Behavioral health treatment plans.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Enrolled
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill aims to ensure that health care service plans and health insurers in California don’t restrict the use of authorized treatment hours for individuals with pervasive developmental disorder or autism. It requires these plans to make those hours available throughout the treatment plan’s 6-month authorization period, as long as the use aligns with the plan and clinical guidelines, and is properly documented. The bill also prohibits requiring rediagnoses for coverage and clarifies definitions related to autism treatment plans and utilization review.
Key provisions
- Prohibits restrictions on utilization of authorized treatment hours within a 6-month period.
- Requires authorized hours to remain available for use throughout the authorization period if consistent with the treatment plan and clinical guidelines.
- Prevents health plans from requiring rediagnoses to maintain coverage for autism treatment.
- Defines ‘behavioral health treatment’ as services meeting specific criteria, including physician prescription and qualified provider supervision.
- Clarifies definitions of ‘qualified autism service provider,’ ‘qualified autism service professional,’ and ‘qualified autism service paraprofessional.’
- Establishes that utilization review is distinct from a rediagnosis.
- Specifies that treatment plans cannot be used for respite, daycare, or educational services reimbursement.
- Provides that no reimbursement is required for local agencies or school districts due to the creation of a new crime.
Bill text
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Sponsors
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2 on record
Primary sponsor
Cosponsor
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