Assembly Bill No. 1977 Health Care Coverage- Behavioral Diagnoses (Introduced on January 30, 2024)
This bill was introduced by Assembly Member Ta on January 30, 2024. This bill, effective January 1, 2025, would prohibit health care service plan contracts or health insurance policies issued, amended, or renewed from requiring individuals previously diagnosed with pervasive developmental disorder or autism to undergo reevaluation or receive a new behavioral diagnosis to maintain coverage for behavioral health treatment. It mandates that every health care service plan contract providing hospital, medical, or surgical coverage must also cover behavioral health treatment for these conditions. Additionally, such plans must maintain an adequate network including qualified autism service providers employing professionals or paraprofessionals who administer behavioral health treatment. While plans can selectively contract within these requirements, qualified autism service providers are responsible for describing patients' behavioral health impairments, designing intervention plans, using evidence-based practices, and discontinuing intensive behavioral intervention services when treatment goals are achieved or no longer appropriate.