Written by Paul Smith Paul Smith

Published: 03 July 2017 03 July 2017

Effective January 1, 2014, requires a health care corporation group or nongroup certificate to provide coverage for the diagnosis of autism spectrum disorders and treatment of autism spectrum disorders. Treatment of autism spectrum disorders prescribed or ordered for an individual diagnosed with 1 of the autism spectrum disorders by a licensed physician or a licensed psychologist includes: (i) Behavioral health treatment; (ii) Pharmacy care; (iii) Psychiatric care; (iv) Psychological care; and (v) Therapeutic care (including services provided by a licensed or certified speech therapist, occupational therapist, physical therapist, or social worker.) Coverage for treatment of autism spectrum disorders may be limited to a member through 18 years of age and may be subject to a maximum annual benefit as follows: (i) For a covered member through 6 years of age, $50,000.00; (ii) For a covered member from 7 years of age through 12 years of age, $40,000.00; and (iii) For a covered member from 13 years of age through 18 years of age, $30,000.00.

Source: Mich. Comp. Laws §550.1461(e) as added by S.B. 414; S.B. 415; S.B. 981