No. SB 922
Filed under Insurance.
Coverage for Treatment of Stuttering; Authorizing the Agency for Health Care Administration to pay for certain services and devices as a treatment for stuttering for Medicaid recipients; authorizing speech therapy in person and via telehealth as a treatment for stuttering; requiring certain individual health insurance policies, group health insurance policies, and health maintenance contracts, respectively, to provide coverage for specified services and devices as treatments for stuttering, etc.
Plain English Summary
AI-GENERATEDIndividual, group, and HMO health plans that already cover habilitative or rehabilitative services must extend that coverage to stuttering treatment, including speech therapy, whether or not the stuttering is classified as developmental.
That required coverage can't carry an annual dollar cap, a limit on visits to a speech-language pathologist, or an exclusion based on what caused the stuttering.
Insurers also can't subject this coverage to prior authorization, utilization review, or a medical-necessity determination, and must cover telehealth speech therapy at least as well as in-person visits.
Separately, Medicaid may now pay for the same habilitative and rehabilitative stuttering treatment, including telehealth speech therapy, though this Medicaid coverage remains optional rather than guaranteed.
AIAHCA may pay for habilitative and rehabilitative services and devices, including speech therapy, as treatment for stuttering for Medicaid recipients, regardless of whether the stuttering is developmental. This authority is discretionary, not a mandated benefit.
AIAn individual, group, or HMO plan that already covers habilitative or rehabilitative services and devices must extend that coverage specifically to stuttering treatment, including speech therapy, whether or not the stuttering is developmental.
AIRequired stuttering coverage cannot carry a maximum annual benefit limit, a cap on visits to a speech-language pathologist, or an exclusion based on the disease, injury, or condition that caused the stuttering.
AIInsurers cannot subject required stuttering coverage to utilization review, utilization management, prior authorization, or a determination that the habilitative or rehabilitative treatment is medically necessary.
AICovered plans must include stuttering-related speech therapy delivered via telehealth, using any HIPAA-compliant communication technology, application, or platform, and that telehealth coverage cannot be worth less than in-person coverage.