Bill Summary for S 676 (2015-2016)

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Summary date: 

Mar 31 2015

Bill Information:

View NCGA Bill Details2015-2016 Session
Senate Bill 676 (Public) Filed Thursday, March 26, 2015
Intro. by Apodaca, Krawiec.

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Bill summary

Amends GS 58-3-220 to amend the definition of mental illness, as it applies to the statute governing mental illness benefits coverage, to include mental disorders defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM‑V (was, DSM-IV),  and adds to the exclusions those coded as autism spectrum disorders (299.00). Makes conforming changes. 

Enacts new GS 58-3-192, requiring health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder for individuals 18 years of age or younger. Prohibits an insurer from terminating coverage or refusing to issue, amend, or renew coverage to an individual solely because the individual is diagnosed with autism spectrum disorder or has received treatment for autism spectrum disorder. Prohibits limiting the number of visits an individual may have for treatment of autism spectrum disorder and allows coverage for adaptive behavior treatments to be limited to a maximum benefit of up $40,000 per year.

Provides that coverage may be subject to co‑payment, deductible, and coinsurance provisions of a health benefit plan that are not less favorable than the co‑payment, deductible, and coinsurance provisions that apply to substantially all medical services covered by the health benefit plan.

 Makes conforming changes to GS 58-51-55, GS 58-67-75, and GS 58-65-90.

Applies to insurance contracts issued, renewed, or amended on or after October 1, 2015.