Removes the age restriction for benefits coverage/requires, after 1/1/26, for policies issued or renewed include coverage for reimbursement for provider services at a rate equal to, or greater than, Medicaid establishments of EOHHS.
If enacted, H5624 would significantly alter the landscape of insurance coverage for autism treatment in Rhode Island. By removing the age cap on benefits, the bill ensures that those in need of ongoing support and treatment can receive necessary services regardless of age. Additionally, by stipulating minimum reimbursement rates for ABA services, the bill aims to improve access to care and ensure that providers are adequately compensated. This is likely to enhance the quality and availability of autism-related healthcare services across the state, benefitting families and individuals affected by autism.
House Bill 5624, introduced in Rhode Island, seeks to amend existing laws regarding health insurance coverage for autism spectrum disorders. The bill's primary objective is to eliminate age restrictions on benefits provision, allowing coverage to continue for individuals with autism spectrum disorders beyond the current limit of age fifteen. Furthermore, it mandates that health insurance plans issued or renewed after January 1, 2026, must include reimbursement for applied behavior analysis (ABA) services, a critical treatment approach for autism, at rates equal to or greater than the prevailing integrated state Medicaid rate as established by the executive office of health and human services.
While the bill has garnered support from many advocacy groups and families seeking improved services for autism treatment, it may face scrutiny regarding its implications on insurance providers. Concerns could arise regarding the financial burdens on health insurance companies, particularly regarding mandated coverage without equivalent adjustments in premium rates. As a result, stakeholders may debate the sustainability of this mandate in the long term, weighing its beneficial effects on access to autism care against potential increases in healthcare costs.