Senate Bill No. 321
(By Senators Kessler (Acting President), Wells, Jenkins, Edgell,
Miller, Wills and Klempa)
____________
[Introduced January 27, 2011; referred to the Committee on Health
and Human Resources; and then to the Committee on Finance.]
____________
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new section, designated §33-15-22; to amend
said code by adding thereto a new section, designated §33-16-
18; and to amend said code by adding thereto a new section,
designated §33-16D-17, all relating to requiring health
insurers to provide full coverage for the prevention, early
detection, diagnosis and treatment of autism spectrum
disorder.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new section, designated §33-15-22; that said
code be amended by adding thereto a new section, designated §33-16-
18; and that said code be amended by adding thereto a new section,
designated §33-16D-17, all to read as follows:
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-22. Autism spectrum disorder full coverage.
Every policy which provides coverage for hospital, surgical,
or medical care coverage shall include full coverage for the
prevention, early detection, diagnosis and treatment of autism
spectrum disorder, regardless of whether such prevention, early
detection, diagnosis or treatment methods are research based or
experimental. Each policy shall also provide full (in-state or in-
network) coverage for the prevention, early detection, diagnosis
and treatment of autism spectrum disorder even if the individual is
unable to receive a service, or treatment, within the State of West
Virginia and must receive this service, or treatment, from an out-
of-state provider. For purposes of this section, "autism spectrum
disorder" means a neurobiological condition that includes Autism,
ADD, ADHD, Asperger syndrome, Rett's syndrome, or pervasive
developmental disorder.
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-18. Autism spectrum disorder full coverage.
A group or blanket accident of health insurance policy or
issuing a group or blanket policy for delivery in this state which
provides coverage for hospital, surgical, or medical care coverage
shall include full coverage for the prevention, early detection,
diagnosis and treatment of autism spectrum disorder, regardless of
whether such prevention, early detection, diagnosis or treatment
methods are research based or experimental. Each policy shall also
provide full (in-state or in-network) coverage for the prevention, early detection, diagnosis and treatment of autism spectrum
disorder even if the individual is unable to receive a service, or
treatment, within the State of West Virginia and must receive this
service, or treatment, from an out-of-state provider. For purposes
of this section, "autism spectrum disorder" means a neurobiological
condition that includes Autism, ADD, ADHD, Asperger syndrome,
Rett's Syndrome, or pervasive developmental disorder.
ARTICLE 16D. MARKETING AND RATE PRACTICES FOR SMALL EMPLOYER
ACCIDENT AND SICKNESS INSURANCE POLICIES.
§33-16D-17. Autism spectrum disorder full coverage.
A medical expense indemnity corporation, a hospital service
corporation or a health service corporation which provides coverage
for hospital, surgical, or medical care coverage shall include full
coverage for the prevention, early detection, diagnosis and
treatment of autism spectrum disorder, regardless of whether such
prevention, early detection, diagnosis or treatment methods are
research based or experimental. Each corporation shall also
provide full (in-state or in-network) coverage for the prevention,
early detection, diagnosis and treatment of autism spectrum
disorder even if the individual is unable to receive a service, or
treatment, within the State of West Virginia and must receive this
service, or treatment, from an out-of-state provider. For purposes
of this section, "autism spectrum disorder" means a neurobiological
condition that includes Autism, ADD, ADHD, Asperger syndrome,
Rett's syndrome, or pervasive developmental disorder.
NOTE: The purpose of this bill is to require health insurers
to provide full coverage for the prevention, early detection,
diagnosis and treatment of autism spectrum disorder.
These sections are new; therefore, strike-throughs and
underscoring have been omitted.