Arizona Revised Statutes Title 20. Insurance § 20-1057.11. Health care services organizations;  autism spectrum disorder;  coverage;  exceptions;  definitions

1. Exclude or deny coverage for a treatment or impose dollar limits, deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder.  For the purposes of this paragraph, “treatment” includes diagnosis, assessment and services.

2. Exclude or deny coverage for medically necessary behavioral therapy services.  To be eligible for coverage, behavioral therapy services shall be provided or supervised by a licensed or certified provider.

1. Apply to an evidence of coverage that is issued to an individual or a small employer.

2. Apply to limited benefit coverage as defined in § 20-1137.

3. Require coverage for services provided outside of this state.

1. A fifty thousand dollar maximum benefit per year for an eligible person up to the age of nine.

2. A twenty-five thousand dollar maximum benefit per year for an eligible person who is between the ages of nine and sixteen.

1. “Autism spectrum disorder” means one of the three following disorders as defined in the most recent edition of the diagnostic and statistical manual of mental disorders of the American psychiatric association:

2. “Behavioral therapy” means interactive therapies derived from evidence based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs and early intensive behavioral intervention.

3. “Small employer” has the same meaning prescribed in § 20-2301.