SB283 Alabama 2012 Session

Summary

Primary Sponsor

Cam Ward

Republican

Session

Regular Session 2012

Title

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

Summary

The bill requires Alabama health benefit plans to cover autism treatment for children nine years old and under, with specific services, limits, and plan requirements.

What This Bill Does

The bill mandates coverage for autism screening, diagnosis, and treatment for insured children age nine and under in certain policies issued to employers with 51 or more employees. It covers behavioral health treatment (including applied behavior analysis), pharmacy care, psychiatric, psychological, and therapeutic care when prescribed by a treating licensed professional and laid out in a treatment plan. It sets a $36,000 annual cap on behavioral therapy (adjusted annually by CPI), requires a detailed treatment plan with periodic updates, and prohibits denying ASD coverage solely because of the diagnosis; it applies to health maintenance organizations and related plans in Alabama.

Who It Affects

• Children with Autism Spectrum Disorder in Alabama who are nine years old or younger, who will receive mandated coverage for ASD screening, diagnosis, and treatment under applicable health plans.
• Health benefit plans, insurers, and employers with 51 or more employees in Alabama (and their HMOs) that issue or deliver policies to Alabama residents, which must offer and maintain ASD coverage and adhere to the caps, treatment-plan requirements, and non-discrimination rules.

Key Provisions

• Defines key terms including Autism Spectrum Disorder, Applied Behavior Analysis, Behavioral Health Treatment, and Treatment for Autism Spectrum Disorder.
• Requires health benefit plans to cover ASD screening, diagnosis, and treatment for insured individuals nine years of age or under in policies issued to employers with 51+ employees that are active at least 50% of the year.
• Covers services such as behavioral health treatment (including ABA), pharmacy care, psychiatric care, psychological care, and therapeutic care when prescribed by a treating licensed physician or psychologist and documented in a treatment plan.
• The treatment plan must include diagnosis, type of treatment, frequency and duration, goals, update schedule, and the treating professional’s signature; plans may request updates every six months.
• Prohibits denying or terminating coverage for ASD solely because of the diagnosis; ensures coverage is provided under the specified plans (including HMOs) and is subject to general plan exclusions and limitations.
• Behavioral therapy has a $36,000 per year cap, adjustable annually by the CPI starting one year after the act’s effective date.
• Effective date is October 1, 2012; the act amends sections relating to health care service plans and HMOs to implement these requirements.

AI-generated summary using openai/gpt-5-nano on Feb 25, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health