Advocacy Alert: HB 4506 -Autism Insurance Equity Bill

House Bill 4506 will be heard in the House Committee on Insurance Tues. April 18, 2023 at 8:00 AM.

Issue:

According to current Texas law, a person must receive their autism diagnosis prior to their 10th birthday to receive coverage for treatment of Autism Spectrum Disorder. In addition, there is an annual maximum cap of $36,000 per year for a person who meets coverage qualifications for applied behavior analysis (ABA) therapy. However, the Texas Insurance Code requires a health benefit plan to provide coverage for all generally recognized services prescribed in relation to autism spectrum disorder, including ABA and other therapies, in the treatment plan recommended by the physician. ABA treatment is included in the Mental Health Parity law, requiring that ABA services be covered if any other services are covered (HB 10). Finally, some policies require an Autism diagnosis re-evaluation every three years. These policies are overly burdensome and result in barriers that delay or prevent people with autism from receiving needed therapies and services. 

House Bill 4506 amends Texas Insurance Code to require that health benefit plans do the following:

• Limit the ability for health plans to force families to reevaluate or reassess the covered individual any more than once every 10 years. (Families should not have to regularly prove their child has Autism to continue services).
• Provide coverage for treatment of Autism Spectrum Disorder to an enrollee who is diagnosed with ASD from the date of diagnosis. (People who are diagnosed after the age of 10 can still benefit from therapies, so age cap should be removed).
• Honor the physician’s prescribed treatment plan regardless of an annual dollar amount limit 

Bill:

HB 4506 – Rep. Phillip Cortez.  Read the full bill text here.Read our information sheet with additional details and background here.

Specific Action Needed:

Ask the House Committee on Insurance: “Please vote in favor of HB 4506! People with Autism deserve insurance equity that will remove barriers and provide greater access to therapies!”

Who to Call/Email:

Please call or email members of the House Committee on Insurance using the “ask” above! It is important to note that our priority contacts are the Chair, Vice-Chair and Clerk:

Let us know if you were successful or if AST Advocacy staff need to do any follow-ups at 512-479-4199 Ext. 4 or advocacy@texasautismsociety.org.