Relating to health benefit plan coverage for certain treatments prescribed for autism spectrum disorder.
Impact
The legislation is set to take effect on September 1, 2025, and will apply to health benefit plans that are delivered or renewed after January 1, 2026. This ensures that individuals diagnosed with ASD will have access to a wider range of therapeutic options that are medically recognized, potentially leading to improved outcomes for affected individuals. It addresses gaps in coverage that have historically left many families with insufficient resources to treat ASD effectively.
Summary
Senate Bill 1678 aims to enhance health benefit plan coverage for treatments prescribed for autism spectrum disorder (ASD). The bill seeks to amend existing sections of the Insurance Code to include broader definitions of 'generally recognized services' that may be covered under health plans. Notably, the bill adds treatments like developmental relationship-based interventions and nutritional supplements specifically for ASD management, aligning health benefit plans more closely with modern treatment practices.
Contention
While the bill is generally viewed favorably by advocates for autism treatment and healthcare access, it may face scrutiny regarding the financial impact on insurance providers. Concerns could arise over the potential increase in costs associated with covering a wider range of services, particularly for small insurers. Additionally, varying interpretations of what constitutes a 'generally recognized service' could lead to disputes between providers and insurers, complicating the implementation of the new provisions.
Texas Constitutional Statutes Affected
Insurance Code
Chapter 1355. Benefits For Certain Mental Disorders