Health care coverage: autism.

Plain English Breakdown

The official source material does not specify whether related bills (AB 280, AB 951, AB 653, and SB 848) have been enacted or will be enacted last with this bill. Therefore, the exact nature of additional changes is uncertain.

Health Care Coverage for Autism

This law moves definitions related to autism service providers from the Health and Safety Code and Insurance Code to the Business and Professions Code, and makes technical changes.

What This Bill Does

• Moves definitions of 'qualified autism service provider,' 'qualified autism service professional,' and 'qualified autism service paraprofessional' from the Health and Safety Code and Insurance Code to the Business and Professions Code.

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

Terms To Know

Qualified Autism Service Provider

A person who provides treatment for autism and is licensed or certified to do so.

Technical Changes

Small changes made to improve the clarity or consistency of a law without changing its meaning.

Limits and Unknowns

• The exact details of additional changes depend on whether related bills are also enacted.
• This bill does not change the requirements for health care coverage for autism, only how those requirements are defined and organized in state laws.

Official Summary Text

SB 402, Valladares.
Health care coverage: autism.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or a health insurance policy to provide coverage for behavioral health treatment for pervasive developmental disorder or autism and defines “behavioral health treatment” to mean specified services and treatment programs, including treatment provided pursuant to a treatment plan that is prescribed by a qualified autism service provider and administered either by a qualified autism service provider or by a qualified autism service professional or qualified autism service paraprofessional. Existing law defines
“qualified autism service provider,” “qualified autism service professional,” and “qualified autism service paraprofessional” for those purposes. Those definitions are contained in the Health and Safety Code and the Insurance Code.
This bill would move those definitions to the Business and Professions Code. The bill would also make technical and conforming changes.
This bill would incorporate additional changes to Section 1367.27 of the Health and Safety Code and Section 10133.15 of the Insurance Code proposed by AB 280 to be operative only if this bill and AB 280 are enacted and this bill is enacted last.
This bill would incorporate additional changes to Section 1374.73 of the Health and Safety Code and Section 10144.51 of the
Insurance Code proposed by AB 951 to be operative only if this bill and AB 951 are enacted and this bill is enacted last.
This bill would incorporate additional changes to Section 11165.7 of the Penal Code proposed by AB 653 and SB 848, to be operative only if this bill and either or both of those bills are enacted and this bill is enacted last.

Current Bill Text

Download Bill PDF