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STATE OF IOWA
KIM REYNOLDS
GOVERNOR
June 11, 2025
The Honorable Paul Pate
Secretary of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretary,
I hereby transmit:
House File 330, an Act relating to insurance coverage for covered individuals for the
treatment of autism spectrum disorder and including applicability provisions.
The above House File is hereby approved on this date.
Sincerely,
Kin•yno
Governor of Iowa
cc: Secretary of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 WWW.GOVERNOR.IOWA.GOV
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House File 330
AN ACT
RELATING TO INSURANCE COVERAGE FOR COVERED INDIVIDUALS FOR
THE TREATMENT OF AUTISM SPECTRUM DISORDER AND INCLUDING
APPLICABILITY PROVISIONS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
Section 1. Section 514C.22, subsection 3, paragraph g, Code
2025, is amended to read as follows:
g. Auti3tic disorders Autism spectrum disorder.
Sec. 2. Section 514C.22, subsection 4, Code 2025, is amended
to read as follows:
4. The commi3sioner, by rule, shall define definitions
of the biologically based mental illnesses identified in
subsection 3. Definition3 cstabliekhed by the eerR..._...._......_
shall be consistent with definitions provided in the most
recent edition of the American psychiatric association 's
diagnostic and statistical manual of mental disorders, as such
definitions may be amended from time to time. The eeffimissieeneer
may adopt the definitions provided in such manual by reference.
Sec. 3. Section 514C.22, subsection 7, Code 2025, is amended
by adding the following new paragraph:
NEW PARAGRAPH. c. Notwithstanding paragraphs „ a„ and b - ,
a group policy, contract, or plan covered under this section
shall not impose an aggregate annual or lifetime limit on
biologically based mental illness coverage benefits for autism
spectrum disorder.
House File 330, p. 2
Sec. 4. Section 514C.22, subsection 8, unnumbered paragraph
1, Code 2025, is amended to read as follows:
A group policy, contract, or plan covered under this
section shall at a minimum allow for thirty inpatient days
and fifty-two outpatient visits annually, and shall not
limit the number of outpatient visits a covered individual
may have with a practitioner for applied behavior analysis
under section 514C.31, or with an autism service provider for
treatment of autism spectrum disorder under section 514C.28.
The policy, contract, or plan may also include deductibles,
coinsurance, or copayments, provided the amounts and extent
of such deductibles, coinsurance, or copayments applicable to
other health, medical, or surgical services coverage under the
policy, contract, or plan are the same. It is not a violation
of this section if the policy, contract, or plan excludes
entirely from coverage benefits for the cost of providing the
following:
Sec. 5. Section 514C.28, subsections 1, 3, and 5, Code 2025,
are amended to read as follows:
1. Notwithstanding the uniformity of treatment requirements
of section 514C.6, a group plan established pursuant to chapter
509A for employees of the state providing for third- party
payment or prepayment of health, medical, and surgical coverage
benefits shall provide coverage benefits to covered individuals
under twenty-one y ar3 of age for the diagnostic assessment
of autism spectrum disorder and for the treatment of autism
spectrum disorder.
3. Coverage -i-s required pursuant to this section in a
maximum benefit amount of not more than thirty six thousand
dollar3 per year but shall not be subject to any limits on
the number of visits to a covered individual may have with
an autism service provider for treatment of autism spectrum
disorder. The eemmissiener shall, en or befere April 1 of
each calendar year, publish an adjustment to the maximum
benefit required equal te the tage change in the United
States department of labor consumer price index for all urban
maximum benefit Shall be applicable to group policic3,
contracts, or plans subject to this section that are i33ucd
House File 330, p. 3
or renewed on or after January 1 of the following alendar
year. Payments made- under a group plan subject to this section
on behalf of a covered individual for treatment of a health
maxims benefit cwtab1i^shed--under thrs—subseetion
5. Coverage required by this section shall be provided
in coordination with coverage required for the treatment of
auti3tic disorders autism spectrum disorder pursuant to section
514C.22.
Sec. 6. Section 514C.28, subsection 2, paragraph c, Code
2025, is amended to read as follows:
C, "Autism spectrum disorder - means a mental health
eenditien — that— rrn_eto the diagno3tic criteria for such disorder
otatiotical manual of mental disordero a3 publi3hed by the
Ameri an p3ychiatric association the same as defined in section
514C.22, subsection 4.
Sec. 7. Section 514C.31, subsection 1, unnumbered paragraph
1, Code 2025, is amended to read as follows:
Notwithstanding the uniformity of treatment requirements of
section 514C.6, a group policy, contract, or plan providing
for third- party payment or prepayment of health, medical, and
surgical coverage benefits shall provide coverage benefits for
applied behavior analysis provided by a practitioner to covered
individuals under nineteen y ar3 of age for the treatment of
autism spectrum disorder pursuant to a treatment plan if the
policy, contract, or plan is either of the following:
Sec. B. Section 514C.31, subsection 3, Code 2025, is amended
by striking the subsection.
Sec. 9. Section 514C.31, subsections 4 and 5, Code 2025, are
amended to read as follows:
4. Coverage required pursuant to this section may be
subject to dollar limits, deductibles, copayments, or
coinsurance provisions that apply to other medical and surgical
services under the policy, contract, or plan, subject to the
requirements of 3ubseetion 3.
5. Coverage required pursuant to this section may be
subject to care management provisions of the applicable
House File 330, p. 4
policy, contract, or plan, including prior authorization—, and
prior approval, and limits on the number of visits a covered
individual may make for applied behavior analysi3.
Sec. 10. APPLICABILITY.
1. The sections of this Act amending section 514C.22 apply
to third- party payment provider policies, contracts, and plans
as specified in section 514C.22 that are delivered, issued
for delivery, continued, or renewed in this state on or after
January 1, 2026,
2. The sections of this Act amending section 514C.28 apply
to a group plan established pursuant to chapter 509A for
employees of the state that are delivered, issued for delivery,
continued, or renewed in this state on or after January 1,
2026.
3. The sections of this Act amending section 514C.31
apply to third- party provider payment contracts, policies, or
plans specified in section 514C.31, subsection 1, paragraph
" a", or to plans established pursuant to chapter 509A for
public employees other than employees of the state, that are
delivered, issued for delivery, continued, or renewed in this
state on or after January 1, 2026.
n
PAT GRASSL
Speaker of"the House
AMY SINCF:âAIR
r
President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 330, Ninety-first General Assembly.
Illk" llp, « 19jon
Approved I• 2025
MEDIAN NELSON
Ch-ef Clerk o-- the House
r KIM RBYNJDLDS
Governor