HB345 Alabama 2012 Session

Summary

Primary Sponsor

Laura HallRepresentative

Democrat

Co-Sponsors

Terri CollinsLynn GreerDan WilliamsApril WeaverEd HenryBecky NordgrenMac ButtramWayne JohnsonMike JonesPaul BeckmanK.L. BrownLawrence McAdoryBlaine GalliherPebblin W. WarrenMac McCutcheonVictor GastonMike BallJack WilliamsChad FincherBarry MaskHoward SanderfordPhil WilliamsGreg WrenMark Tuggle

Session

Regular Session 2012

Title

Health benefit plans, group insurance, coverage of autism spectrum disorder to age 18 under certain conditions, Secs. 10A-20-6.16, 27-21A-23 am'd

Summary

Requires Alabama health benefit plans to cover autism treatment for children 18 and under, with a defined treatment-plan process and a financial cap on behavioral therapy.

What This Bill Does

If enacted, health benefit plans would have to cover screening, diagnosis, and treatment of autism for insured individuals 18 or younger when prescribed by a treating licensed physician or psychologist under a treatment plan. Coverage includes behavioral health, pharmacy, psychiatric, psychological, and therapeutic care, with a $50,000 per-year cap on behavioral therapy that adjusts for inflation annually. Plans cannot deny coverage or terminate coverage solely because of an autism diagnosis, and cannot impose limits more restrictive than those for physical illnesses. A detailed treatment plan must be provided, including diagnosis, proposed treatment, frequency, duration, expected outcomes, and provider signature, with updates allowed no more than every six months unless more frequent review is agreed; self-funded plans may be exempt from these requirements.

Who It Affects

• Children and families dealing with autism (coverage for screening, diagnosis, and treatment up to age 18).
• Health insurers, HMOs, and employers offering health plans (subject to new coverage rules; self-funded plans may be exempt).

Key Provisions

• Requires health benefit plans to cover screening, diagnosis, and treatment of autism spectrum disorder for insured individuals 18 years old or younger when prescribed by the treating licensed physician or licensed psychologist under a treatment plan.
• Covers behavioral health treatment, pharmacy care, psychiatric care, psychological care, and therapeutic care.
• Behavioral therapy coverage is limited to a maximum of $50,000 per year, adjustable annually each January based on the Medical Care Component of CPI for All Urban Consumers.
• Plans cannot deny or terminate coverage solely because of an autism diagnosis, and cannot impose limits that are more restrictive than those for physical illness, except as otherwise allowed.
• A treatment plan must include diagnosis, proposed treatment by type, frequency, and duration; anticipated outcomes; planned update frequency; and the treating provider's signature.
• Plans may request updated treatment plans no more than every six months, unless both parties agree more frequent review is necessary.
• Self-funded plans or plans not insured by the state may be exempt from these coverage requirements.
• Coverage applies to policies issued or renewed in Alabama after October 1, 2012.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health