Senate Bill 946
Not all insurers and health plans in California are subject to the bill. For those that are:
- Coverage must be available for treatment to "develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism"
- Treatment must be recommended by a licensed doctor or psychologist and provided under a treatment plan, which must be reviewed by the provider at least every six months
- Reimbursement must be made for the services of Board Certified Behavior Analysts, as well as the professionals and paraprofessionals whom they supervise
- Coverage for behavioral health treatment must be subject to no specific age limit or dollar cap
- The availability of insurance coverage does not reduce any obligation to provide services under an individualized education program or an individualized service plan
- Health plans and insurers must maintain an adequate network that includes qualified autism service providers