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Regular Session, 2012
HOUSE BILL NO. 771
BY REPRESENTATIVES FOIL, BROSSETT, CONNICK, DOVE, HAZEL, HUVAL,
LAMBERT, LEGER, MACK, MORENO, PUGH, THIBAUT, THIERRY, AND
PATRICK WILLIAMS
INSURANCE/HEALTH: Provides relative to the mandate for coverage of diagnosis and
treatment of autism spectrum disorders
AN ACT1
To amend and reenact R.S. 22:1050(A)(1) and (D)(1) and to repeal R.S. 22:1050(H)(1),2
relative to the mandate for coverage of diagnosis and treatment of autism spectrum3
disorders; to raise the age for such coverage; to eliminate the limitation on lifetime4
benefits; to provide relative to applicability; and to provide for related matters.5
Be it enacted by the Legislature of Louisiana:6
Section 1. R.S. 22:1050(A)(1) and (D)(1) are hereby amended and reenacted to read7
as follows: 8
ยง1050. Requirement for coverage of diagnosis and treatment of autism spectrum9
disorders in individuals less than seventeen twenty-one years of age10
A.(1) Except as otherwise provided in Subsection H of this Section, any11
health coverage plan specified in Paragraph (G)(6) of this Section which is issued for12
delivery, delivered, renewed, or otherwise contracted for in this state on or after13
January 1, 2009, 2014, shall provide coverage for the diagnosis and treatment of14
autism spectrum disorders in individuals less than seventeen twenty-one years of age.15
* * *16
D.(1) Coverage under this Section shall be subject to a maximum benefit of17
thirty-six thousand dollars per year. and a lifetime maximum benefit of one hundred18
forty-four thousand dollars.19
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HB NO. 771
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Section 2. R.S. 22:1050(H)(1) is hereby repealed in its entirety.1
Section 3. To the extent that the provisions of this Act require benefits that exceed2
the essential health benefits specified under Section 1302(b) of the Patient Protection and3
Affordable Care Act, Public Law No. 111-148, as amended, the specific benefits that exceed4
the specified essential health benefits shall not be required of a health benefit plan when the5
plan is offered by a health care insurer in this state.6
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Foil HB No. 771
Abstract: Raises age for mandated health insurance coverage of autism spectrum disorders
from 17 to 21, eliminates lifetime maximum benefit of $144,000, provides relative to
supervision of treatment, and provides for applicability.
Proposed law changes present law relative to mandated health insurance coverage of autism
spectrum disorders as follows:
(1)Present law provides that such mandated coverage applies only to individuals less
than 17 years of age.
Proposed law raises the age for such mandated coverage so that it applies only to
individuals less than 21 years of age.
(2)Present law imposes an annual maximum benefit of $36,000 and a lifetime
maximum benefit of $144,000.
Proposed law eliminates the lifetime maximum benefit of $144,000.
(3)Present law requires coverage for the diagnosis and treatment of autism spectrum
disorders for any health plan issued for delivery, delivered, renewed, or contracted
for on or after Jan. 1, 2009.
(4)Present law provides that such mandated coverage shall not apply to any coverage
plan issued to an employer with 50 or fewer employees.
Proposed law deletes this present law exclusion.
Proposed law otherwise retains present law but changes the implementation date to Jan. 1,
2014.
(Amends R.S. 22:1050(A)(1) and (D)(1); Repeals R.S. 22:1050(H)(1)) HLS 12RS-389 ENGROSSED
HB NO. 771
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Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Insurance to the original
bill.
1. Provided that any provisions of proposed law that would exceed the essential
health benefits provided pursuant to the federal Patient Protection Affordable
Care Act shall not be required of a health benefit plan that is offered by a health
care insurer in this state.
2. Delayed the implementation date of proposed law from plans delivered, renewed,
or issued for delivery on or after Jan. 1, 2013 to those plans delivered, renewed,
or issued for delivery on or after Jan. 1, 2014.
3. Restored the definition of "treatment of autism spectrum disorders" used in
present law which requires that such treatment be supervised by a physician or
psychologist licensed in this state.
4. Restored exclusion of present law that such mandated coverage does not apply
to individually underwritten guaranteed renewable health insurance policies.