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Autism Insurance Legislation
Michigan's Autism Insurance Reform legislation (PA 99 and PA 100 of 2012) went into effect on October 15, 2012. For-profit, commercial, HMO, and non-profit health insurance companies regulated by the state of Michigan are mandated to provide an autism benefit to its insured members covering services related to the diagnosis and treatment of autism spectrum disorders (ASD) through 18 years of age. Self-funded insurance plans are regulated by Employee Retirement Income Security Act commonly referred to as ERISA through federal law. Self-funded insurance plans are not mandated to provide autism coverage.
PA 99 and 100 of 2012 include the following highlights:
- Coverage for the treatment of ASD may be limited to a member through 18 years of age.
- A covered member must receive a diagnosis of ASD by a licensed physician or a licensed psychologist to receive coverage for ASD services.
- Insurance carriers may require an evaluation of the member be conducted every three years.
- Treatment of ASD must be evidence based and includes the following care as determined by a licensed physician or a licensed psychologist:
- Behavioral health treatment (applied behavior analysis),
- Pharmacy care,
- Psychiatric care,
- Psychological care, and/or
- Therapeutic care (speech therapy, occupational therapy).
Behavior Analyst Licensing Legislation
Michigan’s Behavior Analyst Licensing Legislation (PA0403 and PA0404) went into effect on January 3, 2018. PA0403 establishes licensure for Behavior Analysts and Assistant Behavior Analysts in Michigan and PA0404 establishes a licensing board for behavior analysts and assistant behavior analysts.
PA0403 and PA0404 include the following highlights:
- Establishes licensure for behavior analysts and assistant behavior analysts based upon the requirements of the Behavior Analyst Certification Board (BACB).
- Behavior Technicians must have completed a training program based upon the BACB’s RBT task list. This is required three years after PA0402 goes into effect.
- Establishes a nine-member licensing board for Behavior Analysts and Assistant Behavior Analysts.
- Four behavior analysts
- One assistant behavior analyst
- One university-based behavior analyst
- Two public members
- One physician
- The licensing board will establish licensing and disciplinary rules and standards based upon current professional standards and PA0404.
For more information regarding Behavior Analyst licensure, please visit the Department of Licensing and Regulatory Affairs Behavior Analyst page at: https://www.michigan.gov/lara/0,4601,7-154-89334_72600_72603_27529_80658---,00.html.