AUTISM COVERAGE FUND EXTENSION S.B. 1007 (S-2):
SUMMARY OF INTRODUCED BILL
IN COMMITTEE
Senate Bill 1007 (Substitute S-2)
CONTENT
The bill would amend the Autism Coverage Reimbursement Act to require the Department of Insurance and Financial Services (DIFS) to reimburse a health insurance carrier or third-party administrator for paid claims related to the diagnosis and treatment of autism spectrum disorders if the following conditions were met:
-- The services for which the carrier or third-party administrator was seeking reimbursement were provided before the beginning of calendar year 2016.
-- The carrier or third-party administrator submitted its application to DIFS before May 1, 2016.
-- The Department approved the application before August 1, 2016.
-- The Department had not already fully reimbursed the carrier or third-party administrator for the claim.
Any reimbursements made under the bill would have to be prorated based on the available balance in the Autism Coverage Reimbursement Fund. The proration would be calculated by dividing the amount available in the Fund by the total paid claims approved under the bill, and then multiplying that amount by the total of each carrier's or third-party administrator's paid claims submitted under the bill.
FISCAL IMPACT
The bill would have a neutral fiscal impact on DIFS, as the requirement to reimburse paid claims would depend on the availability of a balance in the Autism Coverage Reimbursement Fund. Currently, there is a small balance in the Fund, so the bill would affect that and future appropriations to the Fund made before July 1, 2016.
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.