

(1)covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or

(2)entitled to health services under a contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter.

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

(c)A self-insurance program established under section 7(b) of this chapter to provide health care coverage must provide a covered individual with coverage for the

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1. (a) As used in this section, "covered
individual" means an individual who is:
(1) covered under a self-insurance program established under
section 7(b) of this chapter to provide group health coverage; or
(2) entitled to health services under a contract with a prepaid
health care delivery plan that is entered into or renewed under
section 7(c) of this chapter.
(b) As used in this section, "autism spectrum disorder" means a
neurological condition, including Asperger's syndrome and autism, as
defined in the most recent edition of the Diagnostic and Statistical
Manual of Mental Disorders of the American Psychiatric Association.
(c) A self-insurance program established under section 7(b) of this
chapter to provide health care coverage must provide a covered
individual with coverage for the treatment of an autism spectrum
disorder. Coverage provided under this section is limited to treatment
that is prescribed by the covered individual's treating physician in
accordance with a treatment plan. A self-insurance program may not
deny or refuse to issue coverage on, refuse to contract with, or refuse
to renew, refuse to reissue, or otherwise terminate or restrict coverage
on, an individual under an insurance policy or health plan solely
because the individual is diagnosed with an autism spectrum disorder.
(d) A contract with a prepaid health care delivery plan that is
entered into or renewed under section 7(c) of this chapter must provide
a covered individual with services for the treatment of an autism
spectrum disorder. Services provided under this section are limited to
treatment that is prescribed by the covered individual's treating
physician in accordance with a treatment plan. A prepaid health care
delivery plan may not deny or refuse to provide services to, or refuse
to renew, refuse to reissue, or otherwise terminate or restrict services
to, an individual solely because the individual is diagnosed with an
autism spectrum disorder.
(e) The coverage required by subsection (c) and services required
by subsection (d) may not be subject to dollar limits, deductibles,
copayments, or coinsurance provisions that are less favorable to a
covered individual than the dollar limits, deductibles, copayments, or
coinsurance provisions that apply to physical illness generally under
the self-insurance program or contract with a prepaid health care
delivery plan.