Oklahoma Legislation

This bill requires all in-state health plans to comply with the 2008 federal Mental Health Parity and Addiction Equity Act. Specific provisions include removing exclusion of small employers from the requirement to provide mental health/substance use disorder benefits, and prohibiting health benefit plans from imposing stricter non-quantitative limitations on mental health and substance use disorder benefits than physical benefits. The bill also requires insurance companies that offer mental health or substance use disorder plans to submit annual reports demonstrating compliance with the 2008 Mental Health Parity and Addiction Equity Act, including an analysis for each non-quantitative treatment limitation in each classification of care consistent with the six-step process. Reporting will begin April 1, 2021 and the department will make reports public starting June 1, 2021. The bill also clarifies mental health and substance use disorders to refer to all conditions listed under appropriate diagnostic guides, expanding the definition beyond the previously used “serious mental illness.”

This bill tries to change the state insurance law by adding a subsection about autism coverage. Individual plans, small employer fully-insured plans, and large employer fully-insured plans would be required to cover:

• Behavioral therapy
• Prescription medications
• Psychiatric care
• Psychological care
• Occupational therapy
• Speech therapy
• Physical therapy

This bill tried to add a section about autism coverage to the state insurance law. It would have required individual plans, small employer fully-insured plans, and large employer fully-insured plans to cover autism services under these terms:

• Coverage through age 20
• $50,000 annual maximum for “behavioral therapy” for 3 years; therapy can continue beyond 3 years if child’s provider submits report every 6 months showing that child is making progress
• Financial requirements are the same as those used for other medical services
• Insurance plan can only review a child’s treatment plan once every 6 months
• Autism spectrum disorder is defined as autistic disorder, asperger’s syndrome, and pervasive developmental disorder

• Coverage through age 20
• $50,000 annual maximum for “behavioral therapy” for 3 years; therapy can continue beyond 3 years if child’s provider submits report every 6 months showing that child is making progress
• Financial requirements are the same as those used for other medical services
• Insurance plan can only review a child’s treatment plan once every 6 months
• Autism spectrum disorder is defined as autistic disorder, asperger’s syndrome, and pervasive developmental disorder