January 30, 2009

New Mexico Senate Bill 39

New Mexico Senate Bill 39 was introduced on January 30, 2009. It requires private health insurance companies to provide coverage for the diagnosis and treatment of autism spectrum disorder for individuals under the age of 19, or age 22 if the individual is enrolled in high school. The maximum annual benefit is $36,000, with a lifetime maximum of $200,000. Coverage must be provided for treatments provided or ordered by a licensed physician or a licensed psychologist who determine the care to be medically necessary. Treatments must be detailed in a treatment plan that includes the diagnosis, proposed treatment by types, frequency and duration of treatment, anticipated outcomes stated as goals, frequency of treatment plan updates, and signature of the treating physician. Covered treatments include: diagnosis, habilitative or rehabilitative care (which includes speech therapy, occupational therapy and physical therapy), pharmacy care, psychiatric care, psychological care, therapeutic care, and ABA. The provisions of the bill apply only to fully-funded health plans governed by the state. No starting date was specified.