Arkansas State-Regulated Insurance Coverage

Arkansas requires meaningful coverage for autism under state-regulated plans.

Arkansas’ autism insurance bill, HB 1315, was enacted in 2011. The law became effective on October 1, 2011.

To which plan does the STATE autism insurance law apply?

  • Individual Grandfathered Plans - NO
  • Individual Non-Grandfathered Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Plans - YES

What services are covered by the law?

  • Diagnosis
  • Applied Behavior Analysis
  • Pharmacy Care
  • Psychiatric Care
  • Psychological Care
  • Therapeutic Care (Speech therapy, occupational therapy and physical therapy)
  • Equipment determined necessary to provide evidence-based treatment
  • Any medically necessary and evidence-based care (as determined by a licensed physician)

Does Arkansas have caps on ABA coverage?  

Yes. Coverage for ABA is limited to individuals with autism under 18 years of age and is subject to a $50,000 annual cap.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.  This includes quantitative treatment limits like age and dollar caps.  

Where can I find more details about the Arkansas autism insurance law?

 A copy of HB 1315 as enrolled can be found here.

If you have additional questions, please email advocacy@autismspeaks.org.

 

Last Updated: December 2019