Plain English Breakdown
The official summary states no reimbursement is required for a 'specified reason,' but does not explicitly state what that specific reason is within the provided text.
Behavioral Health Treatment Plans
AB-2233 stops health plans from limiting how patients use their approved therapy hours for autism or pervasive developmental disorders within a six-month period.
What This Bill Does
- Prohibits health care service plans and insurers from restricting the use of authorized treatment hours during a six-month authorization period.
- Requires that all authorized hours remain available to be used at any time throughout the full six months if they follow clinical guidelines.
- Mandates that the use of these hours must match the approved treatment plan and be recorded in progress reports.
Who It Names or Affects
- Health care service plans regulated by the Department of Managed Health Care.
- Health insurers regulated by the Department of Insurance.
- Patients receiving behavioral health treatment for pervasive developmental disorder or autism.
Terms To Know
- Authorization period
- The six-month time frame during which a specific amount of therapy hours is approved by the insurance plan.
- Pervasive developmental disorder
- A condition covered under existing law alongside autism that requires behavioral health treatment plans reviewed every 6 months.
Limits and Unknowns
- The bill does not specify the exact effective date for when these rules begin.
- The text states no state reimbursement is required but only mentions it is for a 'specified reason' without detailing that reason in this summary.
- The law applies only to treatment hours that are already authorized and documented, not to new requests for more hours.