SB 190 Introduced: 2/2015 Sponsor: Sens. Solano, Brown, and Rave and Reps. Munsterman, Cronin, Gosch, and Westra Status: Signed into law 3/2015 Summary: Among other things, this bill added the section to the state insurance law about autism coverage. That section is summarized at the bottom of this page under “South Dakota Parity Law.”
SB 108 Introduced: 1/2014 Sponsor: Sen. Rave and Rep. Cronin Status: 3/2014 Summary: This bill ordered the state Department of Human Services and the state Department of Labor and Regulation (responsible for insurance regulation) to perform a study about autism services and insurance coverage for autism services, including associated costs. The departments were to report their findings to the Governor and the Legislature by November of 2014.
South Dakota Parity Law
There are several sections of the law addressing behavioral health coverage and autism coverage:
Mental Health Coverage(there are many different identical sections regarding mental health coverage that apply to different kinds of plans; for the sake of simplicity we have linked to only one; email firstname.lastname@example.org for links to the other sections)
Substance use disorder coverage (there are many different identical sections regarding substance use disorder coverage that apply to different kinds of plans; for the sake of simplicity we have linked to only one section and its composite subsections; email email@example.com for links to the other sections)
There is also a condition in the state insurance law forbidding insurance plans from excluding coverage of injuries sustained while a person was under the influence of drugs and alcohol. For example, a plan may not refuse to cover treatment for a broken arm because the person was under the influence of drugs or alcohol when the injury occurred. However, plans can exclude coverage for any “sickness or injury caused in the commission of a felony.”
Autism spectrum disorder is defined as “a complex neurodevelopmental medical disorder characterized by social impairment, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior.” There is no mention of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or any other officially recognized diagnostic guide.
Treatment for autism is listed as:
Behavioral health care
Insurance plans are allowed to review a child’s treatment plan once every 3 months.
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